Postoperative physical therapy for breast cancer : sistematyc review

RESUMEN: Introducción: El cáncer de mama es un tumor maligno que se origina en el tejido de la glándula mamaria y es muy común en mujeres. Su diagnóstico se basa en las técnicas de imagen, especialmente la mamografía. Esta enfermedad tiene tratamiento biomédico o quirúrgico, al que se le añade rehabilitación de fisioterapia. Objetivo: Analizar mediante una revisión sistemática qué tratamientos pueden ser beneficiosos para tratar a las mujeres que han sido operadas por cáncer de mama. Material y métodos: Esta revisión se lleva a cabo mediante una búsqueda bibliográfica en las bases de datos PubMED, PEDro y Cochrane, a la cual añadimos una búsqueda manual. Para seleccionar las publicaciones se establecieron unos criterios de inclusión y exclusión y, además, se evaluó la calidad metodológica de cada una mediante la escala CASPe. Resultados: En esta revisión se incluyen diez artículos en los cuales encontramos diversos tratamientos: liberación miofascial (p<0.05, -), EO y LEAP, NPMT y MLD (p=0.01, p=0.038, p=0.067), tratamiento de fisioterapia precoz (p=0.019, p=0.011, p=0.004, p=0.0032), entrenamiento aeróbico o de resistencia (p<0.01), fisioterapia orientada a la funcionalidad del hombro (p<0.001), adición de MLD a la fisioterapia estándar (p<0.001) y entrenamiento de resistencia progresiva y fuerza. Discusión y conclusión: Hay artículos que tienen muestras pequeñas y otros que se contradicen en sus conclusiones, lo que nos demuestra que se necesita más investigación. Sin embargo, esta revisión sistemática puede confirmar que el tratamiento de fisioterapia después de la cirugía es muy importante.ABSTRACT: Introduction: Breast cancer is a malignant tumor that originates in mammary glands tissue and it is very common in women. Its diagnosis is based on imaging techniques, especially mammography. This disease has biomedical or surgical treatment, to which physiotherapy rehabilitation is added. Objetive: Analyze by a systematic review which treatments may be beneficial to treat women who have undergone surgery for breast cancer. Material and methods: This review is carried out through a bibliographic search in PubMED, PEDro and Cochrane databases to which we add a manual search. To select the publications, some inclusion and exclusion criterios were established and, in addition, the methodological quality of each one is evaluated using CASPe scale. Results: Ten articles were included in this review in which we found various treatments: myofascial release (p<0.05, -), EO and LEAP, NPMT and MLD (p=0.01, p=0.038, p=0.067), early physiotherapy treatment ( p=0.019, p=0.011, p=0.004, p=0.0032), aerobic or resistance training (p<0.01), physiotherapy aimed at shoulder functionality (p<0.001), addition of MLD to standard physiotherapy (p <0.001) and progressive resistance and strength training. Discussion and conclusion: There are articles that have small samples and others that contradict each other in their conclusions, which shows us that more research is needed on the subject. However, this systematic review can confirm that physical therapy treatment is very important after surgery.Grado en Fisioterapi

Consequences of the Lack of IL-10 in Different Endotoxin Effects and its Relationship With Glucocorticoids

Sepsis constitutes one of the major causes of death in ICUs. In sepsis induced by gram-negative, although lipopolysaccharide (LPS) initially induces an exacerbated secretion of proinflammatory cytokines leading to endotoxic shock and death resembling a septic shock, it is also capable of inducing refractoriness to subsequent challenge with LPS, a state known as endotoxin tolerance, which is considered the initial step of the immunosuppression found in septic patients. As we previously demonstrated the importance of glucocorticoids in endotoxin tolerance, the aim of this study was to evaluate the contribution of Interleukin-10 (IL-10) both in the endotoxic shock and in the development of the tolerance and its relationship with glucocorticoids. Our results show that, upon LPS challenge, IL-10 knockout mice (KO) mice had an enhanced LPS sensitivity, along with elevated levels of proinflammatory cytokines as tumor necrosis factor-α, IL-12 and interferon-γ, and enhanced tissue damage, despite the high levels of glucocorticoids. This effect may be because, in part, of the higher expression of tumor necrosis factor receptors in IL-10 KO mice. Further, the injection of dexamethasone did not protect IL-10 KO mice from a LPS lethal challenge. Although tolerance was achieved in the absence of IL-10, it was weaker and the elevated levels of glucocorticoids were not able to reverse the high sensitivity of IL-10 KO mice to LPS. Nevertheless, glucocorticoids would play a pivotal role in the establishment and maintenance of this partial tolerance in IL-10 KO mice. Finally, our results show that IL-10 and glucocorticoids could act in a bidirectional way influencing the inflammatory and anti-inflammatory periods.Fil: Córdoba Moreno, Marlina Olyissa. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Todero, Maria Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Fontanals, Adriana Mirta. Fundación Instituto Leloir; ArgentinaFil: Pineda, Gonzalo Ezequiel. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Montagna, Daniela Romina. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Yokobori, Noemí. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Ramos, Maria Victoria. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Barrientos, Gabriela Laura. Hospital Alemán. Laboratorio de Medicina Experimental; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Toblli, Jorge Eduardo. Hospital Alemán. Laboratorio de Medicina Experimental; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Isturiz, Martín Amadeo. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Rearte, María Bárbara. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentin

Effectiveness of a group educational intervention - prolact - in primary care to promote exclusive breastfeeding: a cluster randomized clinical trial

Background: The rates of exclusive breastfeeding at 6months in Spain are far from recommended by the World Health Organization, which is 50% by 2025. Evidence of the efectiveness of group interventions in late postpartum is limited. The objective of this study was to evaluate the efectiveness of the PROLACT group educational intervention for increasing the proportion of mother-child dyads with exclusive breastfeeding at 6months compared to the usual practice in primary care. Method: Multicentre cluster randomized clinical trial. A total of 434 mother-child dyads who breastfed exclusively in the frst 4weeks of the children’s life and agreed to participate were included. The main outcome was exclusive breast‑feeding at 6months. Secondary variables were type of breastfeeding, reasons for abandonment, degree of adherence and satisfaction with the intervention. To study the efectiveness, the diference in the proportions of dyads with exclusive breastfeeding at 6months was calculated, and the relative risk (RR) and number needed to treat (NNT) were calculated with their 95% CIs. To study the factors associated with the maintenance of exclusive breastfeeding at 6months, a multilevel logistic regression model was ftted. All analyses were performed to intention to treat. Results: The percentage of dyads with exclusive breastfeeding at 6months was 22.4% in the intervention group and 8.8% in the control group. PROLACT intervention obtained an RR =2.53 (95% CI: 1.54–4.15) and an NNT=7 (95%CI: 5–14). The factors associated with exclusive breastfeeding at 6months were the PROLACT intervention, OR=3.51 (95%CI: 1.55–7.93); age>39 years, OR=2.79 (95%CI: 1.02–7.6); previous breastfeeding experience, OR=2.61 (95%CI: 1.29–5.29); income between 500 and 833.33 €, OR=3.52 (95%CI 1.47–8.47).); planning to start work before the infant was 6months old, OR=0.35 (0.19–0.63). Conclusions: The PROLACT intervention in primary care is more efective than the usual practice for maintaining exclusive breastfeeding at 6months, and can therefore be considered evidence-based practice for implementation in standard practice. Trial registration: The trial was registered with ClinicalTrials.gov under code number NCT01869920 (03/06/2013).This study was funded by the Projects PI12/02609 and PI12/02020 as a part of the Plan Nacional de I+D+I (National Plan for R+D+I) and co-funded by the ISCIII Subdirectorate General for Evaluation and the European Regional Development Fund (ERDF). The primary researcher received a grant for publication from the Fundación para la Investigación e Innovacion en Atención Primaria (Foundation for Research and Innovation in Primary Care) in its 2019 call. The funding source had no role in the design of this study and did not have any role in its execution, analyses, interpretation of the data or the decision to submit the results.S

Uso de tecnologías digitales en el diseño de una autoevaluación formativa en el curso de Genética General de la Facultad de Ciencias Veterinarias

Los nuevos planteamientos curriculares en la universidad demandan una integración de los contenidos, saberes y una actitud renovada de los docentes frente a las estrategias metodológicas, hechos estos que evocan la evaluación formativa como la manera más propia de acompañar el aprendizaje y la enseñanza. En la FCV- UNLP, las nuevas tecnologías de la información y comunicación (TIC), se comenzaron a utilizar ampliamente en los últimos cinco años para mejorar los modelos formativos y organizativos que sustentan el aprendizaje. El curso Genética General de la Carrera de Ciencias Veterinarias- UNLP (Plan 406/04) se concibe como la base del conocimiento de la Genética y el individuo. El objetivo fue diseñar una autoevaluación virtual optativa, utilizando el entorno virtual Moodle. A partir de los conceptos desarrollados por los docentes, se diseño un cuestionario con 20 preguntas del tipo opciones múltiples; respuesta corta; de emparejamiento y verdadero o falso. Sobre un total de 193 (100%) alumnos, 85 (44%) resolvieron el cuestionario; 47 (55%) aprobaron. En una Universidad presencial, el uso de tecnologías digitales como herramienta pedagógica representa una propuesta innovadora, se utiliza como complemento de las actividades curriculares presenciales.Facultad de Ciencias Veterinaria

Patient preferences and treatment safety for uncomplicated vulvovaginal candidiasis in primary health care

<p>Abstract</p> <p>Background</p> <p>Vaginitis is a common complaint in primary care. In uncomplicated candidal vaginitis, there are no differences in effectiveness between oral or vaginal treatment. Some studies describe that the preferred treatment is the oral one, but a Cochrane's review points out inconsistencies associated with the report of the preferred way that limit the use of such data. Risk factors associated with recurrent vulvovaginal candidiasis still remain controversial.</p> <p>Methods/Design</p> <p>This work describes a protocol of a multicentric prospective observational study with one year follow up, to describe the women's reasons and preferences to choose the way of administration (oral vs topical) in the treatment of not complicated candidal vaginitis. The number of women required is 765, they are chosen by consecutive sampling. All of whom are aged 16 and over with vaginal discharge and/or vaginal pruritus, diagnosed with not complicated vulvovaginitis in Primary Care in Madrid.</p> <p>The main outcome variable is the preferences of the patients in treatment choice; secondary outcome variables are time to symptoms relief and adverse reactions and the frequency of recurrent vulvovaginitis and the risk factors. In the statistical analysis, for the main objective will be descriptive for each of the variables, bivariant analysis and multivariate analysis (logistic regression).. The dependent variable being the type of treatment chosen (oral or topical) and the independent, the variables that after bivariant analysis, have been associated to the treatment preference.</p> <p>Discussion</p> <p>Clinical decisions, recommendations, and practice guidelines must not only attend to the best available evidence, but also to the values and preferences of the informed patient.</p

EstuPlan: Methodology for the development of creativity in the resolution of scientific and social problems

[EN] Creative thinking is necessary to generate novel ideas and solve problems. "EstuPlan" is a methodology in which knowledge and creativity converge for the resolution of scientific problems with social projection. It is a training programme that integrates teachers, laboratory technicians and PhD students, master and undergraduate students which form working groups for the development of projects. Projects have a broad and essential scope and projection in terms of environmental problems, sustainable use of natural resources, food, health, biotechnology or biomedicine. The results show the success of this significant learning methodology using tools to develop creativity in responding to scientific and social demand for problem-solving to transfer academic knowledge to different professional environments. Bioplastics, Second Life of Coffee, LimBio, Algae oils, Ecomers, Caring for the life of your crop and Hate to Deforestate are currently being developed.Astudillo Calderón, S.; De Díez De La Torre, L.; García Companys, M.; Ortega Pérez, N.; Rodríguez Martínez, V.; Alzahrani, S.; Alonso Valenzuela, R.... (2019). EstuPlan: Methodology for the development of creativity in the resolution of scientific and social problems. En HEAD'19. 5th International Conference on Higher Education Advances. Editorial Universitat Politècnica de València. 711-717. https://doi.org/10.4995/HEAD19.2019.9205OCS71171

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

Leer en comunidad: creación de clubes de lectura de literatura escrita por mujeres en la universidad

Depto. de Lengua Española y Teoría de la LiteraturaFac. de FilologíaFALSEUniversidad Complutense de Madridsubmitte