6 research outputs found
DeformaciĂłn osteoarticular a nivel del pie en pacientes con artritis reumatoide.
Objective: The aim of the study was to analyze the feet of rheumatoid arthritis (RA) patients,
to determine the degree to which both feet were affected, primarily analyzing the severity of RA in
both feet looking at structure and morphology, and secondly looking at the symmetry in terms of the
anthropometrics and posture. Method: This cross-sectional study was conducted from January to
December 2018. The data from 229 patients with RA and with foot pain and no RA recruited (Granada,
Spain) were analyzed. Two researchers independently interviewed the patients to obtain the study
data. The clinical data were obtained using specific foot health and quality of life questionnaires
and a validated platform for foot measurement. Anthropometric measurements were obtained by
means of a foot measurement platform and the Foot Posture Index (FPI). The bivariate analysis was
performed with the Studentâs t test and the non-parametricWilcoxon test. The level of significance
was established at p < 0.05. Results: In the RA group, anthropometric measurements revealed
significant differences between the left and right feet in 13 of the 23 parameters considered, as follows:
(non-load-bearing) foot length, length of the first metatarsophalangeal joint, maximum height of the
internal longitudinal arch, and width of the midfoot (p < 0.001, p = 0.038, p < 0.001, and p = 0.037
respectively); and Foot Posture Index (p = 0.001). Conclusions: In patients with RA, statistically
significant differences were found in the Foot Posture Index and in several parameters related to
foot structure and morphology. From this, we conclude that from a morphological, structural, and
postural standpoint, a pattern of symmetric joint involvement should not be viewed as a specific
criterion for RA in the foot.Colegio Podologia Ciudad de Rosario (Argentina).
Universidad de MĂĄlaga. Campus de Excelencia Internacional AndalucĂa Tech
Chiari Syndrome: Advances in Epidemiology and Pathogenesis: A Systematic Review
Arnold Chiari Syndrome; Hydrocephalus; ScoliosisSĂndrome de Arnold Chiari; Hidrocefalia; EscoliosisSĂndrome d'Arnold Chiari; HidrocefĂ lia; EscoliosiArnold Chiari syndrome is a rare congenital disease of unknown prevalence and whose origin is still under study. It is encompassed within the posterior cranial malformations, showing a wide spectrum of symptomatology that can range from severe headache, dizziness, and paresthesia to complete asymptomatology. It is for this reason that early diagnosis of the disease is difficult, and it is usually diagnosed in adolescence. Treatment is based on remodeling and decompression of the malformed posterior cranial fossa, although the risk of residual symptoms after surgery is high. The aim of this review is to update all the existing information on this pathology by means of an exhaustive analysis covering all the scientific literature produced in the last 5 years. In addition, it has been carried out following the PRISMA model and registered in PROSPERO with code CRD42023394490. One of the main conclusions based on the results obtained in this review is that the origin of the syndrome could have a genetic basis and that the treatment of choice is the decompression of the posterior cerebral fossa
Follow-up of health-related quality of life and pain in a cohort of patients with rheumatoid arthritis before and after COVID-19
The foot is one of the anatomical structures of the body most affected in rheumatoid arthritis
(RA), associated with the disability of patients, even more during COVID-19. The aim of this study was to
analyse whether the period of physical inactivity during COVID-19 is an influential factor on health-related
quality of life and foot pain in patients with RA.
Methods: 162 patients with foot pain and RA, recruited from the Hospital Virgen de las Nieves, Granada
(Spain) were included. Data was collected during two different periods: January - December 2018 in person
and June - September 2021 by phone. Patients were asked to complete the Spanish adapted version of the
12-Item Short Form Survey (SF-12) and the Visual Analogue Scale (VAS).
Results: The results from the SF-12 questionnaires were divided between its two subscales (i.e., mental, and
physical component). The physical component shows an improvement between 2018 and 2021, from 32.05in 2018â35.18 in 2021 (p < 0.05). The opposite happened with the mental component, showing a dete-
rioration, from 39.69 in 2018â34.48 in 2021 (p < 0.05). Regarding pain, VAS shows higher levels of pain
with statistically significant differences, both in general pain (from 6 in 2018â7 in 2012) and in foot pain
(from 5 to 7), (p < 0.05).
Conclusion: Mental quality of life and pain, both general and foot pain, are influenced by the period of
physical inactivity during COVID-19.Funding for open access charge: Universidad de MĂĄlaga / CBU
Infections after spine instrumentation: effectiveness of short antibiotic treatment in a large multicentre cohort
REIPI (Spanish Network for Research in Infectious Disease)/GEIOâSEIMC (Group for the Study of Osteoarticular Infections â Spanish Society of Infectious Diseases and Clinical Microbiology).[Background and objectives] Available information about infection after spine instrumentation (IASI) and its management are scarce. We aimed to analyse DAIR (debridement, antibiotics and implant retention) prognosis and evaluate effectiveness of short antibiotic courses on early forms.[Methods] Multicentre retrospective study of patients with IASI managed surgically (January 2010âDecember 2016). Risk factors for failure were analysed by multivariate Cox regression and differences between short and long antibiotic treatment were evaluated with a propensity score-matched analysis.[Results] Of the 411 IASI cases, 300 (73%) presented in the first month after surgery, 48 in the second month, 22 in the third and 41 thereafter. Infections within the first 2âmonths (early cases) occurred mainly to older patients, with local inflammatory signs and predominance of Enterobacteriaceae, unlike those in the later periods. When managed with DAIR, prognosis of early cases was better than later ones (failure rate 10.4% versus 26.1%, respectively; Pâ=â0.02). Risk factors for DAIR failure in early cases were female sex, Charlson Score, large fusions (>6 levels) and polymicrobial infections (adjusted HRs of 2.4, 1.3, 2.6 and 2.26, respectively). Propensity score matching proved shorter courses of antibiotics (4â6âweeks) as effective as longer courses (failure rates 11.4% and 10.5%, respectively; Pâ=â0.870).[Conclusions] IASIs within the first 2âmonths could be managed effectively with DAIR and shorter antibiotic courses. Clinicians should be cautious when faced with patients with comorbidities, large fusions and/or polymicrobial infections.E.B. was supported with a grant of the Instituto de Salud Carlos III â Ministry of Science and Innovation (FI 16/00397). This research was carried out as part of our routine work.Peer reviewe
Experiences of patients with rheumatoid arthritis during and after COVID-19-induced quarantine in terms of physical activity and health status: A qualitative study.
The aim of this study was to explore experiences of people with rheumatoid arthritis during and after COVID-19-induced quarantine in terms of physical activity and health status. Rheumatoid arthritis affects multiple facets of the person, both physically and psychologically. Physical activity is considered a safe and effective intervention to improve symptoms and systemic manifestations of rheumatoid arthritis. In the context of the COVID-19, countries like Spain were forced to impose restrictions on mobility, prohibiting outings even to perform physical activity. Structured interviews were conducted and developed using the Tampa Scale for Kinesiophobia-11 questionnaire. Data were analysed using a six-step thematic analysis. The results make it clear that even though the patients declared that physical activity is essential for them to deal with their disease, most of the participants affirmed that they significatively reduced their levels of physical activity during the pandemic. Physical activity should be promoted in people, even in difficult times, to improve disease outcomes, well-being and mental health. Knowing the experiences of these patients enables nursing managers to develop interventions that ensure the delivery of comprehensive nursing care regarding physical activity and health status, in future situations like this pandemic
Efficacy of Plantar Orthoses in Paediatric Flexible Flatfoot: A Five-Year Systematic Review
Paediatric flexible flatfoot (PFF) is a very common condition and a common concern among parents and various healthcare professionals. There is a multitude of conservative and surgical treatments, with foot orthoses (FO) being the first line of treatment due to their lack of contraindications and because the active participation of the child is not required, although the evidence supporting them is weak. It is not clear what the effect of FO is, nor when it is advisable to recommend them. PFF, if left untreated or uncorrected, could eventually cause problems in the foot itself or adjacent structures. It was necessary to update the existing information on the efficacy of FO as a conservative treatment for the reduction in signs and symptoms in patients with PFF, to know the best type of FO and the minimum time of use and to identify the diagnostic techniques most commonly used for PFF and the definition of PFF. A systematic review was carried out in the databases PubMed, EBSCO, Web of Science, Cochrane, SCOPUS and PEDro using the following strategy: randomised controlled trials (RCTs) and controlled clinical trials (CCTs) on child patients with PFF, compared to those treated with FO or not being treated, assessing the improvement of signs and symptoms of PFF. Studies in which subjects had neurological or systemic disease or had undergone surgery were excluded. Two of the authors independently assessed study quality. PRISMA guidelines were followed, and the systematic review was registered in PROSPERO: CRD42021240163. Of the 237 initial studies considered, 7 RCTs and CCTs published between 2017 and 2022 met the inclusion criteria, representing 679 participants with PFF aged 3â14 years. The interventions of the included studies differed in diagnostic criteria, types of FO and duration of treatment, among others. All articles conclude that FO are beneficial, although the results must be taken with caution due to the risk of bias of the included articles. There is evidence for the efficacy of FO as a treatment for PFF signs and symptoms. There is no treatment algorithm. There is no clear definition for PFF. There is no ideal type of FO, although all have in common the incorporation of a large internal longitudinal arch