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Bolanos R.,San Marcos University of Costa Rica | Del Castillo A.,Medical Institute BVida Plena | Francia J.,Womens Health Medical Institute BVida Plena
Menopause | Year: 2010

OBJECTIVE: The incidence of vasomotor crises during the climacterium varies in women across different populations, and phytoestrogen consumption seems to play an important role in this problem. The aim of this study was to determine whether intervention with soy (dietary, extract, or concentrate), as compared with placebo, reduces the incidence of hot flashes in climacteric women. METHODS: Only published, randomized, placebo-controlled clinical trials were selected, with a 12-week duration of intervention, having selected postmenopausal women affected with hot flashes attributed to the climacterium (without cancer background). The intervention to be evaluated was soy, as "soy dietary supplement," "soy extract," or "isoflavone concentrate" (genistein or daidzein). The results were expressed as the number of hot flashes, average score of vasomotor symptoms, or average percent reduction in hot flashes within a time unit (day, week, or month). RESULTS: Nineteen studies were analyzed. The minimum heterogeneity was observed in the "isoflavone concentrate" group. In the "extract" and "dietary supplement" groups, heterogeneity reached an intermediate level, I = 42% and 59.73%, respectively. The overall result showed a standardized mean difference of-0.39 (95% CI,-0.53 to-0.25) in favor of soy as well as-0.45 (95% CI,-0.64 to-0.25),-0.51 (95% CI,-0.79 to-0.22), and-0.20 (95% CI,-0.46 to-0.06) for the "concentrate," "extract," and "dietary supplement" subgroups, respectively. CONCLUSIONS: Although the overall combined results and the results by subgroups (according to the type of supplement used) showed a significant tendency in favor of soy, it is still difficult to establish conclusive results given the high heterogeneity found in the studies. © 2010 by The North American Menopause Society.

Tello-Barbaran J.,San Marcos University of Costa Rica
Acta odontológica latinoamericana : AOL | Year: 2010

The aim of this study was to evaluate the antibacterial activity of 2% iodine potassium iodide (IKI) used as a final rinse after the cleaning and shaping procedures in mesial root canals of mandibular molars infected with Enterococcus faecalis. Seventy two mandibular first molars were used. The root canals were infected with Enterococcus faecalisfor 30 days. After the infection procedures, the root canals were cleaned and shaped by using the Pro Taper rotary system and manual files. The teeth were randomly assigned to four experimental groups (N = 18). In group 1, the root canals were irrigated with sterile distilled water (control). In group 2, the root canals were irrigated with 1% Sodium hypochlorite (NaOCl) during instrumentation. In group 3, root canals were irrigated with 1% NaOCl during instrumentation and a five minute final irrigation using 2% IKI. In group 4, the root canals were irrigated with 1% NaOCl during instrumentation and a 15 minutes final irrigation with 2% IKI. Bacteria colony-forming units (CFU) from root canals were semi-quantified and the presence of negative cultures among the groups was compared using Fisher's test (p < 0.05). The order of effectiveness was: 1% NaOCI plus 2% IKl for 15 minutes (95%), 1% NaOCl plus 2% IKl for 5 minutes (44%), 1% NaOCl (17%) and sterile distilled water (0%). Fisher's exact test showed a significant difference among the groups (p < 0.05). It was concluded that under in vitro conditions, IKI was able to eliminate the Enterococcus faecalis from infected dentin significantly in a 15-minute time frame after the cleaning and shaping procedures.

Background and Purpose: There are 1.3 million people in the United States living with limb loss, and most of these patients experience some form of residual limb pain and phantom limb pain (PLP). The purpose of this case study was to determine the effectiveness of mirror therapy, biofeedback, and tactile stimulation on decreasing chronic residual limb pain and PLP in a patient with an upper-limb traumatic amputation. Case Description: The patient is a 48-year-old male who is employed as a construction worker. The patient was working on a conveyer belt transporting stones when the conveyer belt caught his arm resulting in a shoulder disarticulation. According to the International Classification of Functioning, Disability, and Health (ICF), the patient's activity limitations included difficulty in sleeping, inability to write, or inability to perform heavy household chores, yard work, cook, or manage his own transportation needs. The patient's participation limitations included decreased recreational activities with his 15-year-old son, maximum difficulty with sexual activities with his wife, and decreased confidence interfering with his normal social activities. Intervention: Interventions include electromyographic (EMG) biofeedback training to infraspinatus and pectoralis major muscle in short/quick, sustained, and gradual contraction with decreasing sensitivity of electrodes. Treatment strategies also included mirror therapy, scapular proprioceptive neuromuscular facilitation (PNF), high-voltage electrical stimulation, retrograde massage, scar mobilizations, tactile cuing, and soft tissue mobilization. Outcomes: The patient demonstrated a 30% decrease in Disability of the Arm, Shoulder, and Hand (DASH) score, decreased pain with Numeric Pain Rating (NPR) from 9/10 to 3/10, increased amplitude of contraction of infraspinatus and pectoral muscles, decreased sensitivity of myoelectric electrodes, and decreased edema. The patient also reported increased confidence in social interactions with friends and personal interactions with his wife. The patient was also able to participate in recreational activities with his teenage son. Discussion: This case is clinically relevant to the field of physical therapy in terms of decreasing chronic residual limb pain, PLP, and improving muscular control with use of mirror therapy, biofeedback, and tactile stimulation. Copyright © 2015 by the American Academy of Orthotists and Prosthetists.

Aramayo V.,San Marcos University of Costa Rica
Fisheries Research | Year: 2015

Large-scale marine fisheries are recognized as one of the main threats to population stability of many commercially important fish species. Selectivity-driven detrimental changes on the population structure (e.g. declines in mean lengths affecting phenotypic traits of the exploited species), and the growing trend toward earlier maturation (reproductive changes); represents a worldwide phenomenon affecting the recovery of several exploited fish species, all which might contribute with a highly unfavourable scenario of exploitation. Large and long-lived individuals are especially (although not restrictively) vulnerable. A lower fishing selectivity (plus other protection measurements) might gradually favour to those heavily exploited fish populations and balance the catch to all exploitable individuals. This approach might also positively contribute to the fishery sustainability, by protecting old, big females, which are important for growth, fecundity, offspring, and survival of the population. All this supposes a major transformation in the universal way for fish exploitation, and a huge challenge, because it will have to deal with other factors such as short-term economic vision that dominates the main fisheries worldwide. © 2015 Elsevier B.V..

Pontons-Melo J.C.,San Marcos University of Costa Rica
Quintessence international (Berlin, Germany : 1985) | Year: 2011

Composite resins can be used to improve the esthetics of the smile at a low cost and with relatively high clinical performance. The aim of this article was to describe an approach to restore and enhance the esthetic appearance of the anterior dentition through vital tooth whitening and the direct layering of composite resin during predictable esthetic procedures.

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