From art to science: the functional damage due to thumb osteoarthritis finely described by Velazquez 300 years before its clinical description

Velazquez showed to know the entity of thumb osteoarthritis by finely describing it in one of his paintings. The concepts of anatomical damage, loss of strenght, and functional impairment are transmitted to the observer

The hominid thumb and its influence on the employment during evolution

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Professional Use of Social Media Among physiotherapy teachers: Results of a Multi-Institutional Study

[EN] Main objective is to know the professional use and perception of social networks by teachers of the Physiotherapy degree in Spanish Universities. To achieve this objective, our methodological approach has been based on the elaboration of a questionnaire of 7 questions that has been distributed among teachers of different Spanish Universities Physiotherapy degrees There is a great diversity in the use of social networks for academic purposes among the teachers of Spanish universities. Only 37% of participants use them for teaching purposes, with YouTube being the most used (76.5%) followed by Facebook. Others like Instagram or twitter are not used for teaching purposes. The use of social networks among physiotherapy teachers is not widespread and directly depends on the preferences of the teacher, although the social network most used for teaching purposes is YouTube, we can not know if these teachers use their own channels or references of other professionals . It is necessary an in-depth study about the advantages and disadvantages of the use of social networks as a means more than in a regulated way can be properly incorporated in university teaching programs.[ES] El objetivo de este estudio es conocer el uso profesional y la percepción de las redes sociales por parte de los docentes del grado de Fisioterapia en las Universidades Españolas. Para acometer este objetivo, nuestro enfoque metodológico se ha basado en la elaboración de un cuestionario de 7 preguntas que se ha distribuido entre docentes de diferentes grados de Fisioterapia de Universidades Españolas. Existe una gran diversidad en cuanto al uso de redes sociales con fines académicos entre los docentes de las universidades españolas. Solo el 37% de los encuestados las usa con fines docentes, siendo YouTube la red social utilizada con mayor frecuencia entre los encuestados (76,5%) seguida por Facebook. Otras como Instagram o twitter no se emplean con fines docentes. El uso de redes sociales entre los docentes de Fisioterapia no está generalizado y depende directamente de las preferencias del docente, aunque la red social más empleada con fines docente sea YouTube, no podemos saber si estos docentes emplean canales propios o referencias de otras profesionales. Es necesario un estudio en profundidad a cerca de las ventajas y desventajas del uso de las redes sociales como un medio más que de forma reglada pueda incorporarse adecuadamente en los programas docentes universitarios.A los docentes del grado de fisioterapia de las diferentes universidades españolas por cedernos su tiempo y por su participación desinteresada en este estudio.Cantero Tellez, R. (2018). Uso profesional de las redes sociales por los Docentes de grado de Fisioterapia. Estudio Multi- Institucional. 227-234. doi:10.4995/redu.2018.9171SWORD22723

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to 300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m 2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to &lt;90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], &gt;300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of &lt;15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P&lt;0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P&lt;0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

From art to science: the functional damage due to thumb osteoarthritis finely described by Velazquez 300 years before its clinical description

Velazquez showed to know the entity of thumb osteoarthritis by finely describing it in one of his paintings. The concepts of anatomical damage, loss of strenght, and functional impairment are transmitted to the observer

Pressure algometry and palpation of the upper limb peripheral nervous system in subjects with hand osteoarthritis are repeatable and suggest central changes

Study Design: Case-control study. Introduction: A subset of patients with hand osteoarthritis (OA) shows evidence of central pain phenotypes. Purpose of the Study: To examine whether differences exist in experimental pain responses in the affected and nonaffected sides of patients with unilateral hand OA. To investigate the test-retest reliability of pressure algometry and manual digital palpation in patients with unilateral hand OA. Methods: The hand OA group consisted of 20 patients, and the control group consisted of 20 healthy subjects. Pressure pain threshold (PPT) measurements were made 2 times, consisting of 3 repeat trials, each using computerized algometry and manual digital palpation. Grip and key strength (dynamometer), pain (visual analog scale), and function (Disabilities of the Arm, Shoulder and Hand [short version]) were also measured. The 2-way analysis of variance was conducted to determine the differences between sides and groups. Intraclass correlation coefficient (ICC) and standard error of measurement were calculated. Results: Patients with hand OA had decreased PPTs over the thumb carpometacarpal joint as well as radial and median nerves compared with controls (all P &lt;.01). No significant group effect by side interaction was detected for any measure. The minimal detectable change values needed to detect change in subjects with hand OA were C5-C6 joint (0.3-0.5 kg/cm2), carpometacarpal joint (0.3-0.5 kg/cm2), hamate bone (0.2-0.4 kg/cm2), radial nerve (0.2-0.8 kg/cm2), median nerve (0.3-0.6 kg/cm2), and ulnar nerve (0.2-0.4 kg/cm2) for PPT. Test-retest reliability was calculated for both hands of participants with OA (ICC, 0.98-0.99) and healthy participants (ICC, 0.74-0.99). Discussion: Although pressure algometry and manual digital palpation are techniques already used in previous studies and have been shown to be reproducible and moderately reliable for joint palpation, this current study suggests that pressure algometry and manual digital palpation could also be reliable methods of determining nerve sensitivity of the radial, ulnar and median nerves in subjects with hand OA. Conclusions: Hyperalgesia in patients with hand OA might be associated with clinical measures, and bilateral signs in unilateral OA could suggest central changes

Prevalence of Myofascial Trigger Points in Poststroke Patients With Painful Shoulders : A Cross-Sectional Study

Background: In patients with stroke, hemiplegic shoulder pain can be a major problem. One source of shoulder pain can be myofascial trigger points (MTrPs). Objective: To determine the prevalence of myofascial trigger points (MTrPs) and the correlation between MTrPs and pain and function in patients presenting with shoulder pain following a stroke. Design: Cross-sectional study. Setting: Department of Physical Therapy. Patients: Fifty patients with stroke with shoulder pain. Intervention: Not applicable. Main Outcome Measurements: The prevalence of the MTrPs located in infraspinatus, supraspinatus, teres minor, and upper trapezius was studied, using the diagnosis criteria recommended by Simons et al. The pressure pain threshold was also evaluated. Pain and function were assessed with the Visual Analogue Scale (VAS) and the Disability of the Arm, Shoulder and Hand (DASH) scale, respectively. Results: The prevalence of latent MTrPs was 68%, 92%, 40%, and 62% for supraspinatus, infraspinatus, teres minor, and upper trapezius muscle, respectively. The prevalence of active MTrPs was 34%, 50%, 12%, and 20% for supraspinatus, infraspinatus, teres minor, and upper trapezius muscle, respectively. Pain was moderately correlated with the prevalence of latent MTrPs (r = 0.35; P =.01) and active MTrPs (r = 0.31; P =.03) in the supraspinatus muscle. Disability was measured with the DASH scale and was moderately correlated with latent MTrPs in the infraspinatus (r = 0.31; P =.03) and active MTrPs of the supraspinatus (r = 0.32; P =.02). Conclusions: This study shows that the prevalence of MTrPs is high in patents following a stroke. MTrPs in this population are moderately associated with pain and function. Level of Evidence: II