Efectos de los programas de autocuidado en pacientes con trastorno temporomandibular. Revisión bibliográfica.

Introducción El trastorno temporomandibular es un conjunto de afectaciones de la articulación temporomandibular y todas las estructuras asociadas. Afecta a ambos sexos, pero de manera predominante a las mujeres. Los programas de autocuidado son parte del tratamiento conservador y demuestran ser de gran utilidad en la reducción de la sintomatología de los pacientes, así como en la mejora de la calidad de vida. ● Objetivos Analizar la evidencia sobre el autocuidado en pacientes con trastornos temporomandibulares, así como, identificar las variables de tratamiento y las intervenciones aplicadas, evaluando los resultados obtenidos y los posibles efectos adversos. ● Material y Métodos Se elabora una revisión bibliográfica, a partir de diferentes estudios, extraídos de diferentes bases de datos: Pubmed, PEDro, Scopus, Web of Science y Science Direct. Solo se incluyeron ensayos clínicos aleatorizados, desde 2013 a 2023. ● Resultados En la revisión se incluyeron 6 estudios. Estos demostraron la eficacia de los programas de autocuidado en los trastornos temporomandibulares. El dolor y la apertura bucal mejoraron en todos los grupos de estudio, no mostrando casi diferencias entre ellos. Los sonidos articulares tuvieron una disminución mayor en los grupos que utilizaban férula de mordida. Además, se demostró la eficacia del autocuidado reduciendo la ansiedad y la depresión. ● Conclusiones Los programas de autocuidado evidencian mejoras de los síntomas de los pacientes, evaluando diferentes variables de estudio como el dolor o la apertura bucal. A pesar de esto, se necesitan más investigaciones para tener mayor evidencia.Introduction Temporomandibular disorder is a set of affectations in the temporomandibular joint and all its associated structures. It affects both genders but predominates in women. Self-care programs are part of conservative treatment and prove to be useful in reducing the symptoms of patients, and in improving the quality of life. ● Objectives Analyze the efficiency of self-care to patients with temporomandibular disorder, as well as, identify treatment variables and applied interventions, evaluating the results obtained and possible adverse effects. ● Material and methods A bibliographical review is elaborated, with different studies, extracted from different databases: Pubmed, PEDro, Scopus, Web of Science and Science Direct. Only randomized clinical trials were included from 2013 to 2023. ● Results In review, 7 articles were included. These demonstrated the efficacy of self-care programs in tmj disorders. Pain and mouth opening improved in all studygroups, showing almost no difference between them. Joint sounds decreased more in the bite splint groups. Also, the effectiveness of self-care in reducing anxiety and depression was demonstrated. ● Conclusions Self-care programs evidences improvement in symptoms of patients, evaluating differents study variables such as pain or mouth opening. Despite this, more research is needed to have more evidence

Acadèmia i art: dinàmiques, transferències i significació a l'època moderna i contemporània

Coordinadores: Irene Gras I Mireia FreixaLes acadèmies de belles arts han estat unes de les institucions més importants en l’esfera cultural dels darrers segles a Occident, com a centres formadors i també com a organismes reguladors de la pràctica artística. Les contribucions aplegades en aquest volum busquen incidir en aspectes com l’evolució dels paradigmes estètics impulsats des de cada entitat, les relacions nacionals i internacionals amb altres institucions, la formació impartida o el funcionament dels centres i els seus protagonistes. Amb l’estímul d’unes jornades organitzades pel grup de recerca GRACMON en col·laboració amb la Reial Acadèmia Catalana de Belles Arts de Sant Jordi, Acadèmia i art proposa noves interpretacions i vies de lectura entorn de les acadèmies fomentant el debat sobre el paper que tenen en el present i que hauran de tenir en el futur

cDf International Congress : proceedings : actes, actas : actes, Barcelona Jun. 2013

El Congrés Internacional coupDefouet Barcelona 2013 ha estat una iniciativa de l'Art Nouveau European Route – Ruta Europea del Modernisme, organitzada per l'Institut del Paisatge Urbà de l'Ajuntament de Barcelona i el grup de recerca GRACMON de la Universitat de BarcelonaCoordinació: Lluís Bosch, Mireia Freixa.[eng] In 2013 the magazine coupDefouet reached its first decade of existence. As a way of celebrating this, the Art Nouveau European Route – the association of cities and other local institutions for the promotion and diffusion of Art Nouveau heritage that created the magazine – organised a magnificent international congress as a framework for scientific exchange and raising public awareness. The first coupDefouet International Congress on Art Nouveau was held in Barcelona, the city from which coupDefouet is published and one of the undisputable world capitals of Art Nouveau. This volume of the Singularitats series comprises the proceedings of that event.[cat] L’any 2013 va fer deu anys de l’aparició de coupDefouet, la revista de la Ruta Europea del Modernisme, una associació de municipis i altres entitats locals per a la promoció i la difusió del patrimoni modernista o Art Nouveau. Per commemorar-ho, s’organitzà un congrés internacional amb l’objectiu de contribuir al coneixement científic i la difusió d’aquest moviment artístic. El primer Congrés Internacional coupDefouet se celebrà a Barcelona, la ciutat en què s’edita coupDefouet i una de les capitals indiscutibles de l’Art Nouveau. En aquest volum de Singularitats s’apleguen les actes d’aquell esdeveniment

Ticagrelor in patients with diabetes and stable coronary artery disease with a history of previous percutaneous coronary intervention (THEMIS-PCI) : a phase 3, placebo-controlled, randomised trial

Background: Patients with stable coronary artery disease and diabetes with previous percutaneous coronary intervention (PCI), particularly those with previous stenting, are at high risk of ischaemic events. These patients are generally treated with aspirin. In this trial, we aimed to investigate if these patients would benefit from treatment with aspirin plus ticagrelor. Methods: The Effect of Ticagrelor on Health Outcomes in diabEtes Mellitus patients Intervention Study (THEMIS) was a phase 3 randomised, double-blinded, placebo-controlled trial, done in 1315 sites in 42 countries. Patients were eligible if 50 years or older, with type 2 diabetes, receiving anti-hyperglycaemic drugs for at least 6 months, with stable coronary artery disease, and one of three other mutually non-exclusive criteria: a history of previous PCI or of coronary artery bypass grafting, or documentation of angiographic stenosis of 50% or more in at least one coronary artery. Eligible patients were randomly assigned (1:1) to either ticagrelor or placebo, by use of an interactive voice-response or web-response system. The THEMIS-PCI trial comprised a prespecified subgroup of patients with previous PCI. The primary efficacy outcome was a composite of cardiovascular death, myocardial infarction, or stroke (measured in the intention-to-treat population). Findings: Between Feb 17, 2014, and May 24, 2016, 11 154 patients (58% of the overall THEMIS trial) with a history of previous PCI were enrolled in the THEMIS-PCI trial. Median follow-up was 3·3 years (IQR 2·8–3·8). In the previous PCI group, fewer patients receiving ticagrelor had a primary efficacy outcome event than in the placebo group (404 [7·3%] of 5558 vs 480 [8·6%] of 5596; HR 0·85 [95% CI 0·74–0·97], p=0·013). The same effect was not observed in patients without PCI (p=0·76, p interaction=0·16). The proportion of patients with cardiovascular death was similar in both treatment groups (174 [3·1%] with ticagrelor vs 183 (3·3%) with placebo; HR 0·96 [95% CI 0·78–1·18], p=0·68), as well as all-cause death (282 [5·1%] vs 323 [5·8%]; 0·88 [0·75–1·03], p=0·11). TIMI major bleeding occurred in 111 (2·0%) of 5536 patients receiving ticagrelor and 62 (1·1%) of 5564 patients receiving placebo (HR 2·03 [95% CI 1·48–2·76], p<0·0001), and fatal bleeding in 6 (0·1%) of 5536 patients with ticagrelor and 6 (0·1%) of 5564 with placebo (1·13 [0·36–3·50], p=0·83). Intracranial haemorrhage occurred in 33 (0·6%) and 31 (0·6%) patients (1·21 [0·74–1·97], p=0·45). Ticagrelor improved net clinical benefit: 519/5558 (9·3%) versus 617/5596 (11·0%), HR=0·85, 95% CI 0·75–0·95, p=0·005, in contrast to patients without PCI where it did not, p interaction=0·012. Benefit was present irrespective of time from most recent PCI. Interpretation: In patients with diabetes, stable coronary artery disease, and previous PCI, ticagrelor added to aspirin reduced cardiovascular death, myocardial infarction, and stroke, although with increased major bleeding. In that large, easily identified population, ticagrelor provided a favourable net clinical benefit (more than in patients without history of PCI). This effect shows that long-term therapy with ticagrelor in addition to aspirin should be considered in patients with diabetes and a history of PCI who have tolerated antiplatelet therapy, have high ischaemic risk, and low bleeding risk