Uso de Ultrasonidos en la patología del tendón del Tibial Posterior

Tibialis Posterior is one of the foot muscle that suffers so much injuries. Often this injuries get in the unit of the muscle and tendon. Below, we´ll do a review about the differents injuries in Tibialis posterior tendon structure and the therapeutics effects that offer us the use of the ultrasound therapy in its differents ways.El tibial posterior es uno de los músculos del pie sobre el que recae más patología. Siendo muy frecuente además la lesión en su estructura tendinosa. A continuación realizaremos un trabajo centrándonos para diferencias las diferentes lesiones que puede sufrir el tendón del músculo tibial posterior y los efectos terapéuticos que nos ofrece el uso de ultrasonidos en sus diferentes modalidades

Incidence of injuries at the foot of Dancer

El baile es una actividad que presenta numerosos beneficios a nivel físico, psíquico y social pero que en determinadas ocasiones puede provocar situaciones patológicas en aquellas personas que lo practican. La técnica en la Danza Clásica es especialmente agresiva con los pies, ya que requiere de fuerza y precisión muscular en los movimientos que se realizan. Por tanto las lesiones y afecciones que pueden sufrir nuestros bailarines son de interés para los profesionales sanitarios. El fin de este trabajo es intentar analizar la distribución de las lesiones que sufren para llegar a un conocimiento más profundo de esta situación logrando un adecuado tratamiento y actuando para disminuir su frecuencia, mediante un adecuado trabajo de prevención. El estudio nos deja entrever que la danza clásica es practicada mayoritariamente por mujeres y que éstas presentan mayor número de patologías podológicas donde las alteraciones de mayor predominio fueron hallux adductus valgus (HAV) e hiperqueratosis (HQ) encontrándose más patología músculo esquelética de la esperada al inicio del estudio.Dance is an activity that has many benefits at the physical, psychological and social level but in some occasions it could cause pathological situations in those persons who practice it. The technique in Classical dance is especially aggressive with their feet, as it requires muscle strength and precision in movements that are performed. Therefore injuries and affections that could suffer our dancers are interesting for health professionals. The purpose of this project is to try analyze the distribution of the injuries that suffered the dancer to reach a deeper knowledge of this situation getting a suitable treatment and acting in order to decrease its frequency, through an appropriate work of prevention. The study show us that classical ballet is practiced mostly by woman and they show larger number of podiatrist pathologies where the alterations highest prevalence were adductus hallux valgus (HAV) and hyperkeratosis (HQ) founding more skeletal muscle pathology than expected at the start of the study

Utilidad del test de la función sudomotora como instrumento clínico de clasificación de riesgo del paciente diabético

Una de las complicaciones más debilitantes de la Diabetes mellitus (DM) es la neuropatía diabética, siendo la polineuropatía diabética simétrica distal la forma más frecuente en pacientes con diabetes, y relacionada con un alto riesgo de ulceración del pie a causa de la pérdida de la sensibilidad. La neuropatía autónoma es un subtipo de neuropatía diabética que afecta a diferentes órganos y sistemas (digestivo, genitourinario, cardiovasculares, etc.) y su manifestación en los pies se refleja mediante una disfunción sudomotora y vasomotora. El diagnóstico clínico de la neuropatía se basa en la exploración del nervio lesionado, y las diferentes pruebas clínicas evalúan el tamaño (fibras grandes o pequeñas) o la función (autonómicas, fibras sensoriales o motoras) de las fibras nerviosas. En la práctica cotidiana, el examen clínico es la prueba de oro del diagnóstico de la neuropatía, sin embargo, a menudo es reconocida o diagnosticada de forma tardía. Las pruebas más utilizadas para la evaluación de la neuropatía sensorial son el monofilamento de Semmes-Weinstein 5.07-10g (MSW) y el biotensiómetro o diapasón de 28 Hz, que exploran las fibras largas mielinizadas A (tipos alfa y beta). Recientemente, se han descrito pruebas de diagnóstico de la función autonómica en base a la evaluación de la función sudomotora, mediante la aplicación de un parche indicador en la zona plantar del pie, para determinar la integridad simpática de la piel y la inervación colinérgica por fibras pequeñas tipo C no mielinizadas autonómicas. La principal utilidad del test de la función sudomotora (TFS) es su capacidad para reconocer los pacientes con neuropatía subclínica y establecer el riesgo de desarrollar una UPD de forma precoz..

Current status of pharmacological invasive treatments in Achilles tendinopathy

[Resumen] Objetivos: El objetivo es aportar evidencia científica sobre tratamientos invasivos farmacológicos para la tendinopatía Aquilea. Material y métodos: Se realizó una búsqueda en PubMed que abarcó trabajos desde 1984 hasta el 30 de enero de 2018 usando términos como: “Achilles tendinopathy and treatment”. “Corticosteroids” “Heparin”. Stem cell” “Platelet Rich Plama” Resultados: Se obtuvieron artículos sobre el tratamiento del tendón de Aquiles con corticoides, heparina, proloterapia, sustancias esclerosantes, transfusiones de sangre autóloga, células madre, plasma enriquecido en plaquetas y ácido hialurónico. Conclusiones: Los tratamientos invasivos evaluados pueden ser una opción de para la tendinopatía aquilea. No obstante hay que ser cauteloso con ciertos efectos adversos derivados de su uso.[Abstract] Objectives: The objective is to provide quality evidence on pharmacological invasive treatments in Achilles tendinopathy. Methods: A search was made in PubMed that included works from 1984 to January 30, 2018. Terms like “Achilles tendinopathy and treatment”. “Corticosteroids” “Heparin”. Stem cell” “Platelet Rich Plama” were used. Results: Articles about Achilles tendon were obtained with this treatments: corticosteroids, heparin, prolotherapy, sclerosing substance, autologous blood transfusions, stem cells, platelet rich plasma and hyaluronic acid. Conclusions: The invasive treatments evaluated may be an option for Achilles tendinopathy. However, we must be careful with certain adverse effects derived from its us

Current status of the validity and reliability of the sonographic assessment of the Achilles tendon

[Resumen] Objetivo: Conocer la validez y fiabilidad de la ecografía musculo esquelética en la valoración del tendón de Aquiles. Conocer los hallazgos ecográficos típicos en el tendón de Aquiles, tanto sano como lesionado. Material y métodos: Se realizó una revisión bibilográfica desarrollando una búsqueda en PubMed que abarcó trabajos desde 1984 hasta el 30 de enero de 2018 Se usaron los siguientes términos: “Ultrasound achilles tendon”, “Ultrasound triceps surae”, “Achilles tendinopathy ultrasound”. Se incluyeron artículos en base a su calidad metodológica, relevancia científica, aportación de una visión novedosa y su utilidad clínica. Resultados: Se encontraron artículos sobre la validez y fiabilidad de la evaluación del tendón de Aquiles, así como de estructuras próximas, con ecografía músculo esquelética. También se encontraron artículos sobre los hallazgos en la imagen del tendón de Aquiles sano y lesionado. Conclusiones: La literatura parece confirmar que la ecografía músculo esquelética es un método valido y fiable para evaluar la tendinopatía aquilea. Existirían diferencias ecográficas entre tendones sanos y lesionados, y no parece diferenciarse éste entre lesión crónica y desgarro interno. El engrosamiento tendinoso y la neovascularización deberían tenerse al diagnosticar la tendinopatía aquilea, pero su simple presencia no determinaría la severidad clínica.[Abstract] Objective: To determine the validity of skeletal muscle ultrasound in the evaluation of the Achilles tendon. To establish the typical sonographic findings in the Achilles tendon, both healthy and injured. Methods: A bibliographic review was carried out, developing a PubMed search that covered papers from 1984 to January 30, 2018. The following terms were used: “Ultrasound achilles tendón”, “Ultrasound triceps surae”, “Achilles tendinopathy ultrasound”. Articles were included based on their methodological quality, scientific relevance, contribution of novelty and their clinical usefulness. Results: Articles about the validity and reliability of the evaluation of the Achilles tendon, as well as of nearby structures, by skeletal muscle ultrasound were found. There were also articles about the findings in the image of the healthy and injured Achilles tendon. Conclusions: The literature seems to confirm that musculoskeletal ultrasound is a valid and reliable method to evaluate Achilles tendinopathy. There were sonographic differences between healthy and injured tendons, and this evaluation did not seem to differentiate between chronic injury and internal tear. Tendon thickening and neovascularization should be considered during diagnosis of Achilles tendinopathy, but the simple presence of these features would not determine the clinical severit

Effectiveness of median nerve neural mobilization versus oral ibuprofen treatment in subjects who suffer from cervicobrachial pain: a randomized clinical trial

9 p.Oral ibuprofen (OI) and median nerve neural mobilization (MNNM) are first line treatments for patients who suffer cervicobrachial pain (CP). OI may produce side effects which are not tolerated by all subjects who suffer CP, whereas MNNM has no known side effects. Therefore, the aim of this study was to assess the effectiveness of both treatments (OI vs. MNNM) in CP. Material and methods: This investigation was a blinded parallel randomized clinical trial (NCT02593721). Sixty-two participants diagnosed with CP were recruited and randomly assigned to 2 groups (n = 31), which received MNNM or 1200 mg/day OI treatment for 6 weeks. The numeric rating scale for pain intensity was the primary outcome. The cervical rotation range of motion (CROM) and the upper limb function were the secondary outcomes. Results: The results showed that OI treatment (η2 = 0.612–0.755) was clearly superior to MNNM (η2 = 0.816–0.821) in all assessments (p 0.05). Three subjects were discharged because of OI side effects. Conclusions: Oral ibuprofen may be superior to MNNM for pain reduction and upper limb function increase of subjects with CP. Nevertheless, both treatments were effective. Median nerve neural mobilization may be considered an effective non-pharmaceutical treatment option in subjects with CP. Regarding OI adverse effects, our findings challenge the role of pharmacologic versus manual therapy as possible treatments that may improve pain intensity and upper limb functionality in subjects with CP. Effectiveness of median nerve neural mobilization versus oral ibuprofen treatment... | Request PDF. Available from: https://www.researchgate.net/publication/320554952_Effectiveness_of_median_nerve_neural_mobilization_versus_oral_ibuprofen_treatment_in_subjects_who_suffer_from_cervicobrachial_pain_a_randomized_clinical_trial [accessed Mar 08 2018].S

Medical Versus Surgical Treatment for the Management of Diabetic Foot Osteomyelitis: A Systematic Review

A systematic review and quality assessment was performed to assess the management of diabetic foot osteomyelitis by medical or surgical treatment. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist was used. All selected studies were evaluated using the Cochrane Risk of Bias Tool to assess the risk of bias for randomized controlled trials. The literature was revised using PubMed (Medline) and Embase (Elsevier) up to September 2020 to identify clinical trials assessing medical or surgical treatment to manage diabetic foot osteomyelitis. A total of six clinical trials that met our inclusion criteria, with a total of 308 participants. Healing rate, complete closure of the wound, and type of complications were the outcomes evaluated. Risk of bias assessment showed that only two of the six clinical trials included in the systematic review had a low risk of bias. Based on our findings, we believe that the management of diabetic foot osteomyelitis remains challenging. There are few high-quality clinical trials that both stratify clinical presentations and compare these treatments. We conclude that the available evidence is insufficient to identify the best option to cure diabetic foot osteomyelitis

Long-Term Complications after Surgical or Medical Treatment of Predominantly Forefoot Diabetic Foot Osteomyelitis: 1 Year Follow Up

Aim: To compare long-term complications according to the treatment received for management of diabetic foot osteomyelitis (surgical or medical) at 1 year follow up. Design and Participants: A prospective observational study was conducted involving 116 patients with diabetic foot osteomyelitis. The patients received surgical or medical treatment based on the principles described in the literature. To register the development of a complication, both groups of treatments were followed-up 1 year after the ulcer had healed. Results: Ninety-six (82.8%) patients received surgical treatment and 20 (17.2%) medical treatment. No differences were found in the time to healing between both groups of treatment, 15.7 ± 9.2 weeks in the surgical group versus 16.4 ± 12.1 weeks in the medical group; p = 0.103. During follow up, 85 (73.3%) patients developed complications without differences between both groups, 68 (70.8%) in the surgical group versus 17 (85%) in the medical group (p = 0.193). The most common complication in both groups was re-ulceration. We did not observe significant differences comparing complication-free time survival between both treatments (p = 0.665). Conclusion: The onset of complications after healing in patients who suffered from diabetic foot osteomyelitis was not associated with the treatment received. Surgical and medical approaches to the management of diabetic foot osteomyelitis produced similar results in long-term follow up

GEODIVULGAR: Geología y Sociedad

Fac. de Ciencias GeológicasFALSEsubmitte

Geodivulgar: Geología y Sociedad

Con el lema “Geología para todos” el proyecto Geodivulgar: Geología y Sociedad apuesta por la divulgación de la Geología a todo tipo de público, incidiendo en la importancia de realizar simultáneamente una acción de integración social entre estudiantes y profesores de centros universitarios, de enseñanza infantil, primaria, de educación especial y un acercamiento con público con diversidad funcional