Efectividad de la fibrolisis instrumental miofacial en pacientes con espasmos a nivel de músculo trapecio

RESUMEN: Liberación miofascial instrumental es una técnica instrumental de fisioterapia indicada para el tratamiento de las algias mecánicas del aparato locomotor por la destrucción de adherencia y los corpúsculos irritativos interaponeuroticos o mioaponeuroticos “Mediante unos ganchos aplicados sobre la piel “,objetivo de la presente investigación es comprobar la efectividad de la fibrolisis instrumental miofascial en el tratamiento de pacientes con espasmos a nivel de musculo trapecio. Metodología de tipo descriptivo es un alcance que ayuda a determinar las diferentes maneras en las cuales pueden presentarse las variables que se van a estudiar en una población.de rehabilitación en la muestra se incluyeron 30 pacientes de ambos sexos con espasmos, de trapecio que acuden al área de terapia física del Hospital Teodoro Maldonado Carbo. La elección de la muestra es no probabilística porque no se escogerá aleatoriamente sino solo aquellos que cumplan los criterios de inclusión. Resultados: se presentan catorce gráficas, reflejado de la siguiente forma: 1. Frecuencia de la patología según el sexo 2. Promedio de edad de la población 3. Resultados de escala de eva 4. Resultado de la prueba del trapecio 5. resultado de examen físico 6. test de flexibilidad de la cintura escapular 7. Test de flexibilidad de miembro superior derecho 8. Test de flexibilidad de miembro superior izquierdo 9. Test de goniometría de flexión de la columna cervical 10. Test de goniometría de extensión de la columna cervical 11. Test de goniometría de rotación lateral derecha de la columna cervical 12. Test de goniometría de rotación lateral izquierda de la columna cervical 13. Test de goniometría de inclinación lateral derecha de la columna cervical 14. Test de goniometría de inclinación lateral izquierda de la columna cervical Conclusión: La implementación de la técnica de fibrolisis instrumental miofascial para espasmos en el músculo trapecio manifestó una respuesta positiva como plan de tratamiento, Recomendación: Realizar futuros estudios e investigaciones acerca de la fibrolisis instrumental miofascial ya que es un método el cual consta de basta actualización científica por lo que se incentiva a los intérpretes de la rehabilitación continuar con un desarrollo integral del tema presentado. ABSCTRACT: The Myofascial Instrumental Liberation its a Physiotherapy instrumental technique used on the treatment of mechanical pains of the human movement system due to adherence destruction and caused by interponeurotics or myoponeurotics corpuscle “through the use of hooks over the skin” OBJECTIVE this research its to proof the efectiveness of the Miofascial Instrumental Liberation on the treatment of patients with spasm at trapezius muscle level. METHODOLOGY of descriptive type its a method that help us defined different ways to represent and show variables to study on a research population used for treatment that includes 30 patients from both sexes that suffer from spasm at trapezius muscle level that are treated on the Physical Therapy area at Hospital Teodoro Maldonado Carbo. The Selection of this Sample was made non-probabilistic due to the research patients require to fill a criteria to be chosen for this research. RESULTS on this Fourteen graphics are shown the next information obtained: 1. Sex frequency over this patology, 2 Average Age of the research population, 3. EVA Scale Results, 4. Trapezius Test Results, 5. Physical Exam Results, 6. Shoulder Girdle Flexibility Test, 7. Superior Right member Flexibility Test, 8. Superior Left member Flexibility Test, 9. Cervical Spine goniometry Flexion test, 10 Cervical Spine goniometry Extension test, 11 Cervical Spine Right rotation goniometry test, 12. Cervical Spine Left rotation goniometry test, 13. Cervical Spine Right Inclination goniometry test, 14. Cervical Spine Left Inclination goniometry test CONCLUSION The Implementation of The Myofascial Instrumental Technique has shown positive results as a treatment plan, RECOMENDATION Elaborate future studies and research about the Miofascial Instumental Technique because its a vast cientific method; its advised to Physicians and Physical Therapist to continue develop this Subject

Final report of the short-term contract for ICCAT SMYTP for the biological samples collection for growth, maturity and genetics studies – Year #3

This document is the final report of the third year of the short-term contract of the Small Tuna Year Program by ICCAT, with the objectives of: a) conduct additional sampling aiming to fill the specific gaps of the biological samples for estimating the growth and maturity parameters for BON and LTA; b) estimate the referred parameters for both species, and preliminary provide preliminary results for WAH; and, c) refine the sampling and stock structure analysis for BON, LTA and WAH. A total of 374 individuals were collected: 145 of BON, 139 of LTA and 90 WAH. Initial target size class was accomplished only for BON in the Mediterranean. Small individuals are need in the Northeast and no samples were obtained in Southeast Atlantic. For LTA, total target sizes were not completely achieved in any case. However, preliminary results were obtained for growth and reproductive parameters. For BON, with samples arrived from Morocco, no genetic differentiation was detected, and the hypothesis provided in the previous contract is maintained. The population genetic analysis of WAH presents a scenario of homogeneous distribution.En prensa

Feeding difficulties in children with food allergies: An EAACI Task Force Report

The term “feeding difficulties” refers to a spectrum of phenotypes characterized by suboptimal intake of food and/or lack of age‐appropriate eating habits. While it is evident that feeding difficulties are prevalent within healthy children, no consensus has been reached for those with food allergies. The aim of this study was to systematically review all the available literature reporting the prevalence of feeding difficulties within food allergic children. We searched eight international electronic databases for all published studies until June 2022. International experts in the field were also contacted for unpublished and ongoing studies. All publications were screened against pre‐defined eligibility criteria and critically appraised by established instruments. The substantial heterogeneity of included studies precluded meta‐analyses, so narrative synthesis of quantitative data was performed. A total of 2059 abstracts were assessed, out of which 21 underwent full‐text screening and 10 studies met the study criteria. In these, 12 different terms to define feeding difficulties and 11 diagnostic tools were used. Five papers included data of feeding difficulty prevalence in children with food allergies, ranging from 13.6% to 40%. Higher prevalence was associated with multiple food allergies. The current literature suggests that feeding difficulties are prevalent within food allergic children, particularly those with multiple food allergies. However, the heterogeneity of terminologies and diagnostic tools makes drawing conclusions challenging. Consensus guidelines for the diagnosis and management of feeding difficulties within food allergic children and further research on the development and perpetuation of feeding difficulties are needed to appropriately manage such patients

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Bienvenida sonrisa : Parte II

La Facultad de Odontología de la Universidad Nacional de La Plata, desde el año 1997, desarrolla un Programa de Salud Bucal en la ciudad de La Plata y sus alrededores, a través de la Asignatura Odontología Preventiva y Social. Esto ha permitido obtener datos estadísticos y de relevamiento de zonas, que impulsa la formulación de nuevas iniciativas en poblaciones vulnerables donde el índice de incidencia de enfermedades bucodentales, es elevado. Entendemos a la salud bucal como un valor que no debe ser considerado como un privilegio, sino como un derecho de todas las personas, reforzando el trabajo multidisciplinario de manera de que la salud recuperada, se mantenga a lo largo del tiempo, con el objetivo de disminuir las desigualdades en salud y con el propósito de brindar atención a poblaciones de difícil acceso, por este motivo, creemos que es fundamental la gestión del Trabajo Social , trabajando de forma efectiva con la comunidad, colaborando en la promoción de la salud y prevención de la enfermedad. Teniendo conocimiento de que la escuela es un espacio privilegiado y del encuentro con el otro, enfocamos nuestros esfuerzos en colaborar para modificar la realidad que se presenta.Este Proyecto surge debido a la necesidad de la Comunidad Educativa perteneciente a la Escuela Nº 45 “Manuel Rocha” del barrio El Mondongo de la Ciudad de La Plata, quienes manifiestan la carencia de información y atención de la comunidad educativa en cuanto a acciones preventivas. Este proyecto se lleva a cabo desde fines del 2019, atravesando el contexto de Pandemia por el virus causante de la enfermedad Covid-19, reacondicionando nuestras actividades.Facultad de Odontologí

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Destructive fishing : an expert‐driven definition and exploration of this quasi‐concept

Numerous policy and international frameworks consider that “destructive fishing” hampers efforts to reach sustainability goals. Though ubiquitous, “destructive fishing” is undefined and therefore currently immeasurable. Here we propose a definition developed through expert consultation: “Destructive fishing is any fishing practice that causes irrecoverable habitat degradation, or which causes significant adverse environmental impacts, results in long-term declines in target or nontarget species beyond biologically safe limits and has negative livelihood impacts.” We show strong stakeholder support for a definition, consensus on many biological and ecological dimensions, and no clustering of respondents from different sectors. Our consensus definition is a significant step toward defining sustainable fisheries goals and will help interpret and implement global political commitments which utilize the term “destructive fishing.” Our definition and results will help reinforce the Food and Agricultural Organization's Code of Conduct and meaningfully support member countries to prohibit destructive fishing practices

Contribution of proteomics to transfusion medicine : impact of transfusion plasma pathogen inactivation and storage conditions on plasmatic proteins

Bien que la protéomique ait été largement appliquée pour l’étude du plasma humain, son application dans le domaine de la transfusion sanguine reste peu employée. En collaboration avec l’EFS, l’objectif de cette thèse a donc été de proposer des outils analytiques destinés à évaluer l’impact des traitements d’inactivation des agents pathogènes et des conditions de stockage sur les protéines plasmatiques. Le traitement au bleu de méthylène est le traitement d’inactivation virale le plus utilisé en France. Une approche globale et ciblée se sont intéressées aux modifications induites par ce traitement photochimique. Plusieurs modifications, notamment sur les sous-unités du fibrinogène, ont pu être identifiées, après analyse nanoLC-nanoESI-Qh-FT-ICR MS. L’origine de la diminution d’activité du fibrinogène a pu ainsi être expliquée. Une étude thermique a permis d’identifier un marqueur de dégradation plasmatique: la RBP4. Dans le plasma, elle forme un complexe avec la transthyrétine. Lors de la dégradation du plasma, ce complexe se dissocie. Une méthode de quantification absolue, basée sur des peptides AQUA, a été développée permettant de doser RPB4 libérée dans le plasma au cours de la conservation du plasma. Enfin, deux matrices innovantes pour l’électrophorèse sur gel ont été évaluées pour la séparation de protéines plasmatiques. L’une incorpore un polymère préformé, le dextran, à une solution d’acrylamide classique. L’autre fait appel à un polymère hydrophile, le NAT. Toutes deux présentent de bonnes propriétés optiques et mécaniques, augmentent significativement la résolution des spots protéiques et facilitent l’identification des protéines par MS.Proteomics has been widely applied to study plasmatic proteins; its application to the field of transfusion medicine is s quite recent. In partnership with the French blood agency (EFS), the main objective of the Ph.D work was to provide analytical tools to evaluate the impact of pathogen inactivation treatments and storage conditions on plasmatic proteins. Photochemical treatment using methylene-blue is the most used for pathogen inactivation in France. Both a global and targeted studies were carried to determine the proteins modifications involved by this treatment. Based on nanoLC-nanoESI-Qh-FT-ICR MS analyses, several modifications were pointed out, especially targeting the sub-unit of fibrinogen. This allows the decrease in fibrinogen clottability after methylene-blue treatment to be explained.A study of thermal degradation on plasma sample pointed out a new marker of plasma degradation: the RBP4. It circulates associated to with transthyretin as a macromolecular complex: during degradation, this complex dissociates releasing RBP4 in plasma. An absolute quantification method was developed using AQUA peptides to assay the amount of the free form of RBP4 in plasma during storage.Two innovative matrices for gel electrophoresis were developed and evaluated for plasma protein separation. One of them relies on the use on a preformed polymer incorporated prior to acrylamide polymerization. The other one is based on a hydroxylated acrylamide monomer, the N-acryol-tris(hydroxymethyl)-amino methane. Both exhibited interesting optical and mechanical properties, enhanced spot resolution and outstanding protein/peptide recovery, which facilitates protein identification by MS