290 resultados para HEEL PRICK


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Daily average Alnus pollen counts (1996-2005) from Worcester (UK) and Poznań (Poland) were examined with the aim of assessing the regional importance of Alnus pollen as an aeroallergen. The average number of Alnus pollen grains recorded annually at Poznań was more than 2.5 times that of Worcester. Furthermore, daily average Alnus pollen counts exceeded the thresholds of 100, 500 and 1,000 grains/m3 more times at Poznań than Worcester. Skin prick test results (1996-2005) and allergen-specific IgE(asIgE) measurements using the CAP (Pharmacia) system (2002-2005), were supplied by the Allergic Diseases Diagnostic Centre in Poznań. The annual number of positive skin prick tests to Alnus pollen allergens was significantly related (p<0.05) to seasonal variations in the magnitude of the Alnus pollen catch recorded at Poznań (r=0.70). The symptoms of patients with positive skin prick tests to Alnus pollen allergens were: 51% pollinosis, 43% atopic dermatitis, 4% asthma, 1% chronic urticaria and 1% eczema. On a scale of 0-6, 20.5% of patients examined for serum asIgE in relation to Alnus pollen allergens had asIgE measurements in classes 5 and 6. Alnus pollen is generally considered to be mildly allergenic. However, the amount of Alnus pollen released into the atmosphere in places such as Poznań may increase its impact on the population and make it one of the more important aeroallergens present.

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Background: Artemisia species pollen represents a major cause of allergy in Central Europe. Variations in the pollen season, the influence of climate variables and the prevalence of pollinosis to it were analyzed in Poznan, in western Poland between 1995 and 2004. Methods: A Hirst volumetric spore trap was used for atmospheric sampling. Pollination date trend analysis and Spearman correlation tests were performed. Skin prick tests (SPT) and allergen specific immunoglobulin (Ig)E antibody measurements were performed in 676 and 524 patients, respectively. Results: The Artemisia species pollen season grew longer due to a clear advance in the starting day and only a slightly earlier end point; the peak day also came slightly earlier. Rainfall in the fi rst fortnight of July highly influenced pollen season severity. Temperature was directly correlated with daily Artemisia species pollen levels; relative humidity was inversely correlated. Twelve percent of patients had a positive SPT reaction to Artemisia species. Their symptoms were rhinitis and conjunctivitis (15%), atopic dermatitis (15%), chronic urticaria (14.3%), bronchial asthma (2.4%), and facial and disseminated dermatitis (1.3%). Elevated specifi c IgE concentrations were detected in the sera of 10.1% of patients. Conclusions: Artemisia species pollen is an important cause of pollinosis in western Poland. Pollen season intensity is highly influenced by rainfall in the previous weeks. Trends towards earlier season starts and longer duration, possibly caused by climate change, may have an impact on the allergic population.

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Background: Children with spina bifida represent the major risk group for latex sensitization. Purpose: To determine the prevalence of latex sensitization in these children and to identify risk factors. Material and methods: We studied 57 patients with spina bifida. The mean age was 5.6 years and the male/female ratio was 0.8/1. In all patients a questionnaire, skin prick test (SPT) with latex (UCBStallergènes, Lofarma and ALK-Abelló), common aeroallergens and fruits (UCB-Stallergènes) and serum determination of total IgE (AlaSTAT) were performed. Results: The prevalence of latex sensitization was 30 %; only two sensitized children (12 %) had symptoms after exposure. Risk factors for latex sensitization were age 5 years (p = 0.008; OR = 6.0; 95% CI = 1.7-22.1), having at least four previous surgical interventions (p < 0.0001; OR = 18.5; 95% CI = 3.6-94.8), having undergone surgery in the first 3 months of life (p = 0.008; OR = 5.4; 95% CI = 0.7-29.2) and total serum IgE 44 IU/ml (p = 0.03; OR = 3.8; 95 %CI = 1.1-13.1). Multiple logistic regression analysis showed that only a history of four or more surgical interventions (p < 0.0001; OR = 26.3; 95 %CI = 2.9-234.2) and total serum IgE 44 IU/ml (p = 0.02; OR = 8.6; 95% CI = 1.4-53.4) were independently associated with latex sensitization. Sex, family and personal allergic history, hydrocephalus with ventriculoperitoneal shunt, cystourethrograms, intermittent bladder catheterization and atopy were not related to latex sensitization. Conclusions: In children with spina bifida, significant and independent risk factors identified for latex sensitization were multiple interventions and higher levels of total serum IgE. A prospective study will clarify the clinical evolution of assymptomatic children sensitized to latex.

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OBJECTIVE: The prevalence of ragweed allergy is increasing worldwide. Ragweed distribution and abundance is spreading in Europe in a wide area ranging from the Rhone valley in France to Hungary and Ukraine, where the rate of the prevalence can peak at as high as 12%. Low-grade ragweed colonisation was seen in Geneva and Ticino, less than two decades ago. There were fears that allergies to ragweed would increase Switzerland. The intent of this study was to assess the rate of prevalence of sensitisation and allergy to ragweed in the population living in the first rural Swiss setting where ragweed had been identified in 1996, and to evaluate indirectly the efficacy of elimination and containment strategies. MATERIAL AND METHODS: In 2009, 35 adults in a rural village in the Canton of Geneva were recruited. Data were collected by means of questionnaires and skin-prick tests were done on each participant. The study was approved by the local Ethics Committee. RESULTS: Based on questionnaires, 48.6% had rhinitis (95% confidence interval [CI] 32.9-64.4; n = 17/35) and 17.1% asthma (95% CI 8.1-32.6; n = 6/35). Atopy was diagnosed in 26.4% (95% CI 12.9-44.4) of the sample (n = 9/34). Ragweed sensitisation was found in 2.9% (95% CI 0.7-19.7; n = 1/34), mugwort sensitisation in 2.9% (95% CI 0.1-14.9; n = 1/35), alder sensitisation in 17.1% (95% CI 6.6-33.6; n = 6/35), ash sensitisation in 12.5% (95% CI 3.5-29.0; n = 4/32) and grass sensitisation in 22.9% (95% CI 10.4-40.1; n = 8/35). Ragweed (95% CI 0.1-14.9; n = 1/34) and mugwort allergies (95% CI 0.1-14.9; n = 1/35) were both found in 2.9% of the population. CONCLUSION: This study showed a surprisingly low incidence of ragweed sensitisation and allergy, of 2.9% and 2.9%, respectively, 20 years after the first ragweed detection in Geneva. The feared rise in ragweed allergy seems not to have happened in Switzerland, compared with other ragweed colonised countries. These results strongly support early field strategies against ragweed.

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A double-blinded, placebo controlled, cross-over design was used to investigate sodium citrate dihydrate (Na-CIT) supplementation improve 200m swimming performance. Ten well-trained, male swimmers (14.9 ± 0.4y; 63.5 ± 4kg) performed four 200m time trials: acute (ACU) supplementation (0.5g/kg), acute placebo (PLC-A), chronic (CHR) (0.1g/kg for 3 days and 0.3g/kg on the 4th day pre-trial), and chronic placebo (PLC-C). Na-CIT was administered 120min pre-trial in solution with 500mL of flavored water; placebo was flavored water. Blood lactate, base excess (BE), bicarbonate, pH, and PCO2 were analyzed at basal, 100min post-ingestion, and 3min post-trial via finger prick. Time, lactate, and rate of perceived exertion were not different between trials. BE and bicarbonate were significantly higher for the ACU and CHR trials compared to placebo. “Responders” improved by 1.03% (P=0.043) and attained significantly higher post-trial lactate concentrations in the ACU versus PLC-A trials and compared to non-responders in the ACU and CHR trials.

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Les changements socioéconomiques des dernières décennies ont profondément transformé le rapport qu’entretient le Québec avec ses professionnels de la santé. En ouvrant le champ à l’accumulation privée du capital dans les années 1990, se met en place au sein de la fonction publique une philosophie politique issue du monde des affaires. Dès lors, le paradigme de la gouvernance investit les hôpitaux, où exerce 65 % de l’effectif infirmier québécois. Des chercheurs ont investigué les contraintes et torts subis par les infirmières consécutivement à la restructuration du système de santé, cependant, peu d’entre eux ont tenu compte des rapports de force et des structures de pouvoir dans lesquels s’enracine le vécu des infirmières. La présente étude a pour but d’explorer les expériences vécues d’infirmières soignantes politiquement engagées qui exercent en centre hospitalier (CH), de rendre compte de l’ordre social existant au sein de cette institution, de décrire la façon dont elles aimeraient idéalement exercer et de répertorier les idées qu’elles ont et les actions qu’elles mettent en place individuellement ou collectivement de façon à favoriser la transformation de l’ordre social et de l’exercice infirmier en CH. Épistémologiquement, notre étude qualitative s’inscrit dans cette idée que la réalité est complexe, mouvante et dépendante de la perception des personnes, proposant une orientation compréhensive et contextualisée de l’action humaine et du politique; c’est ainsi que le point de vue politique des infirmières participantes est pris en compte. L’articulation des expériences vécues, de l’idéal normatif et de l’action politique des participantes est explorée suivant une perspective postmoderniste, praxéologique et dialectique issue de la théorie critique qui réfléchit non seulement sur ce qui est, mais également sur ce qui est souhaitable; une réflexion qui sous certaines conditions s’ouvre sur l’action transformatrice. Les notions de pouvoir, de rapport de force, de résistance et d’émancipation influencent notre analyse. Au terme de cette étude, les résultats indiquent la présence d’une déprofessionnalisation graduelle en faveur d’une technicisation du soin infirmier et d’une dérive autoritaire grandissante au sein des CH s’arrimant au registre sémantique de l’économie de marché à partir des notions d’efficacité, de performance et d’optimisation. Les infirmières soignantes perçues comme des « automates performants » se voient exclues des processus décisionnels, ce qui les prive de leurs libertés de s’exprimer et de se faire critiques devant ce qui a été convenu par ceux qui occupent les hautes hiérarchies du pouvoir hospitalier et qui déterminent à leur place la façon dont s’articule l’exercice infirmier. Le pouvoir disciplinaire hospitalier, par l’entremise de technologies politiques comme la surveillance continue, les représailles et la peur, la technicisation du soin et le temps supplémentaire obligatoire, concourt à la subjectivation des infirmières soignantes, en minimisant l’importance de leur jugement clinique, en affaiblissant la solidarité collective et en mettant au pas l’organisation syndicale, ce qui détournent ces infirmières de la revendication de leurs droits et idéaux d’émancipation les ramenant à une position subalterne. Nos résultats indiquent que les actions politiques que les participantes souhaitent déployer au sein des CH visent l’humanisation des soins et l’autodétermination professionnelle. Toutefois, nombre des actions répertoriées avaient pour finalité fonctionnelle la protection et la survie des infirmières au sein d’un dispositif hospitalier déshumanisant. Certaines infirmières soignantes s’objectent en conscience, déploient des actions de non-coopération individuelles et collectives, font preuve d’actes de désobéissance civile ou souhaitent agir en ce sens pour établir un rapport de force nécessaire à la prise en compte de leurs revendications par une gouvernance hospitalière qui autrement ferait la sourde oreille. Le pouvoir exercé de façon hostile par la gouvernance hospitalière doit à notre avis être contrecarré par une force infirmière collective égale ou supérieure, sans quoi les politiques qui lui sont associées continueront de leur être imposées. Le renouvellement radical de la démocratie hospitalière apparaît comme la finalité centrale vers laquelle doivent s’articuler les actions infirmières collectives qui permettront l’établissement d’un nouveau rapport de force puisque c’est à partir de celle-ci que les infirmières soignantes pourront débattre de l’orientation que doit prendre l’exercice infirmier.

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The most important part of any footwear is the sole (or sole and heel) which withstands all the hannful external factors such as rouglmess of the ground or road, sharp objects, thorns and stones, heat, dampness and cold during walking. The properties desirable in soling material, therefore, would be 1. lightness 2. resistance to wear and tear for long service life 3. flexibility/softness for wearing comfort 4. thennal insulation Rubber soling surpasses all other soling materials in better performance and lower cost. Because MC sole is soft and very light, and has good abrasion resistance, flex properties and set behaviour it has become very popular all over the world and demand for better quality product is ever increasing. Due to the traditional approach adopted by the footwear industry in foot wear design, the rubber based footwear export surprisingly contributes only a small percentage. The essence of success for any industry lies in the expansion of the export market. Microcellular soles are manufactured for the last three decades without much change in the traditional design and colour pattern. In recent years domestic customers have also started demanding better quality products. In view of the changing taste of the customer and growing competition from other countries, substantial improvement in the export potential will require new base materials for regular or fashion rubber based footwears. The main objective of the present study is to develop new base materials for making MC soles with good quality, viz., light weight, durability and bright colours

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Introducción Las rupturas agudas del tendón de Aquiles se presentan en pacientes entre 40 y 50 años. Las causas más comunes son actividades deportivas. Se han descrito técnicas mínimamente invasivas, con complicaciones como infección del sitio operatorio, adherencias y la lesión del nervio sural. El propósito de este estudio es determinar el desenlace clínico y funcional, de los pacientes con rupturas agudas del tendón de Aquiles llevados a reparación quirúrgica mínimamente invasiva entre 2011 y 2013 en nuestra institución. Materiales y métodos. Estudio tipo Serie de casos. Se realizó evaluación de fuerza muscular, fatiga muscular, arcos de movilidad con respecto a la extremidad contralateral, la escala AOFAS y se describieron las complicaciones. Resultados. Se evaluaron 21 pacientes de 31 elegibles, diecisiete hombres y cuatro mujeres. Edad promedio de 42,7 años, duración promedio de seguimiento de 17,47 meses. Como complicación hubo una dehiscencia de sutura treinta días después del procedimiento. Los pacientes regresaron a actividades laborales 48 días después de cirugía. El tiempo promedio de retorno a actividades deportivas fue de 8.47 meses. El puntaje promedio en la escala AOFAS fue 90. Los arcos de movilidad del tobillo fueron en promedio de 52° para el lado afectado y 56° en el no intervenido. El número de repeticiones de elevación de talón de la extremidad afectada fue de 58 en promedio. Discusión. Estos resultados sugieren que la técnica mínimamente invasiva para reparación del tendón de Aquiles provee resultados funcionales satisfactorios a corto y mediano plazo con bajas tasas de complicación.

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Antecedentes El dolor en neonatos ha sido un problema poco explorado. Se ha propuesto el uso de las terapias no farmacológicas para su tratamiento, sin embargo existen pocas aproximaciones sistemáticas para la evaluación de su eficacia. Objetivos Determinar la eficacia de las terapias no farmacológicas en el manejo del dolor en neonatos pretérmino a través de una revisión sistemática. Metodología Se realizó una revisión sistemática de la literatura para evaluar la eficacia de las terapias no farmacológicas en el manejo del dolor en el recién nacido petérmino. La búsqueda se realizó a través de las bases de datos Embase, Cochrane, Bireme y Embase. Se identificaron estudios publicados inglés y español. Se realizó un análisis cualitativo y cuantitativo. Resultados Se incluyeron 10 ensayos clínicos. La solución de sacarosa administrada por vía oral mostró reducir la intensidad del dolor en el recién nacido. La intubación y toma de muestras facilitada por el cuidador mostró también reducir la intensidad del dolor. Conclusión Se recomienda la administración solución de sacarosa y acompañamiento del cuidador durante los procedimientos como medidas para reducir el dolor en el recién nacido pretérmino.

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Children may be at higher risk than adults from pesticide exposure, due to their rapidly developing physiology, unique behavioral patterns, and interactions with the physical environment. This preliminary study conducted in Ecuador examines the association between household and environmental risk factors for pesticide exposure and neurobehavioral development. We collected data over 6 months in the rural highland region of Cayambe, Ecuador (2003–2004). Children age 24–61 months residing in 3 communities were assessed with the Ages and Stages Questionnaire and the Visual Motor Integration Test. We gathered information on maternal health and work characteristics, the home and community environment, and child characteristics. Growth measurements and a hemoglobin finger-prick blood test were obtained. Multiple linear regression analyses were conducted. Current maternal employment in the flower industry was associated with better developmental scores. Longer hours playing outdoors were associated with lower gross and fine motor and problem solving skills. Children who played with irrigation water scored lower on fine motor skills (8% decrease; 95% confidence interval 9.31 to 0.53), problem-solving skills (7% decrease; 8.40 to 0.39), and Visual Motor Integration test scores (3% decrease; 12.00 to 1.08). These results suggest that certain environmental risk factors for exposure to pesticides may affect child development, with contact with irrigation water of particular concern. However, the relationships between these risk factors and social characteristics are complex, as corporate agriculture may increase risk through pesticide exposure and environmental contamination, while indirectly promoting healthy development by providing health care, relatively higher salaries, and daycare options.

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To identify and describe the sociodemographic and nutritional characteristics associated with neurobehavioral development among young children living in three communities in the northeastern Andean region of Cayambe-Tabacundo, Ecuador. Women in the study communities who had a child 3 to 61 months of age completed a questionnaire about maternal and child health and sociodemographic characteristics. The Ages and Stages Questionnaire (ASQ) was directly administered to 283 children by two trained interviewers. Growth measurements and a hemoglobin finger-prick blood test were obtained in 2003–2004. Prevalence of developmental delay was calculated, and associations between child development and maternal, child, and household characteristics were explored. High frequencies of developmental delay were observed. Children 3 to 23 months old displayed delay in gross motor skills (30.1%), and children 48 to 61 months old displayed delay in problem-solving skills (73.4%) and fine motor skills (28.1%). A high frequency of both anemia (60.4%) and stunting (53.4%) was observed for all age groups. Maternal educational level was positively associated with communication and problem-solving skills, and monthly household income was positively associated with communication, gross motor, and problem-solving skills. The results suggest a high prevalence of developmental delay and poor child health in this population. Child health status and the child’s environment may contribute to developmental delay in this region of Ecuador, but sociodemographic factors affecting opportunities for stimulation may also play a role. Research is needed to identify what is causing high percentages of neurobehavioral developmental delay in this region of Ecuador.

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An essay on love and liberty in the writings of Gillian Rose, Marquis de Sade, Max Horkheimer and Theodor W. Adorno, written in response to the following provocation: "Encore un effort. A banderole publicitaire carries the breathless descriptions of the new fashions for 1968, when anything goes and details place the accent on this or that part of the body and its adornment: a pair of shoes that come off in a struggle, for example, the heel of one snapped off; a striking checked shirt, with two buttons undone; a light-coloured trench coat (perfect for a May day); a blouson-style jacket that allows easy freedom of movement; place casual slacks worn with an ankle boot. Beauty is in the streets as fashion becomes democratic (or so say the houses of haute couture), while the philosopher of the boudoir extorts us once again to make an effort if we wish to be republicans. Here, to an assembled crowd of sensitive men and women, which petit-maitre or dangerous man of principles would suggest that the only moral system to reinforce political revolution is that of libertinage, the revenge of nature's course against the aberrations of society?"

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Purpose: To evaluate the duration of the effect of mepivacaine when hyaluronidase is injected immediately prior to the end of pulpal anesthesia. Patients and Methods: Forty bilateral, symmetrical third molar surgeries were performed in 20 healthy patients. Inferior alveolar nerve block was induced using 2.8 mL 2% mepivacaine with epinephrine. Hyaluronidase (75 turbidity-reducing units) or a placebo was injected 40 minutes after the beginning of pulpar anesthesia (randomized and double-blind trial). The duration of effect in the pulpal and gingival tissues was evaluated by response to painful electrical stimuli applied to the Adjacent premolar, and by mechanical stimuli (pin prick) to the vestibular gingiva, respectively. Results: in both tissues, the duration of anesthetic effect with hyaluronidase was longer (P <.01) than with the placebo. Conclusion: Hyaluronidase increases the duration of mepivacaine in inferior alveolar nerve blocks. (c) 2008 American Association of Oral and Maxillofacial Surgeons.

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Foot positioning was investigated when right-handed (Experiment One) and left handed adults (Experiment Two) stopped walking to grasp a stationary 70 mm ball at shoulder height. In both experiments centroid location formed by the toe and heel coordinates relative to the object was highly consistent within a target-location condition, demonstrating a foot-targeting phenomenon. Centroid location in the anterior-posterior direction was uninfluenced by grasping hand but the centroid shifted right for left hand grasps and left for right hand grasps. With the target either centrally located or on the same side as the dominant hand, foot positioning brought the grasping hand closer to the target in the medial-lateral direction. When the target object was aligned with the shoulder opposite the dominant hand both groups adopted foot positions to the left of the target. Thus, neither group adopted optimal foot position when the target was located opposite their dominant hand. Foot orientation angle relative to the target was also influenced by choice of grasping hand. Collectively, the findings demonstrate a close association between grasping hand and foot position when approaching to reach and grasp an object but also suggest that foot-dominance may influence medial-lateral centroid location.

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Introduction: It remains uncertain whether long-term participation in regular weight-bearing exercise confers an advantage to bone structure and strength in old age. The aim of this study was to investigate the relationship between lifetime sport and leisure activity participation on bone material and structural properties at the axial and appendicular skeleton in older men (>50 years).

Methods: We used dual-energy X-ray absorptiometry (DXA) to assess hip, spine and ultradistal (UD) radius areal bone mineral density (aBMD) (n=161), quantitative ultrasound (QUS) to measure heel bone quality (n=161), and quantitative computed tomography (QCT) to assess volumetric BMD, bone geometry and strength at the spine (L1–L3) and mid-femur (n=111). Current (>50+ years) and past hours of sport and leisure activity participation during adolescence (13–18 years) and adulthood (19–50 years) were assessed by questionnaire. This information was used to calculate the total time (min) spent participating in sport and leisure activities and an osteogenic index (OI) score for each participant, which provides a measure of participation in weight-bearing activities.

Results:
Regression analysis revealed that a greater lifetime (13–50+ years) and mid-adulthood (19–50 years) OI, but not total time (min), was associated with a greater mid-femur total and cortical area, cortical bone mineral content (BMC), and the polar moment of inertia (I p) and heel VOS (p ranging from <0.05 to <0.01). These results were independent of age, height (or femoral length) and weight (or muscle cross-sectional area). Adolescent OI scores were not found to be significant predictors of bone structure or strength. Furthermore, no significant relationships were detected with areal or volumetric BMD at any site. Subjects were then categorized into either a high (H) or low/non-impact (L) group during adolescence (13–18 years) and adulthood (19–50+ years) according to their OI scores during each of these periods. Three groups were subsequently formed to reflect weight-bearing impact categories during adolescence and then adulthood: LL, HL and HH. Compared to the LL group, mid-femur total and cortical area, cortical BMC and I p were 6.5–14.2% higher in the HH group. No differences were detected between the LL and HL groups.

Conclusions:
In conclusion, these findings indicate that long-term regular participation in sport and leisure activities categorized according to an osteogenic index [but not the total time (min) spent participating in all sport and leisure activities] was an important determinant of bone size, quality and strength, but not BMD, at loaded sites in older men. Furthermore, continued participation in weight-bearing exercise in early to mid-adulthood appears to be important for reducing the risk of low bone strength in old age.