Postpartum chronic pain: subdermal procaine treatment-neural therapy

Objetivo: evaluar la efectividad de la administración de procaína subdérmica en bajas dosis en la cicatriz del parto vaginal o por cesárea para el alivio del dolor persistente posparto. Pacientes, material y métodos: Estudio observacional y prospectivo de abril de 2014 a marzo de 2016, en mujeres con dolor persistente después de 10 días posparto. Se valoraron: variables demográficas, variables clínicas y obstétricas, motivo de consulta, grado del dolor según la escala visual analógica (EVA), y número de dosis de tratamiento recibidas y coste por dosis. El tratamiento utilizado fue la inyección subdérmica con procaína (1 mg/kg) en sesiones quincenales, hasta conseguir un dolor ≤1 según la EVA. Resultados: se estudiaron 168 mujeres. La media de dolor antes del tratamiento fue de 5,52 en la escala EVA y de 0,17 al final, con una p <0,001. La edad mostró diferencias significativas interpacientes con una p <0,001, donde las pacientes mayores de 40 años tuvieron una valoración inicial del dolor más alta y por tanto necesitaron más sesiones, aunque también consiguieron un grado de dolor ≤1. El 80,9% de las pacientes terminaron el tratamiento a los 30 días con la tercera sesión. Conclusión: la aplicación de procaína subdérmica está asociada a la disminución del dolor persistente posparto

Postpartum chronic pain: subdermal procaine treatment-neural therapy

Objetivo: evaluar la efectividad de la administración de procaína subdérmica en bajas dosis en la cicatriz del parto vaginal o por cesárea para el alivio del dolor persistente posparto. Pacientes, material y métodos: Estudio observacional y prospectivo de abril de 2014 a marzo de 2016, en mujeres con dolor persistente después de 10 días posparto. Se valoraron: variables demográficas, variables clínicas y obstétricas, motivo de consulta, grado del dolor según la escala visual analógica (EVA), y número de dosis de tratamiento recibidas y coste por dosis. El tratamiento utilizado fue la inyección subdérmica con procaína (1 mg/kg) en sesiones quincenales, hasta conseguir un dolor ≤1 según la EVA. Resultados: se estudiaron 168 mujeres. La media de dolor antes del tratamiento fue de 5,52 en la escala EVA y de 0,17 al final, con una p <0,001. La edad mostró diferencias significativas interpacientes con una p <0,001, donde las pacientes mayores de 40 años tuvieron una valoración inicial del dolor más alta y por tanto necesitaron más sesiones, aunque también consiguieron un grado de dolor ≤1. El 80,9% de las pacientes terminaron el tratamiento a los 30 días con la tercera sesión. Conclusión: la aplicación de procaína subdérmica está asociada a la disminución del dolor persistente posparto

Biological geography of the European seas: results from the MacroBen database

This study examines whether or not biogeographical and/or managerial divisions across the European seas can be validated using soft-bottom macrobenthic community data. The faunal groups used were: all macrobenthos groups, polychaetes, molluscs, crustaceans, echinoderms, sipunculans and the last 5 groups combined. In order to test the discriminating power of these groups, 3 criteria were used: (1) proximity, which refers to the expected closer faunal resemblance of adjacent areas relative to more distant ones; (2) randomness, which in the present context is a measure of the degree to which the inventories of the various sectors, provinces or regions may in each case be considered as a random sample of the inventory of the next largest province or region in a hierarchy of geographic scales; and (3) differentiation, which provides a measure of the uniqueness of the pattern. Results show that only polychaetes fulfill all 3 criteria and that the only marine biogeographic system supported by the analyses is the one proposed by Longhurst (1998). Energy fluxes and other interactions between the planktonic and benthic domains, acting over evolutionary time scales, can be associated with the multivariate pattern derived from the macrobenthos datasets. Third-stage multidimensional scaling ordination reveals that polychaetes produce a unique pattern when all systems are under consideration. Average island distance from the nearest coast, number of islands and the island surface area were the geographic variables best correlated with the community patterns produced by polychaetes. Biogeographic patterns suggest a vicariance model dominating over the founder-dispersal model except for the semi-closed regional seas, where a model substantially modified from the second option could be supported

Challenges for Sustained Observing and Forecasting Systems in the Mediterranean Sea

The Mediterranean community represented in this paper is the result of more than 30 years of EU and nationally funded coordination, which has led to key contributions in science concepts and operational initiatives. Together with the establishment of operational services, the community has coordinated with universities, research centers, research infrastructures and private companies to implement advanced multi-platform and integrated observing and forecasting systems that facilitate the advancement of operational services, scientific achievements and mission-oriented innovation. Thus, the community can respond to societal challenges and stakeholders needs, developing a variety of fit-for-purpose services such as the Copernicus Marine Service. The combination of state-of-the-art observations and forecasting provides new opportunities for downstream services in response to the needs of the heavily populated Mediterranean coastal areas and to climate change. The challenge over the next decade is to sustain ocean observations within the research community, to monitor the variability at small scales, e.g., the mesoscale/submesoscale, to resolve the sub-basin/seasonal and inter-annual variability in the circulation, and thus establish the decadal variability, understand and correct the model-associated biases and to enhance model-data integration and ensemble forecasting for uncertainty estimation. Better knowledge and understanding of the level of Mediterranean variability will enable a subsequent evaluation of the impacts and mitigation of the effect of human activities and climate change on the biodiversity and the ecosystem, which will support environmental assessments and decisions. Further challenges include extending the science-based added-value products into societal relevant downstream services and engaging with communities to build initiatives that will contribute to the 2030 Agenda and more specifically to SDG14 and the UN's Decade of Ocean Science for sustainable development, by this contributing to bridge the science-policy gap. The Mediterranean observing and forecasting capacity was built on the basis of community best practices in monitoring and modeling, and can serve as a basis for the development of an integrated global ocean observing system