57 research outputs found

    Clinical-functional evaluation and test-retest reliability of the G-WALK sensor in subjects with bimalleolar ankle fractures 6 months after surgery

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    Ankle fractures can cause significant functional impairment in the short and long term. In recent years, gait analysis using inertial sensors has gained special relevance as a reliable measurement system. This study aimed to evaluate the differences in spatiotemporal gait parameters and clinical- functional measurements in patients with bimalleolar ankle fracture and healthy subjects, to study the correlation between the different variables, and to analyze the test-retest reliability of a single inertial sensor in our study population. Twenty-two subjects with bimalleolar ankle fracture six months after surgery and eleven healthy subjects were included in the study. Spatiotemporal parameters were analyzed with the G-WALK sensor. Functional scales and clinical measures were collected beforehand. In the ankle fracture group, the main differences were obtained in bilateral parameters (effect size: 0.61 d 0.80). Between-group differences were found in cadence, speed, stride length, and stride time (effect size: 1.61 d 1.82). Correlation was moderate (0.436 < r < 0.554) between spatiotemporal parameters and clinical-functional measures, explaining up to 46% of gait performance. Test-retest reliability scores were high to excellent (0.84 ICC 0.98), with the worst results in the gait phases. Our study population presents evident clinicalfunctional impairments 6 months after surgery. The G-WALK can be considered a reliable tool for clinical use in this population

    NSAIDs-hypersensitivity often induces a blended reaction pattern involving multiple organs

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    Las reacciones de hipersensibilidad inducidas por medicamentos antiinflamatorios no esteroideos (AINE) están clasificadas por la Red Europea de Alergia a los Medicamentos (ENDA) como reacciones cruzadas o selectivas. La primera es el tipo más frecuente e incluye a los pacientes con síntomas exclusivamente respiratorios (AINE - enfermedad respiratoria exacerbada, ENDA) o exclusivamente cutáneos: urticaria/angioedema inducido por AINEs (NIUA); y enfermedad cutánea exacerbada por AINEs (NECD). Sin embargo, aunque no se refleja en el esquema de clasificación actual (ENDA), en la práctica clínica se observa con frecuencia una combinación de síntomas tanto cutáneos como respiratorios o incluso de otros órganos, como los síntomas del tracto gastrointestinal (reacciones mixtas o combinadas). Esta entidad no ha sido suficientemente caracterizada. Nuestro objetivo era caracterizar clínicamente las reacciones mixtas a los AINEs, comparando sus características clínicas con las del NERD y la NIUA. Evaluamos a los pacientes con síntomas que sugerían hipersensibilidad a los AINEs que acudieron a la Unidad de Alergia del Hospital Universitario Regional de Málaga (Málaga, España) entre 2008 y 2015. Se incluyeron 880 pacientes con reacción cruzada confirmada en base a la historia clínica, prueba de provocación nasal positiva con acetilsalicilato de lisina (NPT-LASA) y/o prueba de provocación de drogas positiva (DPT) con ácido acetilsalicílico (ASA), que se clasificaron como mezclados (261; 29,6%), NERD (108; 12,3%) o NIUA (511; 58,1%). Se compararon los síntomas, los medicamentos, las enfermedades subyacentes y los métodos de diagnóstico dentro de los grupos y entre ellos. Entre los pacientes mezclados, el subgrupo más común comprendía aquellos que desarrollaban urticaria/angioedema más rinitis/asma (n = 138), que tenían un mayor porcentaje de rinitis subyacente (p < 0,0001) y asma (p < 0,0001) que los pacientes de NIUA, mostrando similitudes con la NERD. Estas diferencias no se encontraron en el subgrupo de pacientes mezclados que desarrollaron síntomas respiratorios como el edema de la glotis; estos eran más similares a la NIUA. El porcentaje de NPT-LASA positivo fue similar para los grupos de mezcla (77%) y NERD (78,7%). Concluimos que las reacciones mixtas son reacciones de hipersensibilidad a los AINEs que afectan al menos a dos órganos. Además de la clásica afectación cutánea y respiratoria, en nuestra población algunos pacientes también desarrollan síntomas gastrointestinales. Dada la alta tasa de respuestas positivas al NPT-LASA en el NERD así como las reacciones mixtas, sugerimos que todos los pacientes que reporten síntomas respiratorios, independientemente de si tienen otros síntomas asociados, deben ser evaluados inicialmente usando el NPT-LASA, lo cual representa menos riesgo que el DPT.Non-steroidal anti-inflammatory drugs (NSAIDs)-induced hypersensitivity reactions are classified by the European Network on Drug Allergy (ENDA) as either cross-reactive or selective. The former is the most frequent type and includes patients with exclusively respiratory symptoms (NSAIDs-exacerbated respiratory disease, NERD) or exclusively cutaneous symptoms: NSAIDs-induced urticaria/angioedema (NIUA); and NSAIDs-exacerbated cutaneous disease (NECD). However, although not reflected in the current classification scheme (ENDA), in clinical practice a combination of both skin and respiratory symptoms or even other organs such as gastrointestinal tract symptoms (mixed or blended reactions) is frequently observed. This entity has not been sufficiently characterised. Our aim was to clinically characterize blended reactions to NSAIDs, comparing their clinical features with NERD and NIUA. We evaluated patients with symptoms suggestive of hypersensitivity to NSAIDs who attended the Allergy Unit of the Regional University Hospital of Malaga (Malaga, Spain) between 2008 and 2015. We included 880 patients confirmed as cross-reactive based on clinical history, positive nasal provocation test with lysine acetylsalicylate (NPT-LASA), and/or positive drug provocation test (DPT) with acetylsalicylic acid (ASA), who were classified as blended (261; 29.6%), NERD (108; 12.3%) or NIUA (511; 58.1%). We compared symptoms, drugs, underlying diseases and diagnostic methods within and between groups. Among blended patients the most common sub-group comprised those developing urticaria/angioedema plus rhinitis/asthma (n = 138), who had a higher percentage of underlying rhinitis (p < 0.0001) and asthma (p < 0.0001) than NIUA patients, showing similarities to NERD. These differences were not found in the sub-group of blended patients who developed such respiratory symptoms as glottis oedema; these were more similar to NIUA. The percentage of positive NPT-LASA was similar for blended (77%) and NERD groups (78.7%). We conclude that blended reactions are hypersensitivity reactions to NSAIDs affecting at least two organs. In addition to classical skin and respiratory involvement, in our population a number of patients also develop gastrointestinal symptoms. Given the high rate of positive responses to NPT-LASA in NERD as well as blended reactions, we suggest that all patients reporting respiratory symptoms, regardless of whether they have other associated symptoms, should be initially evaluated using NPT-LASA, which poses less risk than DPT.• Gobierno de Andalucía. Ayuda PI-0463-2013 • Instituto de Salud Carlos III y Fondo Europeo Regional de Desarrollo. Ayuda RETIC ARADyAL RD16/0006/0001 y PI17/1253 • Sociedad Española de Alergología. Fondo de Investigación de la Fundación de la SEAIC 2016 • Instituto de Salud Carlos III, Ministerio de Economía y Competitividad y Fondo Europeo Social. Contrato de investigación Juan Rodes JR15/00036, para Inmaculada Doña Díaz. Contrato Río Hortega CM16/0067, para Gádor Bogas Herrera. Programa Miguel Servet CP14/00034, para José Antonio Cornejo García. Programa Sara Borrell CD14/00242, para James Richard Perkins.peerReviewe

    Grill & Vinos

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    El proyecto Grill & Vinos, es una propuesta de negocio de plataforma ecommerce que consiste en brindar un servicio de ventas de productos premium de parrillas; en el cual los usuarios puedan encontrar fácilmente todos los productos e insumos necesarios para preparar una parrillada de calidad Premium con quesos variados, carnes de diversos cortes, vinos de la más alta calidad y cervezas artesanales. Por ello, busca satisfacer las necesidades de personas que tienen un estilo de vida moderno que prefieren cuidar de su salud y consumir productos que cumplan con altos estándares de cálida y rapidez. Grill & Vinos dispone de un sistema GPS de rastreo que se realiza en tiempo real para mayor seguridad para el servicio; también, cuentan con alianzas estratégicas de proveedores líderes en el mercado parrillero; por lo que, los convierte en ser un proyecto nuevo en el mercado diferenciándose de otros. Grill & Vinos determina un servicio totalmente personalizado y con un equipo altamente capacitado con experiencia en cada una de las áreas del proyecto con el objetivo de brindar un servicio de calidad. La propuesta de negocio actual cuenta con una tasa de conversión del 29.41% obtenido por medio de la landing page, acreditando su éxito. En el lado financiero, se mantienen positivo con un WACC de 12.27%. Por lo tanto, se espera para el primer año un ingreso total por venta de S/. 895,610.00 y su proyección a cinco años nos da un monto total de S/. 1614,645.54 sin IGV.The Grill & Vinos project is a business proposal for an electronic commerce platform that consists of providing a sales service for premium barbecue products; in which users can easily find all the products and supplies necessary to prepare a Premium quality barbecue with assorted cheeses, meats of various cuts, wines of the highest quality and craft beers. Therefore, it seeks to satisfy the needs of people who have a modern lifestyle who prefer to take care of their health and consume products that meet high standards of warmth and speed. Grill & Vinos has a GPS tracking system that is carried out in real time for greater security for the service; They also have strategic alliances with leading suppliers in the barbecue market; therefore, it becomes a new project on the market, differentiating itself from others. Grill & Vinos determines a totally personalized service with a highly trained team with experience in each of the project areas with the aim of providing a quality service. The current business proposal has a conversion rate of 29.41% obtained through the landing page, proving its success. On the financial side, they remain positive with a WACC of 12.27%. Therefore, a total income from sale of S/. 895,610.00 and its five-year projection gives us a total amount of S/. 1614,645.54 without VAT.Trabajo de investigació

    Perinatal and childhood factors and risk of breast cancer subtypes in adulthood

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    BACKGROUND: Accumulated exposure to hormones and growth factors during early life may influence the future risk of breast cancer (BC). This study examines the influence of childhood-related, socio-demographic and anthropometric variables on BC risk, overall and by specific pathologic subtypes. METHODS: This is a case-control study where 1539 histologically-confirmed BC cases (23-85 years) and 1621 population controls, frequency matched by age, were recruited in 10 Spanish provinces. Perinatal and childhood-related characteristics were directly surveyed by trained staff. The association with BC risk, globally and according to menopausal status and pathologic subtypes, was evaluated using logistic and multinomial regression models, adjusting for tumor specific risk factors. RESULTS: Birth characteristics were not related with BC risk. However, women with high socioeconomic level at birth presented a decreased BC risk (OR=0.45; 95% CI=0.29-0.70), while those whose mothers were aged over 39 years at their birth showed an almost significant excess risk of hormone receptor positive tumors (HR+) (OR=1.35; 95% CI=0.99-1.84). Women who were taller than their girl mates before puberty showed increased postmenopausal BC risk (OR=1.26; 95% CI=1.03-1.54) and increased HR+ BC risk (OR=1.26; 95% CI=1.04-1.52). Regarding prepubertal weight, while those women who were thinner than average showed higher postmenopausal BC risk (OR=1.46; 95% CI=1.20-1.78), associated with HR+ tumors (OR=1.34; 95% CI=1.12-1.61) and with triple negative tumors (OR=1.56; 95% CI=1.03-2.35), those who were heavier than average presented lower premenopausal BC risk (OR=0.64; 95% CI=0.46-0.90) and lower risk of epidermal growth factor receptor positive tumors (OR=0.61; 95% CI=0.40-0.93). CONCLUSION: These data reflect the importance of hormones and growth factors in the early stages of life, when the mammary gland is in development and therefore more vulnerable to proliferative stimuli

    Population-based multicase-control study in common tumors in Spain (MCC-Spain): rationale and study design

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    Introduction: We present the protocol of a large population-based case-control study of 5 common tumors in Spain (MCC-Spain) that evaluates environmental exposures and genetic factors. Methods: Between 2008-2013, 10,183 persons aged 20-85 years were enrolled in 23 hospitals and primary care centres in 12 Spanish provinces including 1,115 cases of a new diagnosis of prostate cancer, 1,750 of breast cancer, 2,171 of colorectal cancer, 492 of gastro-oesophageal cancer, 554 cases of chronic lymphocytic leukaemia (CLL) and 4,101 population-based controls matched by frequency to cases by age, sex and region of residence. Participation rates ranged from 57% (stomach cancer) to 87% (CLL cases) and from 30% to 77% in controls. Participants completed a face-to-face computerized interview on sociodemographic factors, environmental exposures, occupation, medication, lifestyle, and personal and family medical history. In addition, participants completed a self-administered food-frequency questionnaire and telephone interviews. Blood samples were collected from 76% of participants while saliva samples were collected in CLL cases and participants refusing blood extractions. Clinical information was recorded for cases and paraffin blocks and/or fresh tumor samples are available in most collaborating hospitals. Genotyping was done through an exome array enriched with genetic markers in specific pathways. Multiple analyses are planned to assess the association of environmental, personal and genetic risk factors for each tumor and to identify pleiotropic effects. Discussion: This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP), is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain.The study was partially funded by the “Accion Transversal del Cancer”, approved on the Spanish Ministry Council on the 11th October 2007, by the Instituto de Salud Carlos III-FEDER (PI08/1770, PI08/0533, PI08/1359, PS09/00773, PS09/01286, PS09/01903, PS09/02078, PS09/01662, PI11/01403, PI11/01889, PI11/00226, PI11/01810, PI11/02213, PI12/00488, PI12/00265, PI12/01270, PI12/00715, PI12/00150), by the Fundación Marqués de Valdecilla (API 10/09), by the ICGC International Cancer Genome Consortium CLL, by the Junta de Castilla y León (LE22A10-2), by the Consejería de Salud of the Junta de Andalucía (PI-0571), by the Conselleria de Sanitat of the Generalitat Valenciana (AP 061/10), by the Recercaixa (2010ACUP 00310), by the Regional Government of the Basque Country by European Commission grants FOOD-CT- 2006-036224-HIWATE, by the Spanish Association Against Cancer (AECC) Scientific Foundation, by the The Catalan Government DURSI grant 2009SGR1489
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