Acupuncture and rehabilitation of the painful shoulder: study protocol of an ongoing multicentre randomised controlled clinical trial [ISRCTN28687220]

BACKGROUND Although the painful shoulder is one of the most common dysfunctions of the locomotor apparatus, and is frequently treated both at primary healthcare centres and by specialists, little evidence has been reported to support or refute the effectiveness of the treatments most commonly applied. According to the bibliography reviewed, physiotherapy, which is the most common action taken to alleviate this problem, has not yet been proven to be effective, because of the small size of sample groups and the lack of methodological rigor in the papers published on the subject. No reviews have been made to assess the effectiveness of acupuncture in treating this complaint, but in recent years controlled randomised studies have been made and these demonstrate an increasing use of acupuncture to treat pathologies of the soft tissues of the shoulder. In this study, we seek to evaluate the effectiveness of physiotherapy applied jointly with acupuncture, compared with physiotherapy applied with a TENS-placebo, in the treatment of painful shoulder caused by subacromial syndrome (rotator cuff tendinitis and subacromial bursitis). METHODS/DESIGN Randomised controlled multicentre study with blind evaluation by an independent observer and blind, independent analysis. A study will be made of 465 patients referred to the rehabilitation services at participating healthcare centres, belonging to the regional public health systems of Andalusia and Murcia, these patients presenting symptoms of painful shoulder and a diagnosis of subacromial syndrome (rotator cuff tendinitis and subacromial bursitis). The patients will be randomised into two groups: 1) experimental (acupuncture + physiotherapy); 2) control (TENS-placebo + physiotherapy); the administration of rescue medication will also be allowed. The treatment period will have a duration of three weeks. The main result variable will be the change produced on Constant's Shoulder Function Assessment (SFA) Scale; as secondary variables, we will record the changes in diurnal pain intensity on a visual analogue scale (VAS), nocturnal pain intensity on the VAS, doses of non-steroid anti-inflammatory drugs (NSAIDs) taken during the study period, credibility scale for the treatment, degree of improvement perceived by the patient and degree of improvement perceived by the evaluator. A follow up examination will be made at 3, 6 and 12 months after the study period has ended. Two types of population will be considered for analysis: per protocol and per intention to treat. DISCUSSION The discussion will take into account the limitations of the study, together with considerations such as the choice of a simple, safe method to treat this shoulder complaint, the choice of the control group, and the blinding of the patients, evaluators and those responsible for carrying out the final analysis.

Transcatheter aortic valve implantation in very elderly patients: immediate results and medium term follow-up.

OBJECTIVE To evaluate immediate transcatheter aortic valve implantation (TAVI) results and medium-term follow-up in very elderly patients with severe and symptomatic aortic stenosis (AS). METHODS This multicenter, observational and prospective study was carried out in three hospitals. We included consecutive very elderly (> 85 years) patients with severe AS treated by TAVI. The primary endpoint was to evaluate death rates from any cause at two years. RESULTS The study included 160 consecutive patients with a mean age of 87 ± 2.1 years (range from 85 to 94 years) and a mean logistic EuroSCORE of 18.8% ± 11.2% with 57 (35.6%) patients scoring ≥ 20%. Procedural success rate was 97.5%, with 25 (15.6%) patients experiencing acute complications with major bleeding (the most frequent). Global mortality rate during hospitalization was 8.8% (n = 14) and 30-day mortality rate was 10% (n = 16). Median follow up period was 252.24 ± 232.17 days. During the follow-up period, 28 (17.5%) patients died (17 of them due to cardiac causes). The estimated two year overall and cardiac survival rates using the Kaplan-Meier method were 71% and 86.4%, respectively. Cox proportional hazard regression showed that the variable EuroSCORE ≥ 20 was the unique variable associated with overall mortality. CONCLUSIONS TAVI is safe and effective in a selected population of very elderly patients. Our findings support the adoption of this new procedure in this complex group of patients.

Antioxidant Intake and Antitumor Therapy: Toward Nutritional Recommendations for Optimal Results.

The role of the induction of oxidative stress as the mechanism of action of many antitumor drugs is acquiring an increasing interest. In such cases, the antitumor therapy success may be conditioned by the antioxidants present in our own body, which can be synthesized de novo (endogenous) or incorporated through the diet and nutritional supplements (exogenous). In this paper, we have reviewed different aspects of antioxidants, including their classification, natural sources, importance in diet, consumption of nutritional supplements, and the impact of antioxidants on health. Moreover, we have focused especially on the study of the interaction between antioxidants and antitumor therapy, considering both radiotherapy and chemotherapy. In this regard, we found that the convenience of administration of antioxidants during cancer treatment still remains a very controversial issue. In general terms, antioxidants could promote or suppress the effectiveness of antitumor treatment and even protect healthy tissues against damage induced by oxidative stress. The effects may depend on many factors discussed in the paper. These factors should be taken into consideration in order to achieve precise nutritional recommendations for patients. The evidence at the moment suggests that the supplementation or restriction of exogenous antioxidants during cancer treatment, as appropriate, could contribute to improving its efficiency.

Sebastià Juan Arbó, autotraductor: de terres de l'Ebre (1932) a Tierras del Ebro (1940)

Sebastià Juan Arbó (1902-1984) era un escriptor en llengua catalana fins a la Guerra Civil espanyola. Arran del desenllaç de la guerra, Arbó va esdevenir un escriptor tant en llengua catalana com en llengua castellana. Aquest pas d’una llengua a una altra va tenir un pas intermedi: l’autotraducció. A partir de la seva primera autotraducció al castellà (Tierras del Ebro, 1940), Sebastià Juan Arbó es va introduir en les lletres castellanes. Aquesta tasca autotraductora, que encetà el 1940, no l’abandonà en la resta de la seva obra catalana i mai no l’exercí en la seva obra escrita originalment en llengua castellana.Amb aquest treball de recerca es vol establir, en primer lloc, un mètode d’anàlisi per a l’autotraducció de Terres de l’Ebre, de Sebastià Juan Arbó, que pugui ser exportable a l’anàlisi d’altres autotraduccions, i, en segon lloc, analitzar un fragment de les primeres edicions en català (1932) i castellà (1940) de Terres de l’Ebre, que permeti reconèixer-hi les tendències autotraductores de Sebastià Juan Arbó.

Sonidos del metal : el bombardino en las formaciones de viento metal

Este proyecto tiene como objetivo el estudio de la relación que el bombardino tiene con las formaciones más importantes de viento metal. Para ello he creído necesario, antes de profundizar en este tema, dar a conocer su historia y evolución. Mi intención con este proyecto es contribuir al enriquecimiento del patrimonio de este maravilloso instrumento, que poco a poco, va ganando el respeto que se merece.

Analysis of past and future dam formation and failure in the Santa Cruz River (San Juan province, Argentina)

Around 11.5 * 106 m3 of rock detached from the eastern slope of the Santa Cruz valley (San Juan province, Argentina) in the first fortnight of January 2005. The rockslide?debris avalanche blocked the course, resulting in the development of a lake with maximum length of around 3.5 km. The increase in the inflow rate from 47,000?74,000 m3/d between April and October to 304,000 m3/d between late October and the first fortnight of November, accelerated the growing rate of the lake. On 12 November 2005 the dam failed, releasing 24.6 * 106 m3 of water. The resulting outburst flood caused damages mainly on infrastructure, and affected the facilities of a hydropower dam which was under construction 250 km downstream from the source area. In this work we describe causes and consequences of the natural dam formation and failure, and we dynamically model the 2005 rockslide?debris avalanche with DAN3D. Additionally, as a volume ~ 24 * 106 m3of rocks still remain unstable in the slope, we use the results of the back analysis to forecast the formation of a future natural dam. We analyzed two potential scenarios: a partial slope failure of 6.5 * 106 m3 and a worst case where all the unstable volume remaining in the slope fails. The spreading of those potential events shows that a new blockage of the Santa Cruz River is likely to occur. According to their modeled morphometry and the contributing watershed upstream the blockage area, as the one of 2005, the dams would also be unstable. This study shows the importance of back and forward analysis that can be carried out to obtain critical information for land use planning, hazards mitigation, and emergency management.

El alimento de la anchoveta engraulis ringens J. en un área de afloramiento (San Juan)

Información sobre la variación en la predominancia del tipo de alimento ingerido por la anchoveta Engraulis ringens J. colectadas en un área de afloramiento (San Juan 15º-16º L.S.). El material consta de 13 muestras obtenidas desde noviembre de 1973 a setiembre de 1974.

Prospección del chanque y erizo en los puertos de Pisco, San Juan de Marcona y Lomas. Octubre 2000

Efectúa una prospección en los puertos de Pisco con el fin de obtener información biológico-pesquera de los recursos chanque y erizo, relacionados con los desembarques. El estudio sugiere tomar medidas regulativas que protejan estos recursos en estas zonas por su vulnerabilidad, teniendo en cuenta que la extracción afecta a los ejemplares juveniles de chanque que aún no han desovado y a los desovantes de erizo.

Catálogo de zooplancton en el mar peruano. Primera parte: área Pisco-San Juan

EL primer punto de la investigación se encarga de determinar las características del área de estudio. Como segundo punto se ubican taxonómicamente las especies, este aspecto que es ampliamente detallado en el trabajo.

Aspectos biológico pesqueros de la pesquería industrial de anchoveta y sardina en Pisco y Tambo de Mora. 1995-1998

Presenta los resultados de algunos aspectos biológico pesqueros de la pesquería industrial de anchoveta y sardina en Pisco y Tambo de Mora, en donde se registraron cambios en el ecosistema marino durante los años 1995-1996, considerado como período frío o fenómeno La Niña. Indica que tanto las condiciones frías como las cálidas en el ambiente marino, producen cambios en el comportamiento de los recursos pelágicos, especialmente la anchoveta.

Comportamiento del lobo fino de sudamerica (Arctocephalus australis) en Punta San Juan, Perú, durante El Niño 1982-83

Estudio sobre el comportamiento maternal del lobo fino de sudamérica realizados entre enero y junio de 1983.

Impacto del fenómeno El Niño en la población de lobos marinos en Punta San Juan

Estudia el comportamiento de la poblacion de los lobos marinosen Punta San Juan durante 1982-83

Prospección del recurso Erizo (Loxechinus albus) en Pisco, San Juan de Marcona y Lomas 1998 y enero 1999

Describe que la demanda del erizo verde Loxechinus albus con fines de exportación y la influencia que tuvo el evento El Niño 1997-1998 sobre el recurso, el cual fue negativo sobre la mayoría de recursos bentónicos, ya que produjeron una rápida disminución de sus niveles poblacionales en los puertos de Pisco, San Juan de Marcona y Lomas, registrándose 1998 los desembarques más bajos desde 1993-1994.