Effects of photobiomodulation therapy combined with static magnetic field on pain and function in patients with lateral epicondylitis: a multicentre, randomised, placebo-controlled trial

Introduction

Photobiomodulation therapy (PBMT), particularly when combined with a static magnetic field (PBMT-sMF), is a promising non-pharmacological approach for managing musculoskeletal disorders. However, high-quality evidence for its efficacy in lateral epicondylitis remains limited.

Objectives

The study aims to investigate the effectiveness of PBMT-sMF vs placebo in reducing pain, improving function and modulating inflammatory markers in individuals with lateral epicondylitis.

Design

Multicentre, randomised, triple-blinded, placebo-controlled trial.

Setting

Three outpatient physiotherapy clinics in Brazil.

Participants

50 adults (18–50 years) with unilateral lateral epicondylitis and baseline pain ≥50 on the visual analogue scale (VAS).

Interventions

Participants received either active PBMT-sMF (n=25) or placebo (n=25), 2 times per week for 3 weeks. PBMT-sMF involved multi-wavelength irradiation at 4 epicondyle sites (60 s; 27.1 J/site). The placebo group underwent the same procedure without active irradiation.

Primary and secondary outcome measures

The primary outcome was degree of pain rating (VAS). Secondary outcomes included forearm disability (Patient-Rated Tennis Elbow Evaluation, PRTEE), grip strength, serum tumour necrosis factor-alpha (TNF-α) levels and treatment satisfaction. Assessments were conducted at baseline, post-treatment (3 weeks) and at 4-week follow-up.

Results

PBMT-sMF yielded a higher responder rate (defined as the proportion of participants achieving at least a 30% reduction in pain intensity relative to baseline) than placebo (72% vs 40%, p=0.045), with a clinically and statistically significant between-group difference. Compared with placebo, the PBMT-sMF group showed significantly greater reductions in pain intensity both at the end of treatment (51.4±19.8 vs 36.9±22.6; p=0.0223) and at follow-up (37.4±24.1 vs 20.3±21.2; p=0.0049). TNF-α levels also decreased significantly in the PBMT-sMF group compared with placebo at both time points (p

Conclusions

PBMT-sMF significantly reduced pain intensity and TNF-α levels, suggesting an anti-inflammatory mechanism. Although functional outcomes were not improved, PBMT-sMF may be a valuable short-term, non-invasive option for lateral epicondylitis pain management.

Trial registration number

NCT04829734 on ClinicalTrials.gov

Assessing tuberculosis infection prevalence and test concordance in high-risk groups: a cross-sectional study in Mexicali, Baja California

Background

Despite low sensitivity and implementation challenges, the tuberculin skin test (TST) remains the standard-of-care tuberculosis (TB) infection test in Mexico. Interferon gamma release assays (IGRA) may overcome TST-related challenges. Within the confines of the local programmatic setting, this cross-sectional study evaluated the prevalence of TB infection (TBI) and concordance of TST and IGRA in three high-risk populations in Mexicali, Baja California, Mexico.

Methods

Household contacts (HHC) of individuals with TB, people who use drugs (PWUD), people deprived of liberty (PDL) and prison employees underwent evaluation for TBI using TST and QIAreach, a novel IGRA. Prevalence of infection, concordance of test results and reactivity trends of time-to-results (TTR) by TST-induration size were assessed.

Results

In total, 214 of 411 (52.07%) people who had TST and 269 of 460 (58.48%) people who had IGRA tested positive for TBI. Frequency of infection varied across risk groups (HHC 29 (29.6%); PWUD 67 (70.53%); PDL 111 (56.06%) and prison employees 7 (35.0%), p20 mm, p=0.05).

Conclusion

All risk groups had a high frequency of TBI, necessitating locally tailored guidelines for screening, treatment and management of TBI to optimise care for vulnerable populations.

Intravenous Line Labels For High‐Alert Drugs Administered To Critically Ill Patients: A Simulated Experimental Assessment

ABSTRACT

Aims and Objectives

Evaluate the effect of IV line labels on nurses' identification of high-alert medications in a simulated scenario of multiple infusions for critically ill patients.

Design

Randomised crossover simulation experimental study.

Methods

A study was conducted on 29 nurses working in intensive care for over 6 months. They were given two critical scenarios in a simulated environment, one with labels and the other without labels, involving multiple intravenous infusions. The nurses had to identify the medications infused into the critical patients' intravenous lines and disconnect a specific line. The data were collected and analysed to evaluate the errors made by the nurses in identifying and disconnecting the medications and the time they spent carrying out the tasks. The Wilcoxon test was used to analyse the variation in outcome before and after the intervention.

Results

Approximately one-third of the study participants incorrectly identified the intravenous lines in both scenarios. There was no significant difference in the average number of errors between the scenarios with and without labels. However, the time taken to perform the tasks in the scenario with labels was 1 min less than in the scenario without labels, suggesting a potential efficiency gain.

Conclusions

The labels on the intravenous lines allowed for quick drug identification and disconnection. The professionals performed similarly in correctly recognising the high-alert medication intravenous lines, in the scenarios with or without labels.

Relevance to Clinical Practice

The label can be used as a technology to prevent misidentification of high-alert medications administered to critically ill patients through intravenous lines, thereby enhancing medication safety in healthcare institutions.

No Public Contribution.

A New Methodological Approach to Cultural Adaptation of a Mobile Application for Teaching the Nursing Process

No abstract available

Health-related quality of life in Brazilian patients with cutaneous leishmaniasis using EQ-5D

by Janaína de Pina Carvalho, Sarah Nascimento Silva, Tália Santana Machado de Assis, Endi Lanza Galvão, Mayra Soares Moreira, Mônica Viegas Andrade, Kenya Valéria Micaela de Souza Noronha, Gláucia Cota

Cutaneous leishmaniasis (CL) is a neglected infectious disease with a global distribution and a known health-related quality of life (HRQoL) impact. However, no utility-based HRQoL assessments for CL patients are available. The aim of this study was to quantitatively assess the health-related quality of life among patients with CL attending a Brazilian reference center. A retrospective interview-based longitudinal study was conducted using the EQ-5D-3L/VAS to assess the current health status during active disease, and retrospectively before the onset of disease symptoms. In addition, socioeconomic data were collected via a standardized questionnaire, and sociodemographic and clinical data were collected directly from medical records. A total of 143 patients with a mean age of 52 (±17) years were included, 73% of whom were men. The mean utility score before the onset of CL symptoms was 0.858. Comparison of responses related to health status before and after disease onset revealed significant losses (p 

Isolated and Combined Effects of Sedentary Behaviour and Physical Activity on Muscle Strength in Older Adults: A Prospective Cohort Study

ABSTRACT

Aim

We aim the isolated and combined effects of sedentary behaviour exposure time and physical activity levels on muscle strength in older adults.

Design

This prospective observational cohort study, analytical in nature, using exploratory survey methods and physical performance testing. With 5-year longitudinal follow-up (2015–2020).

Methods

A total of 459 older adults participated in the baseline, with a total of 224 being included/located again in the follow-up. We evaluate muscle strength using handgrip tests and sit-to-stand tests. The international physical activity questionnaire was used to measure physical activity and sedentary behaviour. Generalised Estimation Equations tested both independent and combined effects, reporting results as β coefficients and confidence intervals.

Results

Older adults exhibiting low sedentary behaviour displayed enhanced handgrip strength compared to those with high sedentary behaviour. Notably, older adults who were sufficiently active with low sedentary behaviour, sufficiently active with high sedentary behaviour, and insufficiently active with low sedentary behaviour showed increased handgrip strength compared to their counterparts who were insufficiently active with high sedentary behaviour. This trend was consistent for lower limb strength.

Conclusion

Interventions that encourage a reduction in sedentary behaviour and an increase in physical activity are essential to maintain muscle strength among older adults.

Implications for Practice

The findings of this study underscore the importance of addressing both sedentary behaviour and physical activity levels in clinical interventions aimed at preserving muscle strength in older adults. Routine assessments of physical activity and sedentary behaviour could help tailor personalised exercise programs, potentially enhancing functional independence and reducing the risk of frailty and disability in older patients.

Patient or Public Contribution

Patients were involved in the sample of the study.

Reporting Method

This study was conducted in accordance with the Strengthening Research in Observational Studies in Epidemiology (STROBE) guidelines.

Acciones de la enfermería láser y la estomaterapia: revisión integradora

Objetivo principal: Identificar en la literatura las acciones de la enfermería en láser y estomaterapia.Metodología:Revisión integradora de la literatura realizada en abril de 2022, mediante consulta de las Bases de Datos Biblioteca Virtual en Salud (BVS) a partir de los cruces de los descriptores, se realizó una encuesta bibliográfica en las siguientes bases de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS) y Biblioteca Nacional de Medicina (MEDLINE). Resultados principales: Se incluyeron once artículos en la muestra, que destacan el uso de la terapia láser de baja intensidad en la cicatrización de heridas con efectos positivos, su uso por parte de la enfermera profesional y la especialización en estomaterapia, poniendo al profesional en el punto de mira. Conclusión principal:La importancia del uso de las nuevas tecnologías en la cicatrización de heridas, como el láser siendo la enfermera el pilar de esta atención, pudiendo especializarse en el área de la estomaterapia, pero es necesario profundizar en la investigación en esta área por parte de las enfermeras.

Preparación preoperatoria: la percepción de la persona que se somete a una cirugía programada

Objetivo principal: Conocer la percepción de la persona sometida a una cirugía general programada sobre su preparación preoperatoria. Método: Estudio cualitativo y exploratorio. Se realizaron diez entrevistas semiestructuradas con personas que se habían sometido a una cirugía general programada en los últimos seis meses en un hospital universitario de la región central de Portugal. Para analizar los datos se utilizó la técnica del análisis de contenido. Resultados principales: Surgieron cinco unidades temáticas, percepción de la experiencia quirúrgica, sentimientos/emociones percibidas, necesidades de información, expectativas sobre los cuidados de enfermería preoperatorios y perspectivas sobre la existencia de una consulta de enfermería, que se subdividieron en varias categorías y subcategorías. Conclusión principal: Algunas personas siguen viendo la experiencia quirúrgica como algo traumático y consideran el entorno quirúrgico como un generador de estrés. Este estudio refuerza la relevancia del personal de enfermería en la preparación de las personas en situaciones perioperatorias y puede proporcionar importantes contribuciones a la estructuración de una consulta de enfermería.

Caracterización de la conciliación de medicamentos en urgencias

Objetivo: Explorar los aspectos principales de la conciliación de medicamentos en los servicios de urgencias. Metodología: Revisión panorámica de la literatura que sintetice los conocimientos existentes sobre la conciliación de medicamentos en los servicios de urgencias. Para ello se realizó una búsqueda sistemática de artículos originales publicados en revistas específicas de la ciencia enfermera y ciencias de la salud durante los últimos 10 años, e indexadas en bases de datos y otros recursos en español e inglés, como son: Cuiden Plus, Pubmed, IBECS, SCIELO y Google académico. En cada base de datos, se introdujeron una serie de palabras claves relacionadas con el tema y basadas en las nomenclaturas MeSH y DeCS.  Resultados: Se encontraron 5 artículos que identifican áreas claves en la conciliación de medicamentos en urgencias. En este sentido, las personas mayores de 65 años, polimedicadas y pluripatológicas son las más susceptibles de padecer un error en la medicación, sucediendo entre un 79,3 y un 95,8%. La omisión de la medicación es la discrepancia no justificada más frecuente (23,8 - 71,7%). A pesar del tipo de error y la frecuencia que se produce en un perfil de paciente vulnerable de antemano, en raras ocasiones les produce daño. Las barreras principales para una correcta conciliación se observan en la incorrecta anamnesis y registro en la historia clínica, así como la ausencia de un listado único de medicamentos. Los estudios realizados en urgencias se han centrado en el farmacéutico como profesional para detectar dichos errores. Conclusión: La caracterización de los errores en la conciliación de medicamentos facilita diseñar estrategias específicas que prevengan dichos errores o detectarlos precozmente con el fin de reducir los efectos adversos y la descompensación de patologías con consecuencias para la salud de la población y para el sistema sanitario.