Influencia de factores antropométricos en la prevalencia del pie valgo en la infancia

Se realizó estadística descriptiva con medidas de tendencia central y dispersión para las variables cuantitativas, en función de la normalidad de la distribución de las variables, que se comprobó con el test de Kolmogorov-Smirnof y la estimación de la asimetría y curtosis de las distribuciones, mediante análisis exploratorio de los datos. Para las variables cualitativas, se realizó recuento de porcentajes. Se llevó a cabo análisis bivariante mediante t-Student, prueba de Wilcoxon y U de Mann-Whitney, en función de que las variables siguieran o no una distribución normal. Finalmente, se llevó a cabo una regresión logística, tomando como variables dependientes el desarrollo de valgo en cada pie y como predictores la presencia de sobrepeso, obesidad, sexo y edad de inicio de la marcha, calculándose las odds ratios ajustadas para cada factor. La bondad de ajuste de la regresión se comprobó mediante la prueba de Hosmer-Lemeshow.La obesidad es una enfermedad crónica, compleja y multifactorial, que suele iniciarse en la infancia y la adolescencia. En la actualidad, es un importante y creciente problema de salud pública en dicho sector de la población, considerándose como una epidemia del siglo XXI, que tiene su origen en una interacción genética y ambiental, siendo más importante la parte ambiental o conductual (estilos de vida).Con importantes y numerosas comoborbilidades, encontrándose entre ellas problemas ortopédicos que se acompañan de alteraciones en la movilidad física e inactividad. La obesidad puede tener consecuencia negativas en el desarrollo del sistema músculo-esquelético de la extremidad inferior, especialmente en los pies de los niños debido a la inmadurez de sus estructuras. Los estudios muestran diferencias en la morfología del pie entre los niños obesos o con sobrepeso en comparación con niños de peso normal, específicamente diferencias en la estructura general del pie, espesor de la grasa plantar, y el área de contacto y presiones. Objetivos: Como objetivos principales de este estudio: Conocer la prevalencia de valgo de pies y la simetría de su distribución entre ambos pies, y determinar la asociación entre parámetros antropométricos en la aparición del pie valgo. Y como objetivos secundarios: Analizar la asociación del pie valgo con estilos de vida (alimentación/ejercicio físico), los antecedentes del desarrollo psicomotor del niño/a, el tipo de calzado, así como los antecedentes y hábitos de estilo de vida de sus progenitores. Metodología: Nos planteamos un diseño transversal analítico. La población de estudio fueron 134 niños/niñas alumnos de los cursos de 1º ,2º ,3º de primaria del curso escolar 2012-2013 de cinco colegios de la capital de Málaga

Relationship between running spatiotemporal kinematics and muscle performance in well-trained youth female athletes. A cross-sectional study

The purpose of this cross-sectional study was to analyse the relationship of neuromuscular performance and spatiotemporal parameters in 18 adolescent distance athletes (age, 15.5 ± 1.1 years). Using the OptoGait system, the power, rhythm, reactive strength index, jump flying time, and jump height of the squat jump, countermovement jump, and eight maximal hoppings test (HT8max) and the contact time (CT), flying time (FT), step frequency, stride angle, and step length of running at different speeds were measured. Maturity offset was determined based on anthropometric variables. Analysis of variance (ANOVA) of repeated measurements showed a reduction in CT (p < 0.000) and an increase in step frequency, step length, and stride angle (p < 0.001), as the velocity increased. The HT8max test showed significant correlations with very large effect sizes between neuromuscular performance variables (reactive strength index, power, jump flying time, jump height, and rhythm) and both step frequency and step length. Multiple linear regression found this relationship after adjusting spatiotemporal parameters with neuromuscular performance variables. Some variables of neuromuscular performance, mainly in reactive tests, were the predictors of spatiotemporal parameters (CT, FT, stride angle, and VO). Rhythm and jump flying time in the HT8max test and power in the countermovement jump test are parameters that can predict variables associated with running biomechanics, such as VO, CT, FT, and stride angle. © 2021 by the authors. Licensee MDPI, Basel, Switzerland

Effectiveness of the Ponseti method in the treatment of clubfoot: a systematic review

Clubfoot is a common congenital deformity of the lower limbs. It should be treated as soon as possible so that its correction is more easily achieved. The objective of this systematic review was to assess the effectiveness of the Ponseti method in the treatment of clubfoot. A bibliographic search was carried out in different databases, including PubMed and SciELO. Filters such as full text and randomized controlled trial were selected to find those articles that best matched our search. Among the results, we selected the ones that interested us, and the rest were discarded, either because they did not meet the requirements for our work or because they were repeated. In total, we collected 19 articles, but after using the critical evaluation instrument CASPe, 7 of them were eliminated, leaving us with a total of 12 articles for our systematic review. After analyzing the results obtained in the selected articles, we concluded that the Ponseti method is effective in the treatment of clubfoot, presenting a high success rate.Partial funding for open access charge: Universidad de Málag

Induced Systemic Resistance (ISR) and Fe Deficiency Responses in Dicot Plants

Plants develop responses to abiotic stresses, like Fe deficiency. Similarly, plants also develop responses to cope with biotic stresses provoked by biological agents, like pathogens and insects. Some of these responses are limited to the infested damaged organ, but other responses systemically spread far from the infested organ and affect the whole plant. These latter responses include the Systemic Acquired Resistance (SAR) and the Induced Systemic Resistance (ISR). SAR is induced by pathogens and insects while ISR is mediated by beneficial microbes living in the rhizosphere, like bacteria and fungi. These root-associated mutualistic microbes, besides impacting on plant nutrition and growth, can further boost plant defenses, rendering the entire plant more resistant to pathogens and pests. In the last years, it has been found that ISReliciting microbes can induce both physiological and morphological responses to Fe deficiency in dicot plants. These results suggest that the regulation of both ISR and Fe deficiency responses overlap, at least partially. Indeed, several hormones and signaling molecules, like ethylene (ET), auxin, and nitric oxide (NO), and the transcription factor MYB72, emerged as key regulators of both processes. This convergence between ISR and Fe deficiency responses opens the way to the use of ISR-eliciting microbes as Fe biofertilizers as well as biopesticides. This review summarizes the progress in the understanding of the molecular overlap in the regulation of ISR and Fe deficiency responses in dicot plants. Root-associated mutualistic microbes, rhizobacteria and rhizofungi species, known for their ability to induce morphological and/or physiological responses to Fe deficiency in dicot plant species are also reviewed herei

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 8

El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, volumen 8, de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada de acceso abierto a todas las áreas del conocimiento, que cuenta con el esfuerzo de investigadores de varios países del mundo, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico que consoliden la transformación del conocimiento en diferentes escenarios, tanto organizacionales como universitarios, para el desarrollo de habilidades cognitivas del quehacer diario. La gestión del conocimiento es un camino para consolidar una plataforma en las empresas públicas o privadas, entidades educativas, organizaciones no gubernamentales, ya sea generando políticas para todas las jerarquías o un modelo de gestión para la administración, donde es fundamental articular el conocimiento, los trabajadores, directivos, el espacio de trabajo, hacia la creación de ambientes propicios para el desarrollo integral de las instituciones

Proyecto de prevención de drogodependencias

Trabaja la prevención de drogodependencias desde el enfoque psicosocial que incluye tres aspectos: individuo, sustancia y contexto, teniendo en cuenta drogas legales e ilegales dentro de la Educación para la Salud. Determina los factores de riesgo ante los que los centros escolares deben responder favoreciendo: el desarrollo de la autoestima, la autonomía personal, el tener un proyecto de vida, la adaptabilidad, el diálogo, el saber solucionar conflictos, tener construcciones mentales positivas, la participación escolar, las relaciones personales dialogantes y democráticas y la responsabilidad. Ofrece cuatro unidades diácticas: La publicidad y las drogas, Autoestima, Naturaleza y ecología y Valores para la prevención del consumo de drogas. Evalúa la organización del equipo docente, la adecuación de los recursos, la colaboración con instituciones del entorno y la participación del alumnado y sus familias.Madrid (Comunidad Autónoma). Consejería de Educación y Cultura. Ministerio de Educación y Cultura. Ayuntamiento de MadridMadridMadrid (Comunidad Autónoma). Subdirección General de Formación del Profesorado. CRIF Las Acacias; General Ricardos 179 - 28025 Madrid; Tel. + 34915250893ES

Ultrasound Cut-Off Values for Rectus Femoris for Detecting Sarcopenia in Patients with Nutritional Risk

Background: A nationwide, prospective, multicenter, cohort study (the Disease-Related caloric-protein malnutrition EChOgraphy (DRECO) study) was designed to assess the usefulness of ultrasound of the rectus femoris for detecting sarcopenia in hospitalized patients at risk of malnutrition and to define cut-off values of ultrasound measures. Methods: Patients at risk of malnutrition according to the Malnutrition Universal Screening Tool (MUST) underwent handgrip dynamometry, bioelectrical impedance analysis (BIA), a Timed Up and Go (TUG) test, and rectus femoris ultrasound studies. European Working Group on Sarcopenia in Older People (EWGSOP2) criteria were used to define categories of sarcopenia (at risk, probable, confirmed, severe). Receiver operating characteristic (ROC) and area under the curve (AUC) analyses were used to determine the optimal diagnostic sensitivity, specificity, and predictive values of cut-off points of the ultrasound measures for the detection of risk of sarcopenia and probable, confirmed, and severe sarcopenia. Results: A total of 1000 subjects were included and 991 of them (58.9% men, mean age 58.5 years) were evaluated. Risk of sarcopenia was detected in 9.6% patients, probable sarcopenia in 14%, confirmed sarcopenia in 9.7%, and severe sarcopenia in 3.9%, with significant differences in the distribution of groups between men and women (p 2 and 3.66 cm2 for CSA, 32.57 mm and 40.21 mm for the X-axis, and 7.85 mm and 10.4 mm for the Y-axis. In general, these cut-off values showed high sensitivities, particularly for the categories of confirmed and severe sarcopenia, with male patients also showing better sensitivities than women. Conclusions: Sarcopenia in hospitalized patients at risk of malnutrition was high. Cut-off values for the better sensitivities and specificities of ultrasound measures of the rectus femoris are established. The use of ultrasound of the rectus femoris could be used for the prediction of sarcopenia and be useful to integrate nutritional study into real clinical practice

Comprehensive analysis and insights gained from long-term experience of the Spanish DILI Registry

Altres ajuts: Fondo Europeo de Desarrollo Regional (FEDER); Agencia Española del Medicamento; Consejería de Salud de Andalucía.Background & Aims: Prospective drug-induced liver injury (DILI) registries are important sources of information on idiosyncratic DILI. We aimed to present a comprehensive analysis of 843 patients with DILI enrolled into the Spanish DILI Registry over a 20-year time period. Methods: Cases were identified, diagnosed and followed prospectively. Clinical features, drug information and outcome data were collected. Results: A total of 843 patients, with a mean age of 54 years (48% females), were enrolled up to 2018. Hepatocellular injury was associated with younger age (adjusted odds ratio [aOR] per year 0.983; 95% CI 0.974-0.991) and lower platelet count (aOR per unit 0.996; 95% CI 0.994-0.998). Anti-infectives were the most common causative drug class (40%). Liver-related mortality was more frequent in patients with hepatocellular damage aged ≥65 years (p = 0.0083) and in patients with underlying liver disease (p = 0.0221). Independent predictors of liver-related death/transplantation included nR-based hepatocellular injury, female sex, higher onset aspartate aminotransferase (AST) and bilirubin values. nR-based hepatocellular injury was not associated with 6-month overall mortality, for which comorbidity burden played a more important role. The prognostic capacity of Hy's law varied between causative agents. Empirical therapy (corticosteroids, ursodeoxycholic acid and MARS) was prescribed to 20% of patients. Drug-induced autoimmune hepatitis patients (26 cases) were mainly females (62%) with hepatocellular damage (92%), who more frequently received immunosuppressive therapy (58%). Conclusions: AST elevation at onset is a strong predictor of poor outcome and should be routinely assessed in DILI evaluation. Mortality is higher in older patients with hepatocellular damage and patients with underlying hepatic conditions. The Spanish DILI Registry is a valuable tool in the identification of causative drugs, clinical signatures and prognostic risk factors in DILI and can aid physicians in DILI characterisation and management. Lay summary: Clinical information on drug-induced liver injury (DILI) collected from enrolled patients in the Spanish DILI Registry can guide physicians in the decision-making process. We have found that older patients with hepatocellular type liver injury and patients with additional liver conditions are at a higher risk of mortality. The type of liver injury, patient sex and analytical values of aspartate aminotransferase and total bilirubin can also help predict clinical outcomes