Resumen Introducción: los fisioterapeutas y fonoaudiólogos como profesionales de la salud generan impacto en el rol educativo realizando acciones dentro de sus competencias de detección temprana y oportuna de las alteraciones que se presentan frecuentemente en educación inicial y preescolar a nivel de los procesos motores y comunicativos. Objetivo: realizar una reflexión sobre el rol del fisioterapeuta y el fonoaudiólogo en la educación inicial y preescolar de niños en Colombia. Reflexión: es necesaria la inclusión de los fisioterapeutas y los fonoaudiólogos en el sector educativo, formando grupos interdisciplinares en conjunto con los docentes, familias, e instituciones educativas con el fin de impactar positivamente en el bienestar comunicativo y desarrollo motor de la población que se encuentra en educación inicial y preescolar. Conclusión: se resalta la importancia de incluir a los fisioterapeutas y fonoaudiólogos en el equipo interdisciplinar en el sector educativo, con el fin de abordar de manera temprana las dificultades que puedan generarse a nivel comunicativo y en el desarrollo motor.

Abstract Introduction: Health professionals such as physiotherapists and speech therapists, within their competences, generate an impact on the educational role by carrying out early and opportune detection actions of the alterations that frequently occur in initial and preschool education at the level of motor and communication processes. Objective: To make a reflection on the role of the physiotherapist and speech therapist in the initial and preschool education of children in Colombia. Reflection: It is important to highlight and recognize the importance of including physiotherapists and speech therapists in the education sector in such a way that it can impact the population that is in initial and preschool education, forming interdisciplinary groups together with teachers, families, and schools, to impact the communicative well-being and motor development. Conclusion: When making the reflection, the importance of including physiotherapists and speech therapists in the interdisciplinary team of the educational sector is highlighted, to approach the difficulties that may be generated at the communicative level and in motor development in an early stage.

SUMMARY OBJECTIVE: This randomized clinical trial study aims to investigate the effects of antioxidant food supplementation on the total antioxidant capacity of seminal plasma, sperm DNA fragmentation, sperm chromatin quality, and semen parameters. METHODS: In this study, a total of 48 subfertile men with moderate physical activity were included. Group 1 was recommended to use the antioxidant supplements, while antioxidant food supplements were not given to Group 2. Total antioxidant capacity, sperm DNA fragmentation, sperm chromatin structure, hormone levels, physical activities, and semen parameters were evaluated before and after treatment. Total antioxidant capacity, sperm DNA fragmentation, and sperm chromatin structure were assessed using ELISA, transferase dUTP nick end labeling, and aniline blue staining, respectively. RESULTS: Sperm DNA fragmentation (p=0.003) and histone/protamine ratio (p<0.001) were significantly decreased in the patients receiving antioxidant treatment. There was no statistical difference in the total antioxidant capacity values of the post-treatment groups. CONCLUSION: Antioxidant therapy seems to improve sperm DNA fragmentation and histone/protamine ratios in subfertile patients. Clinical Trial Registration Number: NCT06042738. OBJECTIVE plasma quality METHODS 4 included 2 levels activities treatment ELISA labeling staining respectively RESULTS p=0.003 p0003 p 0 003 (p=0.003 histoneprotamine histone protamine p<0.001 p0001 001 (p<0.001 posttreatment post groups CONCLUSION Number NCT06042738 NCT p=0.00 p000 00 (p=0.00 p<0.00 (p<0.00 NCT0604273 p=0.0 p00 (p=0.0 p<0.0 (p<0.0 NCT060427 p=0. p0 (p=0. p<0. (p<0. NCT06042 p=0 (p=0 p<0 (p<0 NCT0604 p= (p= p< (p< NCT060 (p NCT06 NCT0

RESUMEN Introducción: los pacientes con enfermedad renal crónica con requerimiento de terapia sustitutiva renal (hemodiálisis) son frecuentes en el Paraguay, lo que afecta la calidad de vida de los que la padecen. Objetivo: conocer la calidad de vida de los pacientes con enfermedad renal crónica en tratamiento hemodialítico en el Departamento de Nefrología del Centro Médico Nacional-Hospital Nacional en el período 2022-2023. Metodología: observacional, descriptivo, de corte transversal realizado en el Departamento de Nefrología del Centro Médico Nacional-Hospital Nacional de Paraguay. Se incluyeron en el estudio 189 pacientes en que acudieron para tratamiento hemodialítico entre los años 2022-2023. La muestra fue censal. Para determinar la calidad de vida se utilizó el cuestionario Kidney Disease Quality of Life - 36 ítems. Los datos fueron analizados con el programa Epiinfo. Resultados: la edad media de los pacientes fue de 53 años, varones 58.2 %. El 98 % refirió la presencia de algún tipo de comorbilidad concomitante, las más frecuentes fueron diabetes Mellitus 43 % e hipertensión arterial 86 %. La media de meses en tratamiento hemodialítico fue de 20 meses. El cuestionario, Kidney Disease Quality of Life - 36 ítems, arrojó puntajes promedios menores a 50 en el componente mental (65.08) y en el componente físico (71.95) así como en la subescala carga de la enfermedad (55.55). Conclusión: la mayoría de los pacientes con enfermedad renal crónica con tratamiento hemodialítico en el Hospital Nacional evidencian una baja calidad de vida.

ABSTRACT Introduction: patients with chronic kidney disease requiring renal replacement therapy (hemodialysis) are common in Paraguay, which affects the quality of life of those who suffer from it. Objective: to know the quality of life of patients with chronic kidney disease undergoing hemodialysis treatment in the Departmento de Nefrología of the Centro Médico Nacional-Hospital Nacional in the period 2022-2023. Methodology: observational, descriptive, cross-sectional carried out in the Nephrology Department of the Centro Médico Nacional-Hospital Nacional of Paraguay. 189 patients who came for hemodialysis treatment between 2022-2023 were included in the study. The sample was census. To determine quality of life, the Kidney Disease Quality of Life questionnaire - 36 items was used. The data were analyzed with the Epi Info program. Results: the average age of the patients was 53 years, 58.2 % men. 98 % reported the presence of some type of concomitant comorbidity, the most frequent being diabetes mellitus 43 % and arterial hypertension 86 %. The average number of months on hemodialysis treatment was 20 months. The questionnaire, Kidney Disease Quality of Life - 36 items, showed average scores less than 50 in the mental component (65.08) and in the physical component (71.95) as well as in the burden of the disease subscale (55.55). Conclusion: the majority of patients with chronic kidney disease with hemodialysis treatment at the National Hospital show a low quality of life.

RESUMEN Introducción: la salud mental es crucial para el bienestar y el rendimiento académico de los estudiantes universitarios. Los estudiantes de Kinesiología y Fisioterapia enfrentan desafíos únicos que pueden afectar su salud mental. Objetivo: determinar la frecuencia de trastornos mentales comunes en estudiantes de kinesiología y fisioterapia de la Universidad Nacional de Asunción. Metodología: se trata de un estudio observacional, descriptivo y transversal. La muestra no probabilística estuvo compuesta por 150 estudiantes de Kinesiología y Fisioterapia de la Universidad Nacional de Asunción. Se recogieron datos sociodemográficos, académicos, ocupacionales, de estilo de vida y psicopatológicos mediante la Escala de Depresión, Ansiedad y Estrés - 21 (DASS-21). El análisis se realizó mediante Jamovi con regresión logística binomial multivariada. Resultados: la frecuencia de depresión, ansiedad y estrés fue del 61,3 %, 72 % y 54,7 %, respectivamente. Los factores importantes para la depresión incluyeron ser un estudiante irregular, trabajar y no realizar actividad física. Para la ansiedad, fueron significativos ser estudiante irregular y ser mujer. Respecto al estrés, se encontraron relevantes ser estudiante irregular, trabajar y no realizar actividad física. Los modelos resultantes tuvieron clasificaciones correctas del 90,2 %, 88 % y 72 % para depresión, ansiedad y estrés, respectivamente. Conclusión: Este estudio reveló una alta frecuencia de depresión, ansiedad y estrés entre estudiantes de kinesiología y fisioterapia, lo que se asoció significativamente con irregularidad académica, empleo y falta de actividad física. Estos hallazgos subrayan la necesidad de implementar estrategias de intervención y programas de apoyo que aborden estos factores de riesgo para promover la salud mental y el bienestar de los futuros profesionales de la salud.

ABSTRACT Introduction: mental health is crucial for university students’ well-being and academic performance. Kinesiology and Physical Therapy students face unique challenges that can affect their mental health. Objective: to determine the frequency of common mental disorders in kinesiology and physical therapy students at the Universidad Nacional de Asunción. Methodology: this was an observational and descriptive cross-sectional study. The nonprobabilistic sample included 150 Kinesiology and Physiotherapy students from the Universidad Nacional de Asunción. Sociodemographic, academic, occupational, lifestyle, and psychopathological data were collected using the Depression, Anxiety and Stress Scale - 21 (DASS-21). The analysis was performed using Jamovi with multivariate binomial logistic regression. Results: the frequency of depression, anxiety, and stress was 61.3 %, 72 %, and 54.7 %, respectively. The significant factors for depression included being an irregular student, working, and not engaging in physical activity. For anxiety, being an irregular student and being a woman were significant. Regarding stress, being an irregular student, working, and not engaging in physical activity were found to be relevant. The resulting models had correct classifications of 90.2 %, 88 %, and 72 % for depression, anxiety, and stress, respectively. Conclusion: this study revealed a high frequency of depression, anxiety, and stress among kinesiology and physical therapy students, which was significantly associated with academic irregularity, employment, and a lack of physical activity. These findings underscore the need to implement intervention strategies and support programs that address these risk factors in order to promote the mental health and well-being of future health professionals.

Resumo: O Ensino Superior em todo o mundo durante a pandemia da COVID-19 foi obrigado a repensar, atendendo à diretriz estabelecida pela Organização Mundial da Saúde (OMS) para mitigar o impacto na população. A Costa Rica não foi exceção relativamente à situação que se vivia e especificamente na Universidade de Ciências Médicas (UCIMED), que na ausência de um plano de contingência, viveu uma transição do ensino presencial para o virtual. A presente investigação se focou nos desafios vivenciados pelos docentes dos cursos de Fisioterapia e Nutrição, no período de março a junho de 2020, com a virtualização emergencial. As informações foram coletadas pelo meio de pesquisa desenvolvida no Google Forms®. Uma vez tabulado, foi analisado, interpretado e comparado entre carreiras, aplicando estatística descritiva e revisão bibliográfica para compreender a situação mundial. O estudo determinou que a didática do curso representava um grande desafio para o corpo docente; principalmente a avaliação da aprendizagem, a participação dos estudantes, o uso de ferramentas virtuais e problemas de conectividade. Ao comparar as carreiras, identificou-se que pouca formação, menos anos de experiência docente e baixa interação com plataformas virtuais foram fatores que aumentaram a percepção dos desafios. Ao enfrentá-los, enriqueceu-se a experiência docente na gestão das TIC e com ela a transformação do Ensino Superior.

Resumen: La educación superior a nivel mundial durante la pandemia COVID-19 se vio obligada a replantearse, dada la directriz establecida por la Organización Mundial de la Salud (OMS) para mitigar el impacto en la población. Costa Rica no fue la excepción respecto a la circunstancia que se vivía y, específicamente, la Universidad de Ciencias Médicas (UCIMED), ante la ausencia de un plan de contingencia, experimentó una transición de la enseñanza presencial a virtual. Debido a ello, la presente investigación tuvo un enfoque cuantitativo y exploró los desafíos que experimentó el personal docente de las carreras de Fisioterapia y Nutrición, durante el periodo de marzo a junio del 2020, con la virtualización de emergencia. La información se recopiló a través de un cuestionario elaborado en Google Forms®; una vez tabulada, se analizó, interpretó y comparó entre carreras, apli- cando estadística descriptiva y una revisión bibliográfica para comprender la situación a nivel mundial. El estudio determinó que la didáctica del curso representó un alto desafío para el cuerpo docente; principalmente, la evaluación del aprendizaje, la participación del estudiantado, el uso de las herramientas virtuales y los problemas de conectividad. Al comparar las carreras, se identificó que la poca capacitación, la menor cantidad de años de experiencia docente y la baja interacción con plataformas virtuales, fueron factores que aumentaron la percepción de los desafíos. A partir de la confrontación de los desafíos, se enriqueció la experiencia docente en el manejo de las tecnologías de la información y comunicación (TIC) y con ello la transformación de la educación superior.

Abstract: During the COVID-19 pandemic, higher education worldwide was forced to restructure itself according to guidelines established by the World Health Organization (WHO) to mitigate the impact of the pandemic on the population. Costa Rica was no exception. In the absence of a contingency plan, the University of Medical Sciences (UCIMED) underwent a transition from face-to-face to virtual teaching. This study focused on the challenges experienced by physical therapy and nutrition faculty during the period from March to June 2020, due to the emergency virtualization. The information was collected through a Google Forms® survey; once tabulated, the data was analyzed, interpreted and compared between the professions, implementing descriptive statistics and a bibliographic review to better understand the situation at a global level. The study showed that the didactics of the course was a great challenge for the teachers, mainly in terms of learning assessment, student participation, use of virtual tools and connectivity problems. When comparing professions, it was found that limited training, fewer years of teaching experience, and less interaction with virtual platforms were factors that increased the perception of challenges. Confronting the challenges enriched the teaching experience in terms of ICT management and thus the transformation of higher education.

ABSTRACT Background: Hemodialysis is a procedure in which the primary caregiver is not actively involved; however, he or she suffers emotional disturbances due to the workload of caring for the patient. Objective: Identify the prevalence of primary caregiver overload in renal replacement therapy with hemodialysis. Materials and methods: Descriptive cross-sectional study, January-December 2021, in a Regional General Hospital, among caregivers of patients with kidney disease on hemodialysis, over 18 years of age, both sexes. Caregivers who received payment for services was excluded. Their weight, height, blood pressure, sociodemographic variables and care time were measured, and the Zarit caregiver burden scale was applied for primary caregivers. Results: One hundred primary caregivers were surveyed (28% men, 72% women), with an average age of 49 ± 14.6 years. In the relationship, 40% children. Eighty-six per cent had been caregivers for more than six months. They presented mild (12%) and intense (7%) caregiver overload. Conclusions: Primary caregivers of patients on renal replacement therapy with hemodialysis assigned to the General Hospital of Zone No. 2, in Zacapu, Michoacan, has a prevalence of overload of 19%. This is presented in a considerable number of family members, hence the importance of addressing the mental and physical health not only of the patient but also of the primary caregiver.

RESUMEN Antecedentes: La hemodiálisis es un procedimiento en el cual el cuidador primario no se involucra activamente, sin embargo sufre alteraciones emocionales derivadas de la carga de trabajo en el cuidado del paciente. Objetivo: Identificar la prevalencia de sobrecarga del cuidador primario en terapia renal sustitutiva con hemodiálisis. Material y métodos: Estudio transversal descriptivo, enero-diciembre 2021, en un Hospital General de Zona, a cuidadores de pacientes con enfermedad renal en hemodiálisis, mayores de 18 años, ambos sexos. Se excluyeron cuidadores que recibían pago por servicios. Se les midió peso, talla, presión arterial, variables sociodemográficas y tiempo de cuidado, y se aplicó escala de carga del cuidador de Zarit para cuidadores primarios. Resultados: Se encuestaron 100 cuidadores primarios (28% hombres, 72% mujeres), con edad promedio 49 ± 14.6 años. En el parentesco, 40% hijos. El 86% tenían más de seis meses de ser cuidadores. Presentaron sobrecarga del cuidador leve (12%) e intensa (7%). Conclusiones: Los cuidadores primarios de los pacientes en terapia renal sustitutiva con hemodiálisis adscritos al Hospital General de Zona No. 2, en Zacapu, Michoacán, presentan una prevalencia de sobrecarga del 19%. Se presenta en una cantidad considerable de familiares, de ahí la importancia de atender la salud mental y física no solo del paciente, sino también del cuidador primario.

Resumo Introdução: As complicações micro e macrovasculares da diabetes são resultado de um processo de caráter longo sobre a falta dos cuidados da diabetes, de que resultam problemas cardiovasculares, oftalmológicos e neuropáticos, requerendo por essas questões elevada atenção no tratamento. Descrição do caso: Apresenta-se o relato de caso de um paciente adulto de meia-idade, ex-fumador, com diagnóstico de diabetes mellitus, além da hipertensão e obesidade. A sua alimentação não saudável ao longo dos anos, sedentarismo e altos níveis de estresse resultou num quadro de isquemia vascular periférica, que intensificou as complicações da diabetes, ou seja, problemas micro e macrovasculares, entre eles, a retinopatia e a neuropatia. Por esse histórico, a farmacoterapia do paciente resultou entre as insulinas (regular e NPH), antiagregante plaquetátio, estatina, fibratos, psicotrópicos e os anti-hipertensores. Além disso, detetou-se que seus níveis glicémicos e hemoglobina glicada estão elevados. Ainda se verificaram alterações na lipoproteína de alta densidade (HDL) e triglicéridos. Algumas queixas do paciente no período noturno, como boca seca, tontura e sonolência, são problemas que podem estar relacionados com a terapia concomitante de venlafaxina, gabapentina e amitriptilina. Comentários: De forma geral, recomenda-se a este paciente a prática de exercício físico, como caminhada, por exemplo, diminuição do consumo de hidratos de carbono e sódio, além de algumas alterações na farmacoterapia do paciente.

Abstract Introduction: The micro and macrovascular complications of diabetes are the result of a long process of the lack of diabetes care, which results in cardiovascular, ophthalmological, and neuropathic problems, and for these reasons requires high attention in treatment. Case description: This article presents a case report of a middle-aged adult patient, ex-smoker, diagnosed with diabetes mellitus, in addition to hypertension and obesity. Their unhealthy diet over the years, sedentary lifestyle, and high levels of stress resulted in peripheral vascular ischemia, which intensified the complications of diabetes, that is, micro and macrovascular problems, including retinopathy and neuropathy. Due to this history, the patient’s pharmacotherapy resulted in insulins (regular and NPH), antiplatelet agents, statins, fibrates, psychotropics, and antihypertensives. In addition, his blood glucose levels and glycated hemoglobin were found to be elevated. Furthermore, alterations were observed in high-density lipoprotein (HDL) and triglycerides. Some patient complaints at night, such as dry mouth, dizziness, and drowsiness, are problems that may be related to concomitant therapy with venlafaxine, gabapentin, and amitriptyline. Comments: In general, this patient is recommended to practice physical exercises, such as walking, for example, reducing the consumption of carbohydrates and sodium, in addition to some changes in the patient’s pharmacotherapy.

Abstract Knee osteoarthritis (OA) is an inflammatory and degenerative condition resulting in articular cartilage destruction and functional loss. Its prevalence has grown considerably due to increased life expectancy and obesity, and its diagnosis relies on evaluation, medical examination, and confirmation by supplementary radiographic images. Knee OA is multifactorial and influenced by several local, systemic, and external aspects. In addition, its progress and therapeutic responses highly depend on the characteristics of each subject. The initial recommendation is drug treatment and alternative therapies to improve quality of life. However, if these treatments are unsuccessful, one must consider surgical treatment. Surgical options include arthroscopies, osteotomies, and partial and total arthroplasties, while non-surgical treatments include medications and alternative therapies such as infiltrations, acupuncture, and physical exercise. It is worth highlighting that biomarkers can be a significant strategy for early disease detection, assessment of disease activity, prediction of prognosis, and monitoring a better response to therapy. Nevertheless, this topic must be the focus of further research to confirm its findings. (OA loss obesity evaluation examination images local systemic aspects addition subject However unsuccessful arthroscopies osteotomies arthroplasties nonsurgical non infiltrations acupuncture exercise detection activity prognosis therapy Nevertheless findings

Resumo A osteoartrite (OA) do joelho é uma doença inflamatória e degenerativa que ocasiona a destruição da cartilagem articular e leva à perda de funções. Sua prevalência vem crescendo consideravelmente devido ao aumento da expectativa de vida e da obesidade, e o diagnóstico pode ser feito por meio de avaliação e exames médicos, e é confirmado em imagens radiográficas complementares. Uma condição multifatorial, a OA do joelho pode ser influenciada por diversos aspectos locais, sistêmicos e externos; além disso, a sua evolução e as respostas aos tratamentos dependem muito das características de cada indivíduo. Inicialmente, recomenda-se proceder a um tratamento medicamentoso e a terapias alternativas que melhorem a qualidade de vida do paciente; mas, a partir do momento em que se verifica que tais terapias não estão proporcionando resultados satisfatórios, um tratamento cirúrgico deve ser considerado. Entre os tratamentos cirúrgicos, as artroscopias, as osteotomias e as artroplastias parciais e totais são destacadas; os métodos não cirúrgicos incluem o uso de medicamentos e de terapias alternativas, como infiltrações, acupuntura e prática de exercícios físicos. Vale ressaltar ainda que a utilização de biomarcadores pode ser uma importante estratégia para detectar precocemente a doença, avaliar sua atividade, prever um prognóstico e monitorar uma melhor resposta à terapia; porém, esse tema ainda deve ser foco de mais estudos para que os seus resultados sejam comprovados. (OA funções obesidade médicos complementares multifatorial locais externos disso indivíduo Inicialmente recomendase recomenda paciente mas satisfatórios considerado artroscopias destacadas infiltrações físicos atividade terapia porém comprovados

Abstract Objective To investigate whether patients undergoing anatomic total shoulder arthroplasty (ATSA) between January and March 2020 experienced different postoperative outcomes than patients in 2019. We hypothesized that patients in 2020 would have less access to physical therapy (PT) and experience different postoperative outcomes. Methods Records from patients who received ATSA between January 1st, 2019, and March 17th, 2019, and January 1st, 2020, to March 17th, 2020, were analyzed. Patient data, including demographic information, range of motion (ROM), strength, and PT was collected and compared between the two groups. The 2020 patients were contacted by phone during October 2022 and patient-reported metrics were gathered. Results The present study identified 24 patients in 2019 and 27 patients in 2020 who underwent ATSA during the specified time frame and had a minimum 1-year follow-up. Patients in 2019 experienced improvements in forward elevation (FE) ROM (125.4° to 146.7°; p = 0.008), external rotation (ER; 33.0° to 47.7°; p < 0.001), and internal rotation (IR; S1 to L4; p = 0.019). Patients in 2020 also experienced significant improvements in FE (120.2° to 141.1°; p = 0.009), ER (32.9° to 42.0°; p = 0.037), and IR (S1 to L3; p = 0.002). Patients in 2020 terminated PT earlier (2019: 125.8 days; 2020: 91.1 days; p = 0.046) and completed fewer sessions (2019: 21.4 sessions; 2020: 13.1 sessions; p = 0.003). At the final follow-up, patients in 2020 reported an average Visual Analogue Scale (VAS) pain score of 1.67 ± 1.1. Conclusion Despite decreased PT, patients who underwent ATSA in 2020 had significant improvements in ROM and strength and were comparable to patients in 2019. (ATSA 202 (PT 1st st 17th th analyzed data information ROM, , (ROM) groups patientreported patient gathered 2 201 1year year 1 followup. followup follow up. up follow-up (FE 125.4° 1254 125 4 (125.4 146.7° 1467 146 7 0.008, 0008 0.008 0 008 0.008) (ER 330 33 33.0 47.7° 477 47 0.001, 0001 0.001 001 0.001) (IR S L4 L 0.019. 0019 0.019 . 019 0.019) 120.2° 1202 120 (120.2 141.1° 1411 141 0.009, 0009 0.009 009 0.009) 32.9° 329 32 9 (32.9 42.0° 420 42 0.037, 0037 0.037 037 0.037) (S L3 0.002. 0002 0.002 002 0.002) (2019 1258 8 125. days 911 91 91. 0.046 0046 046 214 21 21. 131 13 13. 0.003. 0003 0.003 003 0.003) followup, up, VAS (VAS 167 67 1.6 11 1.1 20 (ROM 125.4 12 (125. 146.7 14 000 0.00 00 3 33. 47.7 0.01 01 120.2 (120. 141.1 32.9 (32. 42.0 0.03 03 (201 0.04 004 04 16 6 1. (125 146. 0.0 47. 120. (120 141. 32. (32 42. (20 (12 0. (3 (2 (1 (

Resumo Objetivo Investigar se os pacientes submetidos à artroplastia total anatômica do ombro (ATAO) entre janeiro e março de 2020 tiveram resultados pós-operatórios diferentes dos pacientes operados em 2019. Nossa hipótese é a de que os pacientes de 2020 teriam menos acesso à fisioterapia (FT) e apresentariam desfechos pós-opera-tórios diferentes. Métodos Foram analisados os prontuários de pacientes submetidos à ATAO de 1° de janeiro de 2019 a 17 de março de 2019 e de 1° de janeiro de 2020 a 17 de março de 2020. Os dados dos pacientes, incluindo informações demográficas, amplitude de movimento (ADM), força e FT foram coletados e comparados entre os dois grupos. Os pacientes de 2020 foram contatados por telefone durante outubro de 2022, e as métricas relatadas por eles pacientes foram coletadas. Resultados Este estudo identificou 24 pacientes em 2019 e 27 pacientes em 2020 que foram submetidos à ATAO durante o período especificado e tiveram acompanhamento mínimo de 1 ano. Os pacientes em 2019 apresentaram melhoras na ADM de elevação anterior (EA; 125,4° a 146,7°; p = 0,008), rotação externa (RE; 33,0° a 47,7°; p < 0,001) e rotação interna (RI; S1 a L4; p = 0,019). Os pacientes em 2020 também apresentaram melhoras significativas de EA (120,2° a 141,1°; p = 0,009), RE (32,9° a 42,0°; p = 0,037) e RI (S1 a L3; p = 0,002). Os pacientes de 2020 terminaram a FT mais cedo (2019: 125,8 dias; 2020: 91,1 dias; p = 0,046) e fizeram menos sessões (2019: 21,4 sessões; 2020: 13,1 sessões; p = 0,003). No acompanhamento final, os pacientes de 2020 relataram uma pontuação média de dor na Escala Visual Analógica (EVA) de 1,67 ± 1,1. Conclusão Apesar da menor realização de FT, os pacientes submetidos à ATAO em 2020 apresentaram melhoras significativas na ADM e na força e foram comparáveis aos pacientes de 2019. (ATAO 202 pósoperatórios pós operatórios (FT opera tórios 201 demográficas ADM, , (ADM) grupos 2022 coletadas 2 ano (EA 1254 125 4 125,4 146,7° 1467 146 7 0,008, 0008 0,008 0 008 0,008) (RE 330 33 33,0 47,7° 477 47 0,001 0001 001 (RI S L4 L 0,019. 0019 0,019 . 019 0,019) 120,2° 1202 120 (120,2 141,1° 1411 141 0,009, 0009 0,009 009 0,009) 32,9° 329 32 9 (32,9 42,0° 420 42 0,037 0037 037 (S L3 0,002. 0002 0,002 002 0,002) (2019 1258 8 125, dias 911 91 91, 0,046 0046 046 214 21 21, 131 13 13, 0,003. 0003 0,003 003 0,003) final EVA (EVA 167 67 1,6 11 1,1 20 (ADM 12 146,7 14 000 0,00 00 3 33, 47,7 0,01 01 120,2 (120, 141,1 32,9 (32, 42,0 0,03 03 (201 0,04 004 04 16 6 1, 146, 0,0 47, 120, (120 141, 32, (32 42, (20 0, (12 (3 (2 (1 (

Acute mesenteric ischemia (AMI) is a rare medical-surgical emergency that must be treated early due to its high morbidity and mortality. It corresponds to a sudden interruption of the blood supply to a segment of the intestine, producing ischemia, cell damage, intestinal necrosis and eventually death if it is not treated. The main etiology of this condition is embolic-type arterial occlusion, followed by thrombotic, nonocclusive, and venous thrombotic. It is an infrequent pathology with a low incidence of 12 per 100,000 inhabitants in international series. During the information collection, no data was found on the Chilean population since before 1983. Its main symptom is colicky abdominal pain with a sudden onset, vomiting and diarrhea that begins after the pain. On physical examination, signs of shock and abdominal distention may be noted. Hemodynamically unstable patients should be urgently taken to exploratory laparotomy as soon as the condition is suspected, and in stable patients, an angio-CT should be requested to confirm the diagnosis and plan treatment. There are two methods to treat this pathology, open surgery and endovascular or minimally invasive surgery. The form of therapy depends on the preoperative or intraoperative findings and the type of etiology. Finally, with the advancement of these new methods, the mortality rate has decreased in the last decade.

Resumen La isquemia mesentérica aguda (IMA) es una emergencia médico-quirúrgica poco frecuente con alta morbimortalidad. Corresponde a una interrupción brusca del aporte sanguíneo a un segmento del intestino, produciendo isquemia, daño celular, necrosis intestinal y eventualmente la muerte. La principal etiología de este cuadro es la oclusión arterial de tipo embólica, seguida por la trombótica, no oclusiva y trombótica venosa. Es una patología infrecuente con una incidencia baja, de 12 por 100.000 habitantes en series internacionales. Su principal síntoma es el dolor abdominal tipo cólico de comienzo brusco, vómitos y diarrea, esta última sucediendo posteriormente. En el examen físico se pueden constatar signos de shock y distensión abdominal. Ante la sospecha, los pacientes hemodinámicamente inestables deben ser llevados urgentemente a laparotomía exploradora, y en aquellos estables, se debe solicitar un Angio-TC para confirmar el diagnóstico y planificar el tratamiento. Existen dos métodos para tratar esta patología: la cirugía abierta y la cirugía endovascular o mínimamente invasiva. Finalmente, con el avance de estos nuevos métodos, la tasa de mortalidad ha disminuido, significativamente, en la última década.

Abstract A 23-year-old male patient who sought emergency care with odynophagia, total dysphagia, and 7 days of fever, treated with oral amoxicillin and clavulanic acid without improvement. The physical examination and CT scan showed tonsillitis with multiple tonsilar abscesses. Due to total dysphagia even after intravenous analgesia, hospitalization was decided for supportive fluid therapy and analgesia. During hospitalization, vesiculopustular skin lesions appeared on the upper and lower limbs and trunk. PCR and culture of the pustule and oropharyngeal exudates, and pustule skin biopsy came positive for Monkeypox virus (MPXV). He remained in isolation measures and was discharged after tolerating oral diet.

Resumo Um doente do sexo masculino, com 23 anos, recorreu ao serviço de urgência com um quaro de 7 dias de evolução de odinofagia, disfagia total e febre, sem melhoria com tratamento com amoxicilina e ácido clavulânico por via oral. O exame físico e a tomografia computadorizada revelaram amigdalite com múltiplos abscessos intra-amigdalinos. Pela disfagia total mesmo após analgesia intravenosa, optou-se por internamento para tratamento de suporte. Durante a hospitalização, surgiram lesões cutâneas vesiculopustulosas nos membros superiores e inferiores e tronco. Foram realizados testes de PCR e cultura dos exsudados das pústulas e orofaringe e biópsia da pele da pústula que foram positivos para MPXV. Manteve medidas de isolamento e teve alta após tolerar dieta oral.

ABSTRACT Objective: To report the responsiveness and interpretability of the Argentine version of the Pain Catastrophizing Scale (PCS-Arg) in a sample of subjects with chronic low back pain (CLBP). Materials and methods: A prospective, observational, and longitudinal study was conducted. Subjects with CLBP referred to the physical therapy unit of a public hospital in the Autonomous City of Buenos Aires were recruited. At baseline, demographic data and PCS-Arg scores, as well as pain intensity, disability, quality of life, and depression were recorded through self-reported questionnaires. In a second instance, at one month or discharge, the same variables were collected, along with a Global Rating Of Change (GROC) scale. Responsiveness was assessed using longitudinal construct validity. Interpretability was calculated using the anchor-based method, and the minimal clinically important difference (MCID) and substantial clinical benefit (SCB) were reported. Results: A total of 102 subjects were included in the study. The PCS-Arg showed acceptable responsiveness. The MCID score was 10 points, with an area under the curve (AUC) of 0.65 and a confidence interval of 95 % (95 % CI 0.47-0.83). The SCB score was 17 points, with an AUC of 0.66 (95 % CI 0.55-0.77). Conclusion: The PCS-Arg is a responsive instrument. The discriminative ability of the values to identify the MCID and SCB was poor. These results will allow for interpreting the impact of different treatments aimed at targeting catastrophizing, as well as enhancing future clinical trials on subjects with CLBP.

RESUMEN Objetivo: Reportar la sensibilidad al cambio e interpretabilidad de la versión argentina de la escala de catastrofización del dolor (PCS-Arg, por sus siglas en inglés) en una muestra de sujetos con dolor lumbar crónico (DLC). Materiales y métodos: Estudio prospectivo, observacional y longitudinal. Se reclutaron sujetos con DLC derivados a la unidad de kinesiología de un hospital público de la Ciudad Autónoma de Buenos Aires. Inicialmente, se registraron los datos demográficos y las puntuaciones de la PCS-Arg, así como la intensidad del dolor, discapacidad, calidad de vida y depresión mediante cuestionarios autoadministrados. En una segunda instancia, al mes o alta del tratamiento, se repitieron los cuestionarios junto con una escala global de cambio. La sensibilidad al cambio fue evaluada mediante la validez de constructo longitudinal. La interpretabilidad se calculó mediante el método basado en el ancla, y se reportaron la diferencia mínima clínicamente importante (DMCI) y el beneficio clínico sustancial (BCS). Resultados: Se incluyeron 102 sujetos en el estudio. La PCS-Arg demostró una sensibilidad al cambio aceptable. La DMCI fue de 10 puntos, con un área bajo la curva (AUC) de 0,65 y un intervalo de confianza del 95 % (IC 95 % 0,47-0,83). El BCS fue de 17 puntos, con un AUC de 0,66 (IC 95 % 0,55-0,77). Conclusión: La PCS-Arg es un instrumento sensible al cambio. La capacidad discriminativa de los valores para identificar la DMCI y el BCS fue pobre. Estos resultados permitirán interpretar el impacto de diferentes terapéuticas orientadas a modificar el catastrofismo, así como potenciar futuros ensayos clínicos que incluyan sujetos con DLC.

ABSTRACT Objective: To perform a cross-cultural adaptation and validation of the Fear and Avoidance Beliefs Questionnaire (FABQ) for Argentine subjects with low back pain (LBP) and to report the psychometric properties of reliability, validity, and interpretability. Materials and method: An observational, prospective, and longitudinal study was conducted. Spanish-speaking Argentine residents aged 18 years or older with LBP were consecutively included. The study comprised an adaptation phase followed by a validation phase. Subjects were evaluated on the day of study admission (T1) and 48 to 72 hours later (T2). A global change scale was used as an external anchor to assess clinical stability. Results: Seventy-four subjects were eligible. The mean FABQ total score was 50.24 (SD 20.64). The internal consistency (Cronbach’s alpha) was 0.85 (95 % CI 0.79 - 0.91). Test-retest reliability was acceptable, with an intraclass correlation coefficient of 0.765 (95 % CI 0.61 - 0.86). The standard error of measurement was 4.85 points, and the minimum detectable change (95 %) was 13.45. The median time for subjects to complete the questionnaire was 3.86 minutes (IQR 3.44 - 4.85), and the mean time to score it was 24.40 seconds (SD 13.77). No floor or ceiling effect was found. Conclusion: The Argentine version of the FABQ is a valid, reliable, and feasible questionnaire for assessing fear and avoidance beliefs in subjects with LBP.

RESUMEN Objetivo: Realizar una adaptación transcultural y validación del cuestionario de creencias de miedo y evitación (FABQ, por sus siglas en inglés) para sujetos argentinos con dolor lumbar (DL) y reportar las propiedades psicométricas de confiabilidad, validez e interpretabilidad. Materiales y métodos: Se realizó un estudio observacional, prospectivo y longitudinal. Se incluyeron de forma consecutiva residentes argentinos hispanohablantes mayores de 18 años con DL. El estudio comprendió una fase de adaptación, seguida de una fase de validación. Los sujetos fueron evaluados el día de su admisión al estudio (T1) y 48 a 72 horas después (T2). Se utilizó una escala global de cambio como anclaje externo para evaluar la estabilidad clínica. Resultados: Fueron elegibles 74 sujetos. La media de la puntuación total del FABQ fue de 50,24 (DE 20,64). La consistencia interna (alfa de Cronbach) fue de 0,85 (IC 95 % 0,79 - 0,91). La confiabilidad test-retest fue aceptable, con un coeficiente de correlación intraclase de 0,765 (IC 95 % 0,61 - 0,86). El error estándar de medición fue de 4,85 puntos, y el cambio mínimo detectable (95 %) fue de 13,45. La mediana de tiempo para que los sujetos completen el cuestionario fue de 3,86 minutos (RIQ 3,44 - 4,85), y la media de tiempo para puntuarlo fue de 24,40 segundos (DE 13,77). No se observó efecto suelo o techo. Conclusión: El FABQ en su versión argentina es un cuestionario válido, confiable y viable para evaluar las creencias de miedo y evitación en sujetos con DL.

ABSTRACT Objective: To evaluate the effect of early active mobilization (EAM) compared to active usual care (AUC) in critically ill adult subjects regarding muscle strength and functional status. Materials and methods: A systematic review with meta-analysis were conducted. Randomized clinical trials comparing EAM with AUC in subjects >18 years of age, of both sexes, in critical condition during or after the period of mechanical ventilation in the intensive care unit (ICU) were included. The search was performed in the Cochrane, Medline/Pubmed, Embase (Elsevier), SciELO, LILACS/BVS, www.controlled-trials.com/, clinicaltrials.gov/, and www.who.int/ictrp/en/ databases. Bias risk was assessed using the RoB 1 tool. A qualitative and quantitative synthesis (meta-analysis) of the results was generated. Registration: OSF: https://bit.ly/430fF72. Results: Seven studies were included in this review, comprising a total of 1905 subjects. The majority of subjects were male (57 %) and aged between 54 and 66 years. The reported outcomes showed low certainty of evidence, according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. In the meta-analysis of functional status at hospital discharge, a favorable effect was observed in the EAM group, with a standardized mean difference of 0.26 (95 % CI 0.11 - 0.41) and low heterogeneity (I2 = 0 %). Conclusion: With low certainty of evidence, the effect of EAM on critically ill adult subjects in the ICU may improve functional status at hospital discharge compared to AUC.

RESUMEN Objetivo: Evaluar el efecto de la movilización activa temprana (MAT) en comparación con el cuidado habitual activo (CHA) en sujetos adultos críticamente enfermos respecto de la fuerza muscular y del estado funcional. Materiales y métodos: Se realizó una revisión sistemática con metaanálisis. Se incluyeron ensayos clínicos aleatorizados que compararon la MAT con el CHA en sujetos >18 años, de ambos sexos, en estado crítico durante o después del período de ventilación mecánica en la unidad de cuidados intensivos (UCI). La búsqueda se realizó en las bases de datos Cochrane, Medline/Pubmed, Embase (Elsevier), SciELO, LILACS/BVS, www.controlled-trials.com/, clinicaltrials.gov/ y www.who.int/ictrp/en/. Se analizó el riesgo de sesgo mediante la herramienta RoB 1. Se generó una síntesis cualitativa y cuantitativa (metaanálisis) de los resultados. Registro: OSF: https://bit.ly/430fF72. Resultados: Se incluyeron siete estudios, con un total de 1905 sujetos. La mayoría de los sujetos eran del sexo masculino (57 %) y tenían entre 54 y 66 años. Los desenlaces reportados mostraron baja certeza de evidencia, según la Clasificación de la valoración, desarrollo y evaluación de las recomendaciones (GRADE, por sus siglas en inglés). En el metaanálisis del estado funcional al alta hospitalaria, se observó un efecto a favor del grupo MAT, con una diferencia de medias estandarizada de 0,26 (IC 95 % 0,11 - 0,41) y baja heterogeneidad (I2 = 0 %). Conclusión: Con una baja certeza de evidencia, el efecto de la MAT en sujetos adultos críticamente enfermos en la UCI podría mejorar el estado funcional al alta hospitalaria en comparación con el CHA.