Evaluación funcional del movimiento: incidencia del valgo dinámico de rodilla en mujeres practicantes de la musculación y sedentarias

La evaluación del movimiento se hace importante y necesaria para la identificación de los riesgos de lesión, posibilitando la elaboración de programas de ejercicios preventivos y correctivos, buscando la mejora del desempeño de las actividades funcionales y el consiguiente bienestar. El objetivo de este estudio fue analizar y comparar la incidencia del valgo dinámico de la rodilla en mujeres practicantes de musculación y mujeres sedentarias, e identificar los síntomas álgicos y el potencial de lesión asociados a esa alteración biomecánica. Sesenta mujeres fueron divididas en dos grupos: practicantes de musculación y sedentarias, con edad entre 18 y 30 años. Los datos fueron recolectados a través del sistema Functional Movement Screen y sometidos a análisis estadístico descriptivo e inferencial. El valgo dinámico de la rodilla fue presentado por el 60% de las mujeres sedentarias y por el 33,3% de las mujeres practicantes de musculación, demostrando asociación entre el valgo dinámico y el sedentarismo (p<0,03). En los dos grupos no hubo asociación entre el dolor y el valgo dinámico de la rodilla (p>0,06). De las mujeres sedentarias, el 50% presentó puntuación FMS menor que seis puntos, representando alto riesgo de lesión. Se concluye que las mujeres sedentarias presentan mayor predisposición al valgo dinámico de la rodilla, mayor sintomatología dolorosa y mayor riesgo de lesión en los miembros inferiores.A avaliação do movimento é importante e necessária para identificar os riscos de lesão possibilitando a elaboração de programas de exercícios preventivos e corretivos, visando a melhora do desempenho das atividades funcionais e o consequente bem-estar. O objetivo deste estudo foi analisar e comparar a incidência do valgo dinâmico do joelho em mulheres praticantes de musculação e mulheres sedentárias, e identificar os sintomas álgicos e o potencial de lesão associados a essa alteração biomecânica. Sessenta mulheres foram divididas em dois grupos: praticantes de musculação e sedentárias, com idade entre 18 e 30 anos. Os dados foram coletados utilizando-se o sistema Functional Movement Screen e foram submetidos a análises estatísticas descritiva e inferencial. O valgo dinâmico do joelho é apresentado por 60% das mulheres sedentárias, quando comparadas às mulheres praticantes de musculação (33,3%), demonstrando associação entre o valgo dinâmico e o sedentarismo (p<0,03). Não houve associação entre a dor e o valgo dinâmico do joelho (p>0,06) para ambos os grupos. Das mulheres sedentárias, 50,0% apresentaram escore FMS abaixo de seis pontos, representando alto risco de lesão. Conclui-se que mulheres sedentárias apresentam maior predisposição ao valgismo dinâmico do joelho, maior sintomatologia dolorosa e maior risco de lesão nos membros inferiores.Movement evaluation is important and necessary to identify the risks of injury, enabling the elaboration of preventive and corrective exercise programs, aiming to improve the performance of functional activities and consequent well-being. This study aimed to analyze and compare the incidence of dynamic knee valgus in bodybuilders and sedentary women, as well as to identify the pain symptoms and the potential for injury associated with this biomechanical change. Sixty women were divided into two groups: bodybuilders and sedentary, aged 18 to 30. Data collection consisted of Functional Movement Screen (FMS) and the data were subjected to descriptive and inferential analysis. A total of 60% of sedentary women had dynamic knee valgus, with a predominance of bodybuilders (33.3%), showing an association between dynamic valgus and sedentary lifestyle (p<0.03). There was no association between pain and dynamic knee valgus (p>0.06) for both groups. 50.0% women and sedentary had a FMS score below six points, representing a high risk of injury. It is concluded that sedentary women are more predisposed to dynamic knee valgus, as well as greater pain symptomatology and greater risk of lower limbs injury

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Global urban environmental change drives adaptation in white clover

Urbanization transforms environments in ways that alter biological evolution. We examined whether urban environmental change drives parallel evolution by sampling 110,019 white clover plants from 6169 populations in 160 cities globally. Plants were assayed for a Mendelian antiherbivore defense that also affects tolerance to abiotic stressors. Urban-rural gradients were associated with the evolution of clines in defense in 47% of cities throughout the world. Variation in the strength of clines was explained by environmental changes in drought stress and vegetation cover that varied among cities. Sequencing 2074 genomes from 26 cities revealed that the evolution of urban-rural clines was best explained by adaptive evolution, but the degree of parallel adaptation varied among cities. Our results demonstrate that urbanization leads to adaptation at a global scale

An Evidence-Based Systematic Review of Elderberry and Elderflower (Sambucus nigra) by the Natural Standard Research Collaboration

An evidence-based systematic review of elderberry and elderflower (Sambucus nigra) by the Natural Standard Research Collaboration consolidates the safety and efficacy data available in the scientific literature using a validated, reproducible grading rationale. This article includes written and statistical analysis of clinical trials, plus a compilation of expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology, and dosing