Bronquiolitis

Es una enfermedad aguda de etiología viral, que afecta el aparato respiratorio en forma difusa y bilateral y puede determinar incapacidad ventilatoria obstructiva. Si bien para algunos autores puede presentarse en niños de hasta 2 años, la mayoría considera como edad límite de presentación el primer año de vida. Con respecto al número de episodios, en la mayoría de las publicaciones se considera posible un único episodio de bronquiolitis y en unas pocas hasta un máximo de dos. En aquellos pacientes que presentan episodios reiterados de sibilancias conviene considerar los diferentes diagnósticos diferenciales. En cuanto a la duración de la enfermedad, debe destacarse que es una enfermedad aguda, cuya sintomatología persiste el tiempo que demanda la reparación histológica de los tejidos afectados, muy especialmente del epitelio respiratorio. Si bien la duración de este proceso depende de la severidad de la agresión viral, habitualmente no demanda más de 10 a 12 días. Por ello, en los niños en los que luego de transcurridas dos semanas de evolución de enfermedad que continúan: 1°) con dependencia de oxígeno y/o 2°) con síntomas y/o signos de obstrucción bronquial (sibilancias, taquipnea), debe considerarse la posibilidad de que la infección viral haya precipitado la expresión de otra enfermedad de base o generado un daño estructural más importante que predisponga al desarrollo de enfermedad pulmonar crónica posviral

ALTE. Evento aparentemente amenazador para la vida

Los lactantes que presentan un episodio de posible amenaza a la vida son un enorme desafío para el clínico pediatra. El concepto de ALTE o episodio de posible amenaza a la vida (del inglés: Apparent Life Threatening Event), describe una multiplicidad de factores observados por la persona que cuidaba a un niño al momento de suceder el episodio. El ALTE no es una enfermedad específica en sí misma, sino la forma de presentación clínica de diversos trastornos o patologías. Se define como aquel episodio inesperado y brusco que alarma al observador pues correspondería a una situación de riesgo de muerte, caracterizado por uno o más de los siguientes signos: 1- un súbito cambio de color (palidez, cianosis o rubicundez). 2- hipotonía o menos frecuentemente, hipertonía. 3- alteraciones en la respiración (paro respiratorio aparente, ruidos bruscos o irregularidades en los movimientos respiratorios, ahogos, arcadas) que cedieron. 4- luego de realizar alguna estimulación intensa (sacudidas, respiración boca a boca), ligera o espontáneamente. Cualquier causa que impresione al observador que lleva al niño súbitamente al borde de la muerte puede considerarse como un ALTE

iStarJSON : a lightweight data-format for i* models

JSON is one of the most widely used data-interchange format. There is a large number of tools open for modelling with i*. However, none of them provides supporting for JSON. In this paper we propose iStarJSON language, a JSON-based proposal for interchanging i* models. We also, present an open source software that transforms XML-based format models to JSON models that expose a set of web services for mining iStarJSON models.Peer ReviewedPostprint (author's final draft

Understanding the landscape of technology in the physiotherapy education: a descriptive analysis through bibliometrics

Background: The usage of technology, in Physiotherapy practice and education, is still growing, with a possible impact also on research. However, the increase of the number of scientific publications make it difficult to know the scientific structure and development of a field. Visualization techniques based on bibliometric data are useful for the understanding of scientific fields. Methods: This is a bibliometric, descriptive and retrospective study. We identified publications from Web of Science and Pubmed databases related to technology in physiotherapy education. From the titles and abstracts of these publications, authors selected the main terms related to the field, extracted by VOSviewer software, to create a visualization of the most important topics studied in the literature. Results: A total of 137 publications were identified in WOS and 648 in Pubmed. After clusterization of the two groups of terms, we could identify that, in the case of Pubmed, the main associations with technology seem to be its use in the context of teaching/learning of the intervention in Physiotherapy, use as a tool to facilitate the patient education, for the prescription and implementation of exercise programs and its use for use in the various stages of the Physiotherapy process. In relation to WOS database we could identify similar patterns with topics like teaching/learning of the intervention in Physiotherapy and Physiotherapy process, but also a big emphasis in the association between the topics Education and Technology. In both databases we could see that this is a recent topic, starting in Pubmed after 2006. Discussion: In both databases the scope of the analysis revealed different topics covered by Pubmed and WOS databases. This is related to their coverage and suggests the need for using more than only one. Their distinct features make it impossible to compare other characteristics of the field as main productive countries or institutions. Conclusion: In our search, although WOS and Pubmed have different topic coverage, most of them are related to use of technology applied to the context of intervention (including several steps of the Physiotherapy Process) but also in the education of students and patients.N/

Impact of physical and psychosocial factors on disability caused by lumbar pain amongst fishing sector workers

[Abstract] Functional disability due to lumbar pain should be considered from the biopsychosocial model. There is inconclusive evidence as to whether the key determining factors in this form of disability are psychosocial or physical. Our aim is to identify variables that cause functional disability due to lumbar pain amongst shellfish gatherers in Galicia by means of a cross-sectional survey. Participants (N = 929) completed a self-administered, paper-based questionnaire including sociodemographic and lifestyle issues, as well as the nature of the lumbar pain, the presence of musculoskeletal pain in other regions of the body, the Roland-Morris Disability Questionnaire (RMDQ) and SF-36. Univariate examination, ROC curve and logistic regression analyses were performed. Most of these workers are women (98.7 %), with a mean age of 50.6 years. The point-prevalence of lumbar pain stands at 65.5 %. The RMDQ mean was 4.9 (SD = 4.7). In the logistic regression analysis, the variables associated with disability (RMDQ > median) were age (OR = 1.04), physical exercise (OR = 0.57), pain intensity (OR = 1.16), the number of regions of musculoskeletal pain (OR = 1.24) and mental health (SF-36) (OR = −0.95). Functional disability is determined by the physical nature of the pain and mental health attributes, although the former has a greater impact. In decreasing order of importance, functional disability is attributable to the presence of lower back pain, the number of regions of musculoskeletal pain, the intensity of that pain and age. Regular physical exercise and better mental health have a protective effect on disability

Informe breve: evaluación del lavado de manos en un equipo de salud

El lavado de manos previo y posterior a la atención de cada paciente es el mejor método para prevenir la transmisión de microorganismos de un paciente a otro y así disminuir la infección hospitalaria. Se evaluó el conocimiento de la norma de lavado de manos y se observó el cumplimiento de la misma al iniciar la investigación y luego de la intervención (concientización). La muestra estuvo integrada por el personal de salud de una sala del sector de Clínica II del Hospital de Niños de La Plata. Se realizó el cultivo de los pulpejos de los dedos sobre agar sangre antes y después de lavarse las manos a todo el personal que se prestó voluntariamente; con estos cultivos se realizaron talleres de mostración. El porcentaje de conocimiento de la norma fue alta, el cumplimiento del lavado de manos pasó de 38,7% a 61,3% luego de la intervención. La educación continua es la manera de mejorar el cumplimiento de la norma del lavado de manos y así contribuir a disminuir la infección hospitalaria.Appropiate hand hygiene before and alter attending patient is the leading measure to reduce cross-infection and nosocomial infections. We evaluated the knowledge of correct hand hygiene practice and observed the compliance at the begining of the investigation and after the educational program. Direct fringerprint samples in blood agar plates before and after washing hands were obtained. Whith this cultures we conducted a workshop. The percentage of knowing the norm was hight, the fulfillment was 38.7% before and 61.3% after the intervention. Continuos education is the best way to improve the compliance and to reduce nosocomial transmited infection

Importance of nutritional treatment in the inflammatory process of rheumatoid arthritis patients: a review

[Resumen] Introducción: Las características clínicas de la artritis reumatoide (AR) justifican su abordaje multidisciplinar, dentro del cual se incluye la intervención nutricional. Ciertos componentes nutricionales tienen implicaciones en el metabolismo celular e interfieren en el proceso inflamatorio patológico por lo que pueden actuar como coadyuvantes en el tratamiento de numerosas enfermedades inflamatorias, entre las que se incluye la AR. Objetivos: Analizar la evidencia sobre los efectos terapéuticos de los ácidos grasos poliinsaturados, de la dieta mediterránea, del aceite de oliva y de ciertos nutrientes antioxidantes en el estado inflamatorio crónico y en la sintomatología de la AR. Métodos: Revisión no sistemática en Cochrane, Pubmed, Scopus, Sportdiscus y Amed, del 2003 a marzo de 2013, y posterior aplicación de los criterios de inclusión y exclusión. Resultados: La evidencia sobre los ácidos grasos poliinsaturados sugiere que éstos producen mejoría clínica y efectos inhibidores sobre la respuesta inflamatoria en la AR. Sobre la dieta mediterránea, la evidencia apunta a que ésta produce una disminución del dolor y de la actividad de la enfermedad. Para el aceite de oliva, aunque no hay estudios suficientes, se aprecian efectos tales como la reducción de marcadores inflamatorios y la inhibición del estrés oxidativo. Sobre la eficacia de los antioxidantes todavía existe evidencia limitada y contradictoria. Conclusiones: Hay estudios que sugieren que algunos componentes dietéticos (ácidos grasos poliinsaturados, dieta mediterránea y antioxidantes) tienen efectos antiinflamatorios y disminuyen la actividad de la AR. Se requieren más estudios para afianzar los resultados en aquellos aspectos donde la evidencia todavía es inconclusa.[Abstract] Introduction: Clinical characteristics of rheumatoid arthritis (AR) justify its multidisciplinary approach, within which nutritional intervention is included. Certain nutritional components influence the cellular metabolism and interfere in the pathological inflammatory process, so that they may act as coadjutant in the treatment of many inflammatory diseases, among which AR is included. Aim: To analyze the evidence related to the therapeutical effects of the polyunsaturated fatty acids, mediterranean diet, olive oil and certain antioxidant nutrients, on chronic inflammation and AR symptomatology. Methods: Non-Systematic revision in Cochrane, Pubmed, Scopus, Sportdiscus and Amed, from 2003 to March 2013, and subsequent applications of inclusion and exclusion criteria. Results: Evidence on polyunsaturated fatty acids suggests that they produce clinical improvement and inhibitory effects over the AR inflammatory response. As regards the mediterranean diet, evidence points out that it decreases both pain and disease activity. In the case of the olive oil, although there are not enough studies, some effects are observed such as inflammatory markers reduction and oxidative stress inhibition. Finally, limited and contradictory evidence is found regarding the effectiveness of antioxidants. Conclusion: There exist studies which suggest that some dietetic elements (polyunsaturated fatty acids, mediterranean diet and antioxidants) have anti-inflammatory effects and decrease AR disease activity. More studies are required to empower the results on those aspects where evidence is still non conclusive

Un compost extret del card complementa el tractament de la metàstasi cerebral en el càncer de pulmó

Premis Pharmanews-Fedefarma 2018Hi ha una gran incidència de metàstasi cerebral (MC) en pacients amb càncer de pulmó, en els quals el pronòstic és molt greu i la supervivència molt reduïda. S’han investigat les propietats de la silibinina en diferents estudis que demostren que pot ser un complement al tractament convencional d’aquest tipus de càncer i que ajuda a reduir de manera significativa el tamany de la metàstasi al cervell augmentant així l’esperança de vida dels pacients afectats. S’ha fet una investigació entre diferents estudis científics publicats, amb l’objectiu de dissenyar una nova estratègia per a frenar i reduir el tamany de les MC. S’ha proposat que la silibinina podria inhibir la STAT3, que és una de les principals causants del creixement de la MC

A therapeutic exercise program improves pain and physical dimension of health-related quality of life in young adults: a randomized controlled trial

Original Research[Abstract] Objective. The aim of this study was to evaluate the effects of an exercise therapy program on pain and physical dimension of health-related quality of life for young adults with musculoskeletal pain. Design. This is a randomized controlled single-blind trial. Fifty-seven subjects (58% women) were randomly assigned to experimental [n = 28, 21.4 (2.9) yrs] and control [n = 29, 21.0 (4.2) yrs] groups. The experimental group participated in a 9-wk stabilization exercise therapy program, 60 mins/wk, whereas the control group did not exercise, with a preintervention and postintervention assessment. Primary outcome was Physical Component Summary of SF-36. Secondary outcomes were Nordic Musculoskeletal Questionnaire, Visual Analogue Scale, Oswestry Disability Index, Neck Disability Index, and Trunk Flexor Endurance Test. The Shapiro-Wilk, independent t test or Mann-Whitney U test, X2, or Fisher's exact test were used for statistical analysis. Results. After intervention, the experimental group improved by 3.2 (4.5) points on the Physical Component Summary (P = 0.01), decreased prevalence of low back pain in the last month (P = 0.02) and cervical disability (P = 0.02), and increased flexor trunk endurance (P = 0.005). Conclusions. This study confirmed that a 9-wk progressive exercise therapy program can improve physical health and reduce the prevalence of cervical disability and low back pain in the last month in young adults with musculoskeletal pain. Musculoskeletal pain (MSP) is a significant health problem in society and has been shown to have a major impact on health-related quality of life, for both physical and mental health (MH),1–3 and this may be even more relevant in a young population. Most people who experience this type of pain go on to have recurrent episodes.3 The prevalence of MSP in younger people, such as university students, has increased significantly in the last decade because of different factors such as sedentary lifestyle with increased use of computers, low physical activity levels, poor sleeping habits, or psychosocial factors.4 The most common locations with symptoms include neck and shoulder regions, lumbar region, and simultaneously in multiple other regions.4 They may have a number of negative effects, including more generalized and chronic pain.1,2 Considering the increasingly higher prevalence of MSP in young adults and the predictive value that this pain has on suffering MSP as an adult, it seems appropriate to focus greater attention on early prevention at a young age. Exercise therapy has been investigated extensively, and there is evidence that it is effective for the prevention and treatment of low back and cervical pain.5,6 Although there is limited evidence regarding the specific content of exercises, their intensity, as well as the number, duration, and frequency of sessions; the accumulated evidence5–9 on the topic provides the best indications for which and how therapeutic exercises should be used. In the case of subjects with lower back pain (LBP), the most recommended exercises consist of coordination, relaxation, and resistance of the trunk muscles,7 as well as motor control or dynamic stabilization exercises and integrated activation of the global muscles.9 In turn, in subjects with neck pain, the recommended methods involve strengthening, resistance, stretching, and stabilization exercises.6,8 Despite the available evidence regarding the effects of exercise therapy on the prevention of MSP, we have found hardly any studies that apply this to young adults.10 However, we consider that more attention should be paid to this collective because of their imminent incorporation in the labor market, and the socio-economic consequences these symptoms may have for these future workers and their employers. Taking into consideration the increase in MSP in younger persons, the evidence supporting exercise therapy for its prevention in adults, and at the same time the lack of consensus regarding the specific characteristics of the intervention program, this study aims to evaluate the effect of a progressive, multimodal therapeutic exercise program on pain, physical health, disability, and trunk flexor muscle endurance in a group of young university adults