Efectividad del vendaje neuromuscular en las secuelas del ictus: una revisión sistemática

[Resumen] Introducción: el ictus o accidente cerebrovascular (ACV) representa la tercera causa de muerte en España y la primera causa de dependencia en el adulto derivada de sus secuelas. El vendaje neuromuscular o Kinesio Taping (KT) es una de las intervenciones que se aplican actualmente en los tratamientos de rehabilitación de las secuelas musculoesqueléticas del ictus. Objetivos: conocer la efectividad del vendaje neuromuscular en la recuperación funcional y/o mejora de la sintomatología en pacientes con secuelas musculoesqueléticas postictus, a partir de la revisión sistemática de la bibliografía publicada al respecto. Justificación: el KT es una técnica que empíricamente aporta buenos resultados en el tratamiento de múltiples alteraciones estructurales o funcionales del sistema musculoesquelético. Metodología: se ha llevado a cabo una revisión sistemática de la literatura mediante una búsqueda exhaustiva en las principales bases de datos especializadas en ciencias de la salud. Se incluyeron revisiones sistemáticas y ensayos clínicos, publicados en los últimos 10 años, en idioma inglés, francés, portugués o español, en los que se analizara la efectividad del KT en el tratamiento de las secuelas musculoesqueléticas del ictus. Se realizó una evaluación de calidad metodológica de aquellos estudios que cumplieron los criterios de inclusión, como último filtro de selección. Fueron seleccionadas las siguientes variables de estudio: intensidad del dolor en el hombro, rango de movilidad (ROM) del hombro y del tobillo, volumen de edema del miembro superior, espasticidad de los músculos de la pierna, velocidad de la marcha y longitud del paso, funcionalidad del miembro superior y calidad de vida. Resultados: fueron seleccionados siete artículos para la revisión final. El KT tuvo efectos inmediatos en la disminución del dolor y la discapacidad del miembro superior, así como en el aumento del ROM del tobillo y de la actividad muscular de la pierna. También produjo efectos favorables en el corto plazo sobre la disminución del dolor en el hombro. En cambio, para el resto de secuelas estudiadas, no se mostró más eficaz que el tratamiento estándar o que el placebo. Conclusiones: la aplicación de KT, asociado a otras técnicas de fisioterapia, se considera una intervención segura y puede ofrecer beneficios inmediatos y a corto plazo en el tratamiento de las secuelas musculoesqueléticas del ictus, pero se precisan más estudios con rigor metodológico y nivel alto de evidencia científica que den respuesta a las lagunas de conocimiento existentes acerca de su mecanismo de actuación según el tipo de aplicación, y de su efectividad a lo largo del tiempo sobre las diversas secuelas musculoesqueléticas del ictus.[Abstract] Introduction: Stroke represents the third cause of death in Spain and the first cause of dependence in adults derived from its sequelae. Kinesio Taping (KT) is one of the interventions currently applied in rehabilitation of post-stroke musculoskeletal sequelae. Objectives: To know the effectiveness of KT on functional recovery as well as the improvement of the symptomatology in patients with post-stroke musculoskeletal sequelae from the systematic review of the published bibliography. Justification: KT is a technique that empirically provides good results in the treatment of multiple structural or functional alterations of the musculoskeletal system. Methodology: A systematic review of the published literature has been carried out through a comprehensive search of the main databases specialized in health sciences. Systematic reviews and clinical trials in which the effectiveness of KT in the treatment of musculoskeletal sequelae of stroke is analyzed and which have been published in the last ten years in English, French, Portuguese or Spanish, are also included. As the last selection filter, a methodological quality assessment was carried out of those studies that met the inclusion criteria. The following clinical variables were selected: pain intensity in the shoulder, range of motion (ROM) of the shoulder and ankle, volume of edema of the upper limb, lower leg spasticity, gait speed and step length, upper limb functionality and quality of life. Results: Seven studies were included in the final review. KT had immediate effects on the decrease of pain and disability of the upper limb as well as on the increase of the range of motion of the ankle and the muscular activity in lower limb. It also produced favorable short-term effects on the reduction of pain in the shoulder. In contrast, KT was not more effective than standard treatment or placebo for the rest of the sequelae studied. Conclusion: the application of KT combined with other physiotherapy techniques is considered a safe intervention and may offer immediate and short-term benefits in the treatment of post-stroke musculoskeletal sequelae. Nevertheless, more studies with methodological rigor and high-level evidence are required to respond to existing gaps in knowledge about its mechanism of action depending on the type of application and its effectiveness over time on the multiple post-stroke musculoskeletal sequelae.[Resumo] Introdución: o ictus ou o accidente vascular cerebral (ACV) representa a terceira causa de morte en España e a primeira causa de dependencia en adultos derivada das súas secuelas. O vendaxe neuromuscular ou Kinesio Taping (KT) é unha das intervencións que se aplican actualmente nos tratamentos de rehabilitación das secuelas musculoesqueléticas do ACV. Obxectivos: coñecer a eficacia do KT na recuperación funcional e / ou mellora da sintomatoloxía en pacientes con secuelas musculoesqueléticas do ACV, a partir da revisión sistemática da literatura publicada. Xustificación: o KT é unha técnica que proporciona empíricamente bos resultados no tratamento de múltiples alteracións estruturais ou funcionais do sistema músculo-esquelético. Metodoloxía: realizouse unha revisión sistemática da literatura a través dunha exhaustiva busca nas principais bases de datos especializadas en ciencias da saúde. Están incluídos revisións sistemáticas e ensaios clínicos, publicados nos últimos 10 anos, en inglés, francés, portugués ou español, nos que se analiza a eficacia do KT no tratamento das secuelas musculoesqueléticas do ictus. Levouse a cabo unha avaliación de calidade metodolóxica dos estudos que cumpriron os criterios de inclusión, como o último filtro de selección. Se seleccionaron as seguintes variables de estudo: intensidade da dor no ombreiro, rango de mobilidade (ROM) do ombreiro e do nocello, volume de edema dos membros superiores, espasticidade dos músculos da perna, velocidade de marcha e lonxitude de paso , funcionalidade do membro superior e calidade de vida. Resultados: sete artigos foron seleccionados para a revisión final. O KT tivo efectos inmediatos na diminución da dor e discapacidade do membro superior, así como no aumento do ROM do nocello e na actividade muscular da perna. Tamén produciu efectos favorables a curto prazo sobre a redución da dor no ombreiro. En contraste, para o resto das secuelas estudadas, non era máis eficaz que o tratamento estándar ou o placebo. Conclusións: a aplicación da KT, asociado a outras técnicas de fisioterapia, é considerado un procedemento seguro e pode ofrecer beneficios inmediatos e a curto prazo no tratamento das secuelas musculoesqueléticas do ACV, pero máis estudos con rigor metodolóxico e altos estándares de evidencia científica son necesarios para responder ás lagoas no coñecemento sobre o seu mecanismo de acción, dependendo do tipo de aplicación, e a súa eficacia ao longo do tempo sobre as diversas secuelas musculoesqueléticas do ACV.Traballo fin de mestrado (UDC.FCS). Asistencia e investigación sanitaria. Especialidade en investigación clínica. Curso 2017/201

Feasibility Study of an Educational Intervention to Improve Water Intake in Adolescent Soccer Players: A Two-Arm, Non-Randomized Controlled Cluster Trial

Futbol; Comportament; Promoció de la salut; Adolescent; Estat d’hidratació corporalFútbol; Comportamiento; Promoción de la salud; Adolescente; Estado de hidratación corporalSoccer; Behavior; Health promotion; Adolescent; Body hydration statusThis study aimed to assess the feasibility of an educational intervention on hydration behavior in adolescent soccer players. A pilot study of a two-arm, non-randomized controlled cluster trial was conducted. A total of 316 players aged 13-16 agreed to participate. The response variables were the players' participation in the intervention, their perception of the knowledge acquired, the usefulness and the overall assessment of the intervention. Hydration patterns and acquisition of knowledge on hydration behavior were also assessed. The intervention involved two elements: posters and a web app. A total of 259 adolescents completed the study (intervention group (IG) = 131; control group (CG) = 128). 80.6% of the players responded to the survey assessing the feasibility of the intervention. The mean number of correct answers regarding behavior was significantly higher in the IG (3.54; SD = 1.162) than in the CG (2.64; SD = 1.174) (p < 0.001). The water consumption pattern at all the clubs was ad libitum. Of the players, 10% did not drink any water at all during the game. In conclusion, this intervention has been shown to be feasible for implementation with adolescent soccer players. It suggests that hydration guidelines should be informed by personal factors and that ad libitum water consumption should be avoided

Water-assisted HDO of biomass model compounds enabled by Ru-based catalysts

Biofuels upgrading gathering momentum in view of the gradual depletion of fossil fuels and the pursuit of renewable energy sources to mitigate global warming. Hydrodeoxygenation (HDO) is a key reaction in the upgrading of bio-oil to produce hydrocarbon fuels or high-value chemicals. Oxygen removal in bio-oil increases its calorific value, improve thermal and chemical stability, reduce corrosiveness, etc., making the upgraded bio-oil suitable as a fuel or blending fuel. However, the dependence on high-pressure hydrogen is a serious disadvantage, as it is an expensive resource whose use also poses safety concerns. In this scenario, we propose a pioneering route for model biomass compounds upgrading via H2-free HDO. Herein we have developed multifunctional catalysts based on Ru and ceria supported on carbon able conduct the hydrodeoxygenation reaction using water as hydrogen source. We found that cerium oxide improves ruthenium metallic dispersion and the overall redox properties of the multicomponent system leading to enhanced catalytic performance. Along with the successful catalytic formulation we identify 300 °C as an optimal temperature validating the H2-free HDO route for bio-compounds upgrading.Ministerio de Ciencia e Innovación (MICIN). España PID2019-108502RJ-I00, IJC2019-040560-I, PLEC2021-008086, FPU21/ 04873European Commission (EC) PID2019-108502RJ-I00, IJC2019-040560-I, PLEC2021-008086Junta de Andalucía P20_0066

El grupu neandertal de la Cueva d'El Sidrón (Borines, Piloña).

Na monografía clásica de Puig y Larraz (1896: 250-252) amiéntense delles cavidaes del Conceyu de Piloña2 , pero non la Cueva d’El Sidrón (Fig. 1). Esta conocíase, ensin dulda, dende la Guerra Civil y el maquis al servir d’abellugu a persiguíos políticos, y guarda una alcordanza imborrable nuna de les sos múltiples entraes, yá qu’ellí ta enterrada Olvido Otero González (1908-1938). Per El Sidrón pasaron munches persones a lo llargo de los años, pero en 1994 prodúxose’l descubrimientu per parte d’unos espeleólogos xixoneses d’unos güesos humanos que dieron un importante xiru a la conocencia de los nuesos antepasaos neandertale

El grupu neandertal de la Cueva d' El Sidrón (Borines, Piloña)

El artículo está en la lengua asturianaPeer reviewe

Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

2 nd Brazilian Consensus on Chagas Disease, 2015

Abstract Chagas disease is a neglected chronic condition with a high burden of morbidity and mortality. It has considerable psychological, social, and economic impacts. The disease represents a significant public health issue in Brazil, with different regional patterns. This document presents the evidence that resulted in the Brazilian Consensus on Chagas Disease. The objective was to review and standardize strategies for diagnosis, treatment, prevention, and control of Chagas disease in the country, based on the available scientific evidence. The consensus is based on the articulation and strategic contribution of renowned Brazilian experts with knowledge and experience on various aspects of the disease. It is the result of a close collaboration between the Brazilian Society of Tropical Medicine and the Ministry of Health. It is hoped that this document will strengthen the development of integrated actions against Chagas disease in the country, focusing on epidemiology, management, comprehensive care (including families and communities), communication, information, education, and research