Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) for Shoulder Mobility Improvement in Women with Upper Limb Lymphedema Secondary to Breast Cancer: A Multicenter Controlled Clinical Trial

Lymphedema, secondary to breast cancer (BCRL), is the abnormal accumulation of protein-rich fluid in the interstitium caused by a malfunction of the lymphatic system. It causes swelling, deficiencies in upper limb functions and structures, sensory pain and emotional alterations, which have a chronic course and affect the upper limb’s functionality. This study aims to verify the efficacy and efficiency in the upper limb´s functionality of a protocolized experimental approach based on occupational therapy, TAPA (activity-oriented proprioceptive antiedema therapy), in the rehabilitation of BCRL in stages I and II, comparing it with the conservative treatment considered as the standard, complex decongestive therapy (CDT), through a multicenter randomized clinical trial.The study has been financed in the call for competitive competition of research and innovation projects in the field of Primary Care, Regional Hospitals and High Resolution Hospital Centers of the Public Health System of Andalusia for the year 2021, of the Andalusian Public Foundation Progress and Health, according to the definitive list of funded projects, published on 23 December 2021, with EXP. No.: AP-0160-2021-C2-F2, also in the call for “Grants for research projects in Occupational Therapy. Call 2020”, granted by the Professional Association of Occupational Therapists of Extremadura (COPTOEX), Spain and, in 2020, received an economic contribution from the Research Group in Primary Health Care of Aragon (GAIAP-B21-17R group)

Impact of Activity-Oriented Propioceptive Antiedema Therapy on the Health-Related Quality of Life of Women with Upper-Limb Lymphedema Secondary to Breast Cancer—A Randomized Clinical Trial

Alterations derived from lymphedema in the upper-limb secondary to breast cancer-related lymphedema (BCRL) decrease the health-related quality of life (HRQoL), but there is limited evidence of the impact of the different interventions on it. The aim of this research was to compare the effect of conventional treatment with another treatment based on Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) on HRQoL in women diagnosed with BCRL.This research was funded by the Call for research and innovation projects in the field of primary care, regional hospitals and high-resolution hospital centres of the Public Health System of Andalusia in 2021 by the Progreso y Salud Foundation, of the Ministry of Health and Families of the Junta de Andalucía, with EXP. No.: AP-0160-2021-C2-F2. He has also been awarded a scholarship by the Professional Association of Occupational Therapists of Extremadura (COPTOEX) (Spain) call 2020 and awarded a financial contribution from the Research Group in Primary Health Care of Aragon (GAIAP-B21-17R group), recognized and financed by the Government of Aragón (Spain) and by Feder Funds “Another way of making Europe”

Gangrena gaseosa, una patología mortal

Gas gangrene is a severe skin and soft tissue infection (SSTI), a rapidly progressive pathology caused by different bacteria that induce severe ne-crosis with gas production and sepsis.Considering that gas gangrene complications develop in just one day, from the initial injury to shock, delirium, and death, fast detection and care in the emergency service are vital to preserving the patient's life.Next, we present a clinical case of a diabetic 53-year-old woman, who recently underwent sur-gery, where the celerity of the Emergency Service response was essential for a satisfactory resolutionLa gangrena gaseosa se encuentra dentro de las infecciones graves de los tejidos blandos (IGTB), siendo una patología progresivamente rápida cau-sada por diferentes bacterias que inducen una se-vera necrosis con producción de gas y sepsis1.Teniendo en cuenta que la complicación de la gangrena gaseosa se desarrolla en tan sólo un día desde la lesión inicial hasta el shock, delirio y muerte, la detección y atención en urgencias es vi-tal para poder conservar la vida del paciente2.A continuación, se presenta un caso clínico en una mujer de 53 años diabética y recién operada de neoplasia de mama, en donde la celeridad en la actuación en el servicio de Urgencias fue determi-nante para una resolución satisfactoria

Utilización de recursos sanitarios y sociales por parte de personas con COVID persistente y su relación con la sintomatología persistente: estudio secundario descriptivo y correlacional

Introduction: Approximately 10% of patients who have been infected with SARS-COV-2 have persistent symptoms that have reduced their quality of life. This is especially relevant in people who were infected during the first wave. The aim of this study is to analyze the consumption of health and social resources by people with persistent COVID and its relationship with the persistent symptomatology they present. Methodology: Cross-sectional descriptive and correlational study in which data are collected from patients with persistent COVID collecting sociodemographic, clinical variables (number of persistent symptoms), and consumption of health and social resources. A descriptive and correlational study was performed. Results: The participants in this study show a high affectation reflected in the large number of residual symptoms they present (mean 16.47 symptoms).  Therefore, there is a considerable increase in the use of public and private health, social and legal resources. Primary care services are the most frequently used by these patients. Conclusion: Timely planning of patient-centered resources and services for post-COVID-19 care is needed.Introducción: Aproximadamente, 10% de los pacientes que tuvieron una infección por SARS-COV-2, presentan una sintomatología persistente, que les ha mermado su calidad de vida. Esto es especialmente relevante en personas que se contagiaron durante la primera ola.  El objetivo de este estudio es analizar el consumo de recursos sanitarios y sociales por parte de personas con COVID persistente y su relación con la sintomatología persistente que presentan. Metodología: Estudio descriptivo transversal y correlacional en el que se recogen datos de pacientes con COVID persistente recogiendo variables sociodemográficas, clínicas (número de síntomas persistentes), y de consumo de recursos sanitarios y sociales. Resultados: Los participantes en este estudio muestran una alta afectación reflejado en la gran cantidad de síntomas residuales que presentan (media 16,47 síntomas).  Por ello, hay un incremento considerable en la utilización de los recursos sanitarios, sociales y legales tanto públicos como privados. Los servicios de Atención Primaria son los que más se han utilizado por parte de estos pacientes. Conclusión: Es necesaria una planificación oportuna de recursos y servicios centrados en el paciente para la atención posterior a la COVID-19

Activity-Oriented Antiedema Proprioceptive Therapy (TAPA) for Shoulder Mobility Improvement in Women with Upper Limb Lymphedema Secondary to Breast Cancer: A Multicenter Controlled Clinical Trial

Background: Lymphedema, secondary to breast cancer (BCRL), is the abnormal accumulation of protein-rich fluid in the interstitium caused by a malfunction of the lymphatic system. It causes swelling, deficiencies in upper limb functions and structures, sensory pain and emotional alterations, which have a chronic course and affect the upper limb’s functionality. This study aims to verify the efficacy and efficiency in the upper limb´s functionality of a protocolized experimental approach based on occupational therapy, TAPA (activity-oriented proprioceptive antiedema therapy), in the rehabilitation of BCRL in stages I and II, comparing it with the conservative treatment considered as the standard, complex decongestive therapy (CDT), through a multicenter randomized clinical trial. Methods: a randomized and prospective clinical trial was conducted with experimental and control groups. Women diagnosed with BCRL belonging to institutions in Córdoba and Aragon (Spain) participated. Sociodemographic variables and those related to the functionality of the affected upper limb were evaluated before and after the intervention. Results: The results showed statistically significant differences in the analysis of covariance performed for the variable joint balance of the shoulder´s external rotation (p = 0.045) that could be attributed to the intervention performed; however, the effect size was minimal (η2 ≤ 0.080). In the rest of the variables, no significant differences were found. Conclusions: TAPA may be an alternative to the conservative treatment of women with BCRL. It was shown to be just as effective for volume reduction and activity performance as CDT but more effective in improving external rotation in shoulder joint balance