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Resumen: Antecedentes y objetivos: El Wound-QoL es un cuestionario validado para medir la calidad de vida en pacientes con heridas crónicas, que fue desarrollado originalmente para su uso en alemán.El objetivo de este estudio fue traducir el cuestionario Wound-QoL para su uso en la práctica clínica y estudios de investigación en España, así como validar esta versión. Materiales y métodos: Se realizaron dos traducciones independientes del Wound-QoL, directa e inversa, a partir de la versión original en alemán, seguidas de un consenso de expertos sobre las versiones resultantes. Después de su perfeccionamiento se realizó un estudio piloto y posteriormente el estudio de validación. Resultados: Se incluyó un total de 115 pacientes. La edad media fue de 69,5 (DE 14,5) años, y el 60,0% eran mujeres. La versión española del Wound-QoL mostró una excelente consistencia interna (índice alfa de Cronbach > 0,8 en todas las escalas). El análisis factorial dio como resultado las mismas escalas que la versión original. Se objetivaron características satisfactorias de la distribución de la puntuación global y de las subescalas. La validez de constructo y la validez convergente con otros resultados (calidad de vida genérica, tasa de curación) fueron satisfactorias. La gran mayoría de los pacientes consideraron que el cuestionario era una herramienta sencilla y factible. El tiempo medio necesario para completar el cuestionario fue de 5 minutos. El 99,1% de los participantes consideraron que las preguntas eran fáciles de entender y el 94,7% declaró que personal. Conclusiones: La versión española del Wound-QoL muestra una excelente validez en la práctica clínica. Por lo tanto, puede ser recomendada para su uso tanto en la rutina clínica como en los ensayos. Abstract: Background and aims: The Wound-QoL is a validated and feasible questionnaire for measuring disease-specific health-related quality of life in chronic wounds, originally developed for use in German.The objective of this study was to translate the Wound-QoL for use in clinical care and in clinical trials in Spain and to validate this version. Materials and methods: Two independent fourth- and back translations of the Wound-QoL from the original German version were conducted, followed by an expert consensus of the resulting versions. After refinement, the final tool was piloted in N = 10 patients and then used in the validation study. Results: A total of 115 patients were recruited. Mean age was 69.5 (SD 14.5) years, 60.0% were female. The Spanish version of Wound-QoL showed high internal consistency (Cronbach's alpha > 0.8 in all scales). Factor analysis resulted in the same scales as the original version. There were satisfactory distribution characteristics of the global score and the subscales. Construct validity and convergent validity with other outcomes (generic QoL, healing rate) were satisfactory. The vast majority of patients considered the Wound-QoL a simple and feasible tool. Mean time needed for completing the questionnaire was 5 minutes. Overall, 99.1% of the participants found it easy to understand the questions and 94.7% stated that the questionnaire suits the personal situation. Conclusions: The Spanish version of the Wound-QoL shows good validity in clinical practice. It can be recommended for use in clinical routine and trials.

Introduction The Spanish Mohs Surgery Registry is used to collect data on the use and outcomes of Mohs micrographic surgery (MMS) in Spain. The aim of this study was to describe perioperative and intraoperative data recorded for MMS procedures performed between July 2013 (when the registry started) and January 2016. Material and methods Prospective cohort study of data from 18 hospitals. The data collected included type of anesthesia, surgical technique, hospital admission, number of Mohs stages, management of preoperative risk factors, additional treatments, previous treatments, type of tumor, operating time, and complications. Results Data were available for 1796 operations. The most common tumor treated by MMS was basal cell carcinoma (85.96%), followed by squamous cell carcinoma (6.18%), lentigo maligna (2.81%), and dermatofibrosarcoma protuberans (1.97%). Primary tumors accounted for 66.9% of all tumors operated on; 19.2% of tumors were recurrent and 13.9% were persistent. The most common previous treatment was surgical. MMS was mostly performed under local anesthesia (86.7% of cases) and as an outpatient procedure (71.8%). The frozen section technique was used in 89.5% of cases. One stage was needed to achieve tumor-free margins in 56.45% of patients; 2 stages were required in 32.1% of patients, 3 in 7.1%%, 4 in 2.7%, and 5 or more in 1.8%. The defect was reconstructed by the dermatologist in 98% of patients and the most common technique was flap closure (47.2%). Intraoperative complications were recorded for just 1.62% of patients and the median (interquartile range) duration of surgery was 75 (60-100) minutes. Conclusion The characteristics of the patients and tumors treated by MMS are similar to those reported for similar studies in other geographic areas. Lentigo maligna and dermatofibrosarcoma protuberans accounted for a higher proportion of cases in our series, and repair of the surgical defect by a dermatologist was also more common. Operating times in MMS are not much longer than those reported for other procedures and the rate of intraoperative complications is very low.

Background People with intellectual disability (ID) have lower performances in physical fitness (PF) tests than people without ID, a situation that exists during all the life stages. However, the assessment of the FP of persons with ID often uses instruments that were designed for non-disabled people. Aim To check the reliability and feasibility of 8 PF tests in adults with mild to moderate ID. Methods A cross-sectional study was carried out with a test-retest design in a maximum interval of 2 weeks with 240 adults (160 men and 80 women) with mild to moderate ID in order to assess the feasibility and reliability of the following 8 tests: body mass index (BMI), waist circumference (WC), the timed up & go test (TUG), the deep trunk flexion test (DTF), the hand grip test (HG), the timed stand test (TST), the 30-s sit-up (SUP) test, and the 6-min walk test (6MWT). The complete battery was called the SAMU-Disability Fitness Battery (SAMU-DISFIT). The psychometric properties of the battery, feasibility, reliability, the standard error of the measurement (SEM) and the minimal detectable change (MDC) were calculated. Results The TUG, DTF, HG, TST, and 6MWT showed an intraclass correlation coefficient (ICC) from fair to high reliability. Only the SUP test in men had an ICC lower than 0.7 and high SEM values. Conclusion The psychometric properties provide robust data on the use of the SAMU-DISFIT battery in people with ID and can be considered a useful tool for assessing PF in adults with mild to moderate ID in future research.

ResumenObjetivoEn la presente investigación hemos planteado como objetivos principales, por un lado, valorar el efecto del ejercicio físico y el entrenamiento vibratorio sobre la amplitud de movimiento en mujeres con fibromialgia (FM) y, por otro, determinar si existe alguna relación entre dicha variable y el dolor y la rigidez.MétodoLa muestra estuvo constituida por un total de cuarenta y seis mujeres (edad: 58,2±8,5 años; peso: 72,1±9,6kg; altura: 156,9±6,1cm) diagnosticadas con FM. Los participantes fueron divididos aleatoriamente en tres grupos: ejercicio físico y entrenamiento vibratorio (WBV + EJ; n=15); ejercicio físico sin vibraciones (EJ; n=15) y un grupo control (GC; n=16). Los grupos WBV + EJ y EJ realizaron dos sesiones semanales de ejercicio físico durante 8 semanas. Además, los integrantes de WBV + EJ realizaron 3 sesiones semanales de entrenamiento vibratorio (30Hz, 4mm). Las pruebas de evaluación incluyeron el test de sit and reach (variable principal), la valoración del número de tender points (TP) y una escala analógica visual (VAS) para determinar la rigidez.ResultadosLos resultados derivados del análisis intra e intergrupo no mostraron diferencias significativas en la rigidez o el número de TP, si bien, la prueba de sit and reach mostró una mejora estadísticamente significativa en WBV + EJ (58%; p

Objectives The main goal of our study is to compare the hamstring/quadriceps ( H / Q ) ratio at different knee angles between level-matched male and female soccer players and to determine whether differences in the H / Q ratio exist between the dominant and the non-dominant leg. Methods A cross-sectional study design was used to compare an isometric H / Q ratio and functional isokinetic ratio (between hamstring in eccentric contraction and quadriceps in concentric contraction) between males ( n = 14) and females ( n = 14). These ratios were studied at two different speeds of movement (60° s −1 and 180° s −1 ) and in five different positions (40°, 50°, 60°, 70° and 80° degrees of knee flexion). Results Our results showed no differences in the H / Q ratio between genders. The ratio in the dominant leg showed an average of 9% higher values. The ratios were an average of 53.4% lower in positions near flexion than in positions near extension. Conclusions For both men and women, the results showed lower ratios in the non-dominant leg compared to the dominant leg. At higher velocities, the force ratios were higher, while in more knee-flexed positions, the ratios were lower. Finally, we did not find differences in ratios between men and women.

The main objective of this study is to understand the differences in equilibrium control between normal subjects and those with Down syndrome. A total of 54 subjects participated voluntarily, divided into control group and Down syndrome group. The equilibrium of the subjects was tested under two conditions: bipedal support with eyes open and closed. The signals were analyzed in a time and frequency domain. The statistical parameters selected (i.e., RMS distance, mean velocity, mean frequency and sway area) to analyze the behavior of the center of pressures (CoP) are calculated employing the result of the combination of the time series data in both directions (i.e. resultant distance). In order to calculate the frequency bands produced by the displacements of the CoP, a Fast Fourier Transform of the data was performed. The group with Down syndrome showed poorer static equilibrium control than the control group in the time domain. In the frequency domain, we found differences between the groups in the distribution of energy in the frequency bands analyzed. In addition, we observed the existence of an interaction effect of the group and the condition tested (p

Fundamento Existen varias opciones terapeuticas para los pacientes con un primer episodio de neumotorax espontaneo idiopatico. El objetivo de este estudio es comparar la efectividad de dos alternativas de tratamiento, la puncionaspiracion con cateter fino y el drenaje pleural grueso. Pacientes y metodos Comparamos una serie actual de 91 pacientes tratados con puncion-aspiracion con una serie historica de 216 casos tratados con drenaje pleural grueso. La puncion-aspiracion fue realizada por los medicos de los servicios de urgencias hospitalarias y el drenaje pleural grueso por cirujanos toracicos. Se siguio a los pacientes tras el tratamiento durante un periodo de 24 meses. Resultados La efectividad inmediata de la puncion-aspiracion fue superior al drenaje pleural grueso (el 86,7 frente al 76%; p Conclusiones La puncion-aspiracion es una maniobra terapeutica tan efectiva como el drenaje pleural grueso. Se trata de un procedimiento sencillo, que los medicos de los servicios de urgencias hospitalarias pueden realizar correctamente. Las incomodidades para el paciente, el coste sanitario y el tiempo de ingreso se reducen de forma notable.

El eccema herpetico o erupcion variceliforme de Kaposi es una variante clinica de la infeccion por el virus herpes simple (VHS) en pacientes con dermopatia previa. A pesar de ser infrecuente, es considerada como una urgencia dermatologica. La entidad subyacente mas frecuente es la dermatitis atopica. Se caracteriza por la aparicion de lesiones vesiculosas y pustulosas diseminadas asociadas a mal estado general. La sobreinfeccion bacteriana es una complicacion frecuente en el eczema herpeticum severo. Se recomienda el tratamiento antiviral sistemico precoz para controlar la replicacion viral y prevenir lesiones cicatriciales. Se suele emplear aciclovir durante 8 dias. Se aconsejan cuidados locales (fomentos, antiobiotico topico) y, en caso de sobreinfeccion importante, antibioterapia sistemica. Un buen control de la dermatitis atopica es importante para prevenir el eczema herpeticum y su recurrencia.

La hernia pulmonar o neumocele es una protrusion del pulmon a traves de un defecto de la pared toracica. Presentamos un caso de hernia pulmonar intercostal espontanea y realizamos una descripcion de la patogenia y de la clasificacion de las hernias pulmonares. Se discuten los hallazgos clinicos y radiologicos, asi como los diferentes metodos de tratamiento. En este caso, el paciente presento un intenso dolor toracico en la base del hemitorax izquierdo. Las imagenes obtenidas por radiografia simple y tomografia axial computarizada (TAC) toracicas pusieron de manifiesto la existencia de una hernia intercostal izquierda. Despues del diagnostico radiologico se realizo tratamiento quirurgico reparador con buenos resultados.