Enhancing the Sense of Coherence and Social Acceptance in Married Female Students with Education-Family Conflict: A Positive-Cognitive Behavioral Group Therapy Approach

The study highlights the concept of education-family conflict, where educational roles clash with familial obligations, negatively affecting the sense of coherence and social acceptance of married female students. Previous studies have highlighted the increasing tendency of married women to pursue higher education and career advancement, which would emphasize the need for psychological interventions to support them. The study introduces Positive-Cognitive Behavioral Group Therapy (PCBGT) as a novel intervention to address these concerns. Based on their education-family conflict scores, sense of coherence, and social acceptance, sixty married female students (aged 25-35) were purposively selected and equally assigned to experimental and control groups. The experimental group engaged in eight weekly 90-minute PCBGT sessions. Data were analyzed using One-way ANOVA with repeated measures. The findings underscore PCBGT's potential to empower students, enhancing their sense of coherence, manageability, meaningfulness, and social acceptance, persisting up to three months post-intervention. PCBGT enhances the sense of coherence by helping individuals recognize and apply their signature strengths, manage emotions, cultivate self-acceptance, and develop a more comprehensive and meaningful outlook on life. It also fosters social acceptance by promoting self-compassion, identifying strengths, regulating emotions, and enhancing interpersonal skills through structured sessions, ultimately improving individuals’ interactions and relationships. However, further investigation is necessary to comprehensively understand how PCBGT influences the sense of coherence and social acceptance among married female students managing education-family conflict. (AU)

Impacto de un programa de rehabilitación respiratoria domiciliario en la calidad de vida y ansiedad/depresión de pacientes con bronquiectasias no fibrosis quística / Impact of a home respiratory rehabilitation program on the quality of life and anxiety/depression of patients with bronchiectasia not cystic fibrosis

Introducción y objetivos: La valoración del efecto de la rehabilitación respiratoria domiciliaria (PRRD) en bronquiectasias no fibrosis quística (BQ no FQ) es un campo poco explorado hasta la fecha. El objetivo fue evaluar cómo influye un PRRD piloto en la disnea, la calidad de vida y en los trastornos del estado de ánimo así como su relación con la gravedad de la enfermedad. Material y métodos: Ensayo clínico no farmacológico en pacientes con BQ no FQ del Hospital Universitario Virgen Macarena. Se aleatorizó en: 1) grupo estudio (GE): programa de entrenamiento (resistencia y fuerza) en domicilio durante 8 semanas, 2) grupo control (GC): medidas educacionales por escrito. Se evaluó la gravedad de la enfermedad con el E-FACED, síntomas (cuestionario de Leicester (LCQ) y disnea (escala mMRC)), la calidad de vida (cuestionario de enfermedades respiratorias de Saint George (SGRQ)) y ansiedad y depresión (cuestionario hospitalario de ansiedad y depresión (HADS). Resultados: Después de 8 semanas en el GE existió mejoría en disnea de 0,46 ± 0,80, p = 0,010 y en la esfera física del LCQ de -0,68 ± 1,2, p = 0,043. Se produjo una mejoría en SGRQ actividad (-9 puntos, p = 0,025) y en el SGRQ total un cambio clínicamente relevante (-7 puntos, p = 0,063). La escala de depresión descendió 2,3 ± 4,2 puntos, p = 0,044. La gravedad no se relacionó con ninguna variable. Conclusiones: El PRRD mostró un claro beneficio en calidad de vida, síntomas y depresión de nuestros pacientes con BQ no FQ. (AU)

Introduction and objectives: the assessment of the effect of home-based pulmonary rehabilitation programmes (HPRP) in noncystic fibrosis bronchiectasis (non-CF BQ) is a field that has been little explored to date. Our objective was to evaluate how a pilot HPRP influences dyspnoea, quality of life and mood disorders and their relationship the severity of the disease. Material and methods: we present non-pharmacological clinical trial in patients with non-CF BQ at the Virgen Macarena University Hospital. It was randomized into1) study group (SG): received training program (resistance and strength) at home for 8 weeks and 2) control group (CG): received written educational measures. We assessed the impact of the program on disease severity (E-FACED), symptoms (Leicester Questionnaire (LCQ) and dyspnea (mMRC scale)), and quality of life (Saint George RespiratoryQuestionnaire) and anxiety and depression (Anxiety and Depression Hospital (HAD)). Results: after 8 weeks there was an improvement in dyspnoea of 0.46 ± 0,80, p = 0.010 and in the physical sphere of the LCQ of -0.68 ± 1.2, p = 0.043.There was an improvement in SGRQ activity (-9 points, p = 0.025) and in the total SGRQ a clinically relevant change (-7 points, p = 0.063).The depression scale decreased 2.3 ± 4.2 points, p = 0.044. There was no relationship between severity and any of the variables studied. Conclusions: the PRRD showed a clear benefit in quality of life, symptoms and depression of our patients with non-CF BQ. KeywordsMesH: Non-cystic fibrosis bronchiectasis, homebased respiratory rehabilitation, impact quality of life. (AU)

A dynamical method to objectively assess infantile nystagmus based on eye tracking. A pilot study

Purpose The purpose of this research is to propose a new method for the easy, inexpensive and objective quantification of nystagmus using eye-tracking records collected during a simple reading task that could be implantable in clinical practice to assess patients with nystagmus. Methods This is a prospective, observational pilot study. Eye movements of 4 nystagmus patients and 9 healthy children during a reading task (a paragraph with 82 words) on a 15′’ monitor were collected and compared. Data are time series indicating the gaze position on the screen. Two quantifiers were proposed: IndS (based on the speed of movements) and IndF (based on the variation of the gaze trajectory). Results The indices proposed reflect differences in the behavior of eye movements between the two groups. Nystagmus patients present higher values of IndS - indicating smaller number of slow movements (16% of movements with speeds <0.33 1/s for nystagmus and 85% for the control group, with p = 0.01) - and higher values of IndF - indicating higher gaze fluctuation (p = 0.01). Differences were not related with reading speed as show the mean and standard deviation: the nystagmus group required 115±45 s to complete the task and the control group 151±85 s; p = 0.73. Conclusions The proposed indices provide a new method that allows an objective assessment of nystagmus, with potential use in clinical and research practice to improve the follow-up of patients by monitoring the nystagmus over time or treatment. (AU)

School-based Psychosocial Interventions’ Effectiveness in Strengthening Refugee and Migrant Adolescents’ Mental Health, Resilience, and Social Relations: A Four-country Cluster Randomized Study / [La eficacia de las intervenciones psicosociales centradas en la escuela para potenciar la salud mental, la resiliencia y las relaciones sociales de adolescentes refugiados y migrantes: un estudio de grupos aleatorizados en cuatro países]

School-based psychosocial interventions are increasingly put forward as a way to support young refugees’ and migrants’ well-being and mental health in resettlement. However, the evidence on these interventions’ effectiveness remains scarce and scholars denounce particular gaps in the evidence to date, pointing to a lack of large-scale, controlled studies and studies including social outcome measures. This cluster randomized study aims to strengthen the evidence base on school-based psychosocial interventions for refugee and migrant youth by assessing the effect of two interventions, Classroom Drama and Welcome to School, on youth’s mental health, resilience, and social relations in Belgium, Denmark, Norway, and the United Kingdom. Multilevel analyses were conducted separately for the two interventions (Classroom Drama, n = 307, ages 11-19; Welcome to School, n = 251, ages 11-23), using separate no-treatment control groups. Our analyses indicated a significant main, positive effect of Classroom Drama on perceived family support, and an effect on perceived support from friends that was moderated by country: in the United Kingdom, the intervention group reported an increase in perceived friend support, whereas the control group reported a decrease. Furthermore, baseline resilience moderated the effect of the Classroom Drama intervention on behavioral difficulties and well-being. No effects of Welcome to School on any of the outcome variables were found. Overall, this study provides novel, nuanced evidence on school-based psychosocial interventions for refugee and migrant adolescents.(AU)

Cada vez se proponen más las intervenciones psicosociales centradas en la escuela como ayuda al bienestar de jóvenes refugiados y migrantes en su realojamiento. No obstante hay pocas pruebas sobre la eficacia de tales intervenciones y los expertos denuncian fallas en dichas pruebas hasta el momento debido a la falta de estudios controlados a gran escala que incluyan medidas de los resultados sociales. El presente estudio de grupos aleatorizados pretende potenciar la base de pruebas sobre intervenciones psicosociales centradas en la escuela con jóvenes refugiados y migrantes analizando el efecto de dos intervenciones, “El drama en el aula” y “Bienvenido al colegio”, en la salud mental, la resiliencia y las relaciones sociales de los jóvenes en Bélgica, Dinamarca, Noruega y el Reino Unido. Se efectuaron análisis multinivel por separado para las dos intervenciones (“El drama en el aula”, n = 307, edad entre 11 y 19 años; “Bienvenido al colegio”, n = 251, edad entre 11 y 23 años) con grupos de control sin tratamiento separados. Los análisis mostraron un efecto positivo principal significativo de “El drama en el aula” en el apoyo familiar percibido y un efecto en el apoyo percibido de los amigos moderado por el país: en el Reino Unido el grupo de intervención presentó un aumento del apoyo percibido de los amigos, mientras que en el grupo control disminuyó. Además la resiliencia básica moderaba el efecto de la intervención de “El drama en el aula” en las dificultades conductuales y en el bienestar. No se apreció efecto de “Bienvenido al colegio” en ninguna de las variables resultado. En términos generales el estudio supone un inédito y detallado aval de las intervenciones psicosociales centradas en la escuela en el caso de adolescentes refugiados y migrantes.(AU)

Exploring the feasibility and safety of ropinirole combined with nerve growth factor for enhancing neurological health in football players

Objective: This study aims to investigate the viability and safety of utilizing ropinirole in combination with nerve growth factor for the management of neurological health in football players.Methods: A total of 92 athletic inpatients diagnosed with Parkinson's disease were enrolled in this study from December 2018 to December 2020. They were randomly divided into two groups: the control group and the research group, each comprising 46 athletic patients. The control group received nerve growth factor treatment, while the research group received a combination of ropinirole and nerve growth factor. Various serum markers, brain nerve factors, quality of life indicators, therapeutic outcomes, and safety profiles were evaluated and compared between the two groups.Results: Following treatment, both groups exhibited a significant increase in superoxide dismutase (SOD) levels compared to baseline, accompanied by substantial reductions in the levels of interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α), and nuclear factor-kappa B P65 (NF-κB P65). Moreover, the research group demonstrated significantly higher SOD levels and lower IL-1β, TNF-α, and NF-κB P65 levels compared to the control group (P<0.05). The levels of ciliary neurotrophic factor (CNTF), brain-derived neurotrophic factor (BDNF), dopamine (DA), and serotonin (5-HT) significantly increased in both groups post-treatment, with the research group exhibiting notably higher levels of these factors compared to the control group (P<0.05). Assessment of cognitive function (Montreal Cognitive Assessment - MoCA), balance (Berg Balance Scale - BBS), and activities of daily living (ADL) scores revealed significant improvements in both groups after treatment. However, the research group displayed higher MoCA and BBS scores and lower ADL scores than the control group (P<0.05). (AU)

Evaluación de los comparadores empleados en los estudios pivotales de nuevos medicamentos e indicaciones / Assessment of comparators used in pivotal studies of new medicines and indications

Objetivo: En algunos casos, los estudios pivotales para aprobar nuevos medicamentos no emplean el comparador más adecuado. El objetivo es cuantificar este problema analizando los Informes de Posicionamiento Terapéutico (IPT) publicados por el Ministerio de Sanidad español.Métodos: El comparador se clasificó en seis categorías según la adecuación del tratamiento, es decir, si coincidía con el estándar de tratamiento al ser autorizado: A-“inicialmente adecuado”, B-“sin comparador por causa ética”, C-“sin comparador excluyendo los clasificados en B”, D-“inadecuado” y E-“parcialmente subóptimo” (cuando era estándar solo para parte de los pacientes).La variable principal fue la proporción de nuevos fármacos/indicaciones con comparación suficiente (categorías A, B y C) o deficiente (el resto). La información sobre comparadores y tratamiento estándar se extrajo del IPT. Resultados: Se analizaron aleatoriamente 186 IPT con nuevos medicamentos/indicaciones, publicados entre 2013 y 2022. La comparación se consideró suficiente en un 73,7% (IC95 66,9-79,5) de los casos. El 26,3% restante (IC95 20,5-33,1) presentaba comparaciones deficientes en el ensayo pivotal, ya fuera por comparador inadecuado (11,3%), parcialmente subóptimo (5,4%) o ausencia de un estudio comparativo (9,7%). No hubo diferencias en relación con el año de aprobación.Conclusiones: Aproximadamente uno de cada cuatro nuevos medicamentos o indicaciones carece de una comparación suficiente en el momento de empezar a ser utilizado en la práctica clínica. La proporción no mejora a lo largo de los últimos 10 años. Las agencias reguladoras deben ser más exigentes en la selección del comparador para los ensayos clínicos pivotales, por cuestiones éticas y sanitarias. (AU)

Objective: Pivotal studies to approve new medicines often do not use the most appropriate comparator. The objective is to quantify this problem by analysing the Therapeutic Positioning Reports (IPT for its acronym in Spanish) published by the Spanish Health Ministry.Methods: The comparator was classified into six categories, based on the appropriateness of the treatment, i.e. whether it matched the standard of treatment when authorised: A-«initially adequate» (at the start of the study), B-«no comparator for ethical reasons», C-«no comparator -excluding B-«, D-«inadequate» and E-«partially suboptimal» (when it was standard for part of the included patients but not for all of them).The primary endpoint was the proportion of new drugs/indications with sufficient (categories A, B and C) or poor comparator (the rest). Information on comparators and standard treatment was extracted from the IPT. Results: We randomly analysed 186 IPTs with new drugs or indications, published between 2013 and March 2022. Comparability was assessed as sufficient in 73.7% (95%CI 66.9-79.5) of cases. The remaining 26.3% (95%CI 20.5-33.1) had poor comparisons in the pivotal trial, either due to inadequate comparator (11.3%), partially suboptimal (5.4%) or absence of a comparative study excluding ethical justification (9.7%). Conclusions: Approximately one in four new medicines or indications lacks sufficient comparability at the time of entry into clinical practice. The proportion has not improved over the last 10 years. Regulatory agencies need to be more stringent in comparator selection for pivotal clinical trials, for ethical and health reasons. (AU)

Effects of a 10-week dry-land strength and conditioning program in physical capacities and start of previously federated and regular swimming practitioners / Efecto de un programa de entrenamiento de fuerza y acondicionamiento en seco sobre las habilidades físicas en practicantes federados en natación / O efeito de um programa de treino de força e condicionamento em seco nas capacidades físicas e partida em praticantes regulares de natação previamente federados

The aim of this study was to evaluate the effects of a 10-week strength and conditioning (S&C) program in physical capacities and start in previously federated and regular swimming practitioners. 16 swimmers (9 male, 17.00±2.16 years of age, 179.14±5.76 cm of height and 69.79±3.11 kg of weight; 7 female, 15.86±2.34 years of age, 163.86±4.98 cm of height and 60.19±3.60 kg of weigh) were equality, but randomly separated in two groups (control group and experimental group, CG and EG, respectively). In the pre-test, swimmers performed three starts in two different models, grab start and track start, the best start was registered. Kinematic parameters of the swimming start and time at 15 m were determined. Flexibility, countermovement jump and 3 kg medicine ball throw were also assessed. In post-test, 10-weeks after a regular 2-sessions week specific dry-land S&C program of 60 min was performed by the EG, all tests were repeated. Flexibility, strength and muscular power gains were significant in EG, contrarily to CG. Swimming start flight phase variables improved more in EG compared to CG, with specificities observed in grab and track start but not a linear consequence with performance in 15-m mark in both groups. A 10-week dry-land S&C program can provide benefits in physical capacities in regular swimming practitioners, fact that may improve the initial phase of the swimming start, prior to the underwater moment, which should deserve attention by the coaches in daily training aiming performance enhancement at 15 m. (AU)

El propósito de esto estudio fue evaluar el efecto de un programa de fuerza y acondicionamiento (F&A) en seco de 10 semanas sobre las habilidades físicas y el salto en practicantes habituales de natación previamente federados. 16 nadadores (9 masculino, 17.00±2.16 años de edad, 179.14±5.76 cm de altura y 69.79±3.11 kg de peso and 7 mujer, 15.86±2.34 años de edad, 163.86±4.98 cm de altura y 60.19±3.60 kg de peso) fueron equitativamente, pero al azar divididos en dos grupos (control y experimental, respectivamente, GC e GE). En el pre-test realizaron tres saltos en dos modelos, grab start e track start, siendo el mejor registrado. Se han determinado parámetros cinemáticos del salto en natación y el tiempo a los 15 m. También se evaluaron la flexibilidad, el salto con contramovimiento y el lanzamiento de una pelota medicinal de 3 kg. En el post-test, 10 semanas después de un programa de F&A en seco con 2 sesiones semanales de 60 min interpretado por GE, las pruebas se repitieron. Las mejoras de flexibilidad, fuerza y potencia muscular fueron significativas en el GE, en contraste con el GC. Las variables de la fase de vuelo en el salto mejoraron más en el GE en comparación con el CG, con especificidades observadas en el grab start e track start, pero no una consecuencia lineal con el rendimiento a 15 m en ambos grupos. Un programa de F&A seco de 10 semanas puede promover beneficios en las habilidades físicas de nadadores habituales, hecho que puede mejorar la fase inicial del salto en la natación, previa al momento subacuático, que debe merecer la atención de los entrenadores en las sesiones diarias con el objetivo de a una mejora del rendimiento a 15 m. (AU)

O objetivo deste estudo foi avaliar o efeito de um programa de força e condicionamento (F&C) em seco de 10 semanas nas capacidades físicas e salto em praticantes regulares de natação previamente federados. 16 nadadores (9 masculinos, 17.00±2.16 anos de idade, 179.14±5.76 cm de altura e 69.79±3.11 kg de peso; 7 femininos, 15.86±2.34 anos de idade, 163.86±4.98 cm de altura e 60.19±3.60 kg de peso) foram equitativamente, mas de forma aleatória divididos em dois grupos (controlo e experimental, respetivamente, GC e GE). No pré-teste, nadadores realizaram três saltos em dois modelos, grab start e track start, sendo registado o melhor. Foram determinados parâmetros do salto na natação e o tempo aos 15 m. Flexibilidade, salto em contramovimento e lançamento de bola medicinal de 3 kg foram também avaliados. No pós-teste, 10 semanas após programa de F&C em seco com 2 sessões semanais de 60 min realizado por GE, testes foram repetidos. As melhorias de flexibilidade, força e potência muscular foram significativas no GE, contrariamente ao GC. As variáveis da fase inicial do salto associadas ao voo melhoraram mais no GE comparativamente ao GC, com especificidades observadas no grab start e track start, mas não uma consequência linear com o desempenho aos 15 m em ambos os grupos. Um programa de F&C em seco de 10 semanas pode promover benefícios nas capacidades físicas de praticantes regulares de natação, facto que pode melhorar a fase inicial do salto na natação, anterior ao momento subaquático, que deve merecer atenção pelos treinadores nas sessões diárias visando uma melhoria de desempenho aos 15 m. (AU)

Effects of yoga on pulmonary functions among asthmatic patients: A protocol synthesis

OBJECTIVE: This study aimed to synthesize protocol of yoga pranayama's practice through combining yoga pranayama's steps into the new integrated formations of yoga pranayama's steps for adult asthmatic patients as a protocol. METHOD: Literature review from the last 20 years publication of original trial articles on adult asthmatic subjects from 4 databases: PubMed, Science Direct, EBSCO, and Scopus was conducted. Review and non-trial articles were excluded. Articles were appraised using Joanna Bridge Institute (JBI) critical appraisal tools. RESULTS: There were 4 out of 252 articles which met the criteria and being included in this study. The synthesized protocol resulting 11 pranayama steps in the new synthesized protocol. CONCLUSIONS: The regular 13 yoga pranayama steps within 11 pranayama steps based on synthesized protocol takes 30-45min for each session and can be conducted 2-5 times a week for 2-6 months to be able to reveal pulmonary function outcomes

No disponible

Effectiveness of a self-myofascial conditioning programme on pain, depression, anxiety and sleep quality in people with Fibromyalgia / Efectividad de un programa de autoacondicionamiento miofascial sobre el dolor, la depresión, la ansiedad y la calidad del sueño en personas con fibromialgias / Efetividade de um programa de auto-condicionamento miofascial na dor, depressão, ansiedade e qualidade do sono em pessoas com fibromialgia

Self-myofascial release can facilitate the diminution or disappearance of the intense pain perceived by the nerve endings located in the myofascial tissue. According to some researchers, fibromyalgia (FM) can be directly related to the "central sensitization" theory. The present study aims to determine the effectiveness of the application of a self-myofascial conditioning programme on pain, depression, anxiety, and quality of sleep in people diagnosed with Fibromyalgia (FM). The sample was randomly assigned to intervention (n = 33) and control groups (n = 33). Subjects in the intervention group took part in a self-myofascial conditioning programme, which consisted of 40 sessions of 50 minutes each. Pre and post-intervention measurements were taken. Results were obtained by a 2x2 ANOVA for repeated measures with two factors (time and group). Results show that, after completing the programme, subjects in the intervention group had seen a significant decrease in general pain (p < 0,01), level of depression (p < 0,05), state (p < 0,01) and trait anxiety (p < 0,01), as well as three subscales related to the quality of sleep, such as "sleep subjective quality" (p < 0,05), "habitual sleep efficiency" (p < 0,05) and "daily dysfunction" (p < 0,001). These results indicate that participating in a self-myofascial conditioning programme regularly and under the control of a physical education and sport professional can affect patients with FM positively both physically and psychologically

La autoliberación miofascial puede facilitar la disminución o desaparición del dolor intenso percibido por las terminaciones nerviosas localizadas en el tejido miofascial. Según algunos investigadores, la fibromialgia (FM) puede estar directamente relacionado con la teoría de la "sensibilización central". El presente estudio tiene como objetivo determinar la efectividad de la aplicación de un programa de autoacondicionamiento miofascial sobre el dolor, la depresión, la ansiedad y la calidad del sueño en personas diagnosticadas con fibromialgia (FM). La muestra se asignó al azar a los grupos de intervención (n =33) y control (n =33). Los sujetos del grupo intervención participaron en un programa de autoacondicionamiento miofascial compuesto por un total de 40 sesiones de 50 minutos cada una de ellas. Se tomaron medidas pre y post intervención. Los resultados se obtuvieron mediante un ANOVA 2x2 de medidas repetidas con dos factores (tiempo y grupo). Los resultados muestran que, después de completar el programa, los sujetos del grupo intervención obtuvieron una disminución significativa en el dolor general (p <0,01), el nivel de depresión (p <0,05), la ansiedad-estado (p <0,01) y rasgo (p <0,01), así como en tres subescalas relacionadas con la calidad del sueño, como son la "calidad subjetiva del sueño" (p <0,05), la "eficiencia habitual del sueño" (p <0,05) y la "disfunción diaria "(p <0,001). Estos resultados indican que participar en un programa de autoacondicionamiento miofascial regularmente, bajo el control de un profesional de educación física y deporte, puede afectar positivamente a los pacientes con FM tanto física como psicológicamente

A auto-liberação miofascial pode facilitar a diminuição ou o desaparecimento da dor intensa percebida pelas terminações nervosas localizadas no tecido miofascial. Segundo alguns pesquisadores, a fibromialgia (FM) pode estar diretamente relacionada à teoria da "sensibilização central". O presente estudo tem como objetivo determinar a eficácia da aplicação de um programa de auto-condicionamento miofascial na dor, depressão, ansiedade e qualidade do sono em pessoas diagnosticadas com fibromialgia (FM). A amostra foi randomizada para os grupos intervenção (n =33) e controle (n =33). Os sujeitos do grupo de intervenção participaram de um programa de auto- condicionamento miofascial composto por um total de 40 sessões de 50 minutos cada. Medidas de intervenção pré e pós foram tomadas. Os resultados foram obtidos por meio de uma ANOVA 2x2 de medidas repetidas com dois fatores (tempo e grupo). Os resultados mostram que, após o término do programa, os sujeitos do grupo de intervenção obtiveram uma diminuição significativa na dor geral (p <0,01), o nível de depressão (p <0,05), estado de ansiedade (p < 0,01) e traço (p <0,01), assim como em três subescalas relacionadas à qualidade do sono, como a "qualidade subjetiva do sono" (p <0,05), a "eficiência habitual do sono" (p <0,05) e "disfunção diária" (p <0,001). Esses resultados indicam que participar de um programa de auto-condicionamento miofascial regularmente, sob o controle de um profissional de educação física e esportes, pode afetar positivamente os pacientes com FM fisicamente e psicologicamente

¿Está el estrés oxidativo asociado a la gravedad de la enfermedad, a la función pulmonar y al síndrome metabólico en la enfermedad pulmonar obstructiva crónica? / Is oxidative stress associated with disease severity, pulmonary function and metabolic syndrome in chronic obstructive pulmonary disease?

OBJETIVO: Investigar las asociaciones entre los biomarcadores oxidantes/antioxidantes y el estado de gravedad, la función pulmonar y la presencia de síndrome metabólico (SM) en pacientes con EPOC. MÉTODOS: Se incluyeron 74 sujetos, 39 con EPOC (edad 69+/-7 años; mujeres 41%) y 35 para el grupo control (edad 69+/-7 años; mujeres: 43%). Fueron diagnosticados con SM y asignados a uno de los 4 subgrupos: EPOC y control, con y sin SM, respectivamente. Se analizaron los productos de oxidación avanzada de proteína (AOPP), la paraoxonasa-1, la actividad de catalasa, el grupo sulfhidrilo y el hidroperóxido de lípidos totales. La función pulmonar fue analizada por medio de un pletismógrafo. RESULTADOS: El estado de gravedad de la EPOC (GOLD≥3) y la función pulmonar fueron asociados con el grupo sulfhidrilo y AOPP (p≤0,03 para todos). La prevalencia de SM se asoció con AOPP en la EPOC (p = 0,04). Los individuos con EPOC y SM mostraron niveles de AOPP más altos en comparación con los sujetos con EPOC sin SM (p < 0,0001). CONCLUSIÓN: La gravedad de la EPOC, el deterioro de la función pulmonar y la presencia de síndrome metabólico están asociados con el estrés oxidativo en individuos con EPOC

OBJECTIVE: To investigate associations between oxidant/antioxidant biomarkers with the disease severity, pulmonary function and diagnosis of metabolic syndrome (MetS) in patients with COPD. METHODS: Seventy-four subjects were included, 39 with COPD (age 69+/-7 years; female 41%) and 35 for control group (age 69+/-7 years; female 43%). They were diagnosed with MetS and allocated in one of 4 subgroups: COPD and control, with and without MetS, respectively. Advanced oxidation protein products (AOPP), paraoxonase-1, catalase activity, sulfhydryl group and total lipid hydroperoxide were assayed. Pulmonary function was performed with a plethysmograph. RESULTS: COPD severity (GOLD≥3) and pulmonary function were associated with sulfhydryl group and AOPP (P≤.03 for all). The prevalence of MetS was associated with AOPP in COPD (P=.04). Individuals with COPD and MetS showed higher AOPP compared to COPD without MetS (P<.0001). CONCLUSION: COPD severity, worse pulmonary function and presence of metabolic syndrome are associated with oxidative stress in individuals with COPD

Increased number of regulatory T cells in esophageal tissue of patients with eosinophilic esophagitis in comparison to gastro esophageal reflux disease and control groups

Background: Eosinophilic esophagitis (EoE) is a primarily polygenic allergic disorder. Although most patients have IgE sensitization, it seems that non-IgE mediated responses mainly contribute to the pathogenesis of EoE. Regulatory T cells (Tregs) may have an important role in allergies. There are limited data on the association of Tregs and EoE. In this study, we enumerated and compared T lymphocytes and Tregs in esophageal tissue of patients with EoE, gastroesophageal reflux disease (GERD) and normal controls. Methods: Ten patients with EoE, ten patients with GERD and eight normal controls were included. Immunohistochemistry staining was used to enumerate T lymphocytes and Tregs. CD3+ cells were considered as T cells and FOXP3+, CD3+ cells were considered as Tregs. T cells and Tregs were counted in 10 high power fields (HPF) (×400) for each patient and the average of 10 HPFs was recorded. Results: The mean±SEM of Tregs in esophageal tissue of patients with EoE (10.90 ± 2.14cells/HPF) was significantly higher than the GERD (2.77 ± 0.66 cells/HPF) and control groups (0.37 ± 0.08 cells/HPF) (P < 0.001). Additionally, the mean ± SEM of T lymphocytes in esophageal tissue of patients with EoE (24.39 ± 3.86 cells/HPF) were increased in comparison to the GERD (10.07 ± 2.65 cells/HPF) and control groups (3.17 ± 0.93 cells/HPF) (P < 0.001). Conclusion: There is an increase in the number of esophageal T lymphocytes and regulatory T cells in patients with EoE compared to the GERD and control groups

No disponible

Mejora de la atención en niñosy niñas con TDAH tras una intervención física deportiva dirigida / Improving attention in children with ADHD after a directed physical activity intervention / Melhoria do cuidado em crianças com TDAH após uma intervenção esportiva dirigida

El principal objetivo de este estudio ha sido evaluar si la actividad física mejora la función cognitiva de pacientes en edad escolar (segundo ciclo de infantil, primaria y secundaria) con trastorno por déficit de atención con hiperactividad (tdah). En este trabajo, se estudia el efecto de una actividad física deportiva dirigida de 6 semanasde duración consistente en 2 sesiones de 1 hora de duración por semana realizando juegos aeróbicos a una intensidad aproximada de 60%-70% de VO2máx. Un total de 13 participantes de edades entre 5 y 15 años, han realizado las sesiones deportivas (grupo deintervención) mientras que otros 11 (de 5 a 15 años) continuaban en clase haciendo las actividades escolares rutinarias (grupo control). Tras la aplicación de la Escala Magallanes de Atención Visual (EMAV),se encuentra una mejora significativa en la calidad de la atención en los participantes del grupo de intervención, pero no en los del grupo control. Los resultados por tanto sugieren un efecto positivo de la realización de ejercicio físico sobre la calidad de la atención. Se recomienda usar una intervención físico-deportiva como terapia complementaria en el tratamiento del tdah y para mejorar los síntomas del trastorno

The main objective of this work has been to evaluate if sport ameliorate cognitive function in children with attention deficit hyperactivity disorder (ADHD). In the present work, we have studied the effect of a 6 weeks physical activity program twice aweek for 1 hour duration and 60%-70% VO2máxintensity in 13 children (from 5 to 15 years old) (intervened group) with ADHD. Other 11 children (from 5 to 15 years old) with ADHD remained in class without sport practice (control group).We found that the intervened group ameliorates cognitive test (attention parameters) but not the control group. Result suggests a positive effect of sport in the physiopathology of the disease and we propose to use sport as complementary therapy for ADHD

O principal objetivo deste estudo foi avaliar se o esporte melhora a função cognitiva de pacientes em idade escolar com transtorno do déficit de atenção e hiperatividade (TDAH). Neste trabalho, estudamos o efeito de uma intervenção esportiva dirigida de 6 semanas de duração (2 sessões de 1 hora de duração por semana realizando jogos com uma intensidade aproximada de 60% -70% do VO2max). Um total de 13 participantes executamas sessões de esporte (grupo de intervenção), enquanto 11 outros eles permanecem aula fazendo atividades escolares de rotina (grupo controle).Após a aplicação da Magellan Visual Attention Scale (EMAV), encontramos uma melhoria significativa na qualidade do atendimento nos participantes do grupo de intervenção, mas não nos do grupo controle.Os resultados sugerem, portanto, um efeito positivo da realização de exercícios físicos na qualidade do cuidado. Propomosa utilizar o esporte como terapia complementar no tratamento do TDAH

Respuesta de los autores: Comentarios al artículo:La atropina superdiluida al 0.01% frena el aumento de la miopía en niños españoles. Un estudio a largo plazo 5 años de evolución: seguridad y eficacia / Author's reply: Comments on: Superdiluted atropine at 0.01% reduces progression of myopia in children and adolescents. A 5-year study of safety and effectiveness

No disponible

Inhibidores de la proproteína convertasa plasmática subtilisina kexina tipo 9 y riesgo de cataratas: revisión sistemática y metaanálisis / Plasma proprotein convertase subtilisin/kexin type 9 inhibitors and cataract risk: A systematic review and meta-analysis

Antecedentes: El marcado descenso en los niveles de C-LDL producidos por los inhibidores de la proproteína convertasa plasmática subtilisina kexina tipo 9 (iPCSK9) podría asociarse con un mayor riesgo de cataratas. Métodos: Realizamos un metaanálisis que incluyó ensayos clínicos aleatorizados y controlados con iPCSK9, solos o combinados con otros fármacos hipolipidemiantes, que reportaron nuevos casos de cataratas, buscando en PubMed/Medline, bases de datos de EMBASE y Cochrane Clinical Trials. Se utilizó un modelo de efectos fijos y se realizó una metarregresión evaluando la relación entre el C-LDL intratratamiento y el riesgo de desarrollar cataratas. Resultados: Se tomaron en cuenta 5 estudios elegibles con iPCSK9 que incluyeron 83.492 pacientes para el análisis, refiriendo 531 nuevos casos de cataratas en el grupo con iPCSK9 frente a 532 en el grupo placebo. La terapia con iPCSK9 no se asoció con un mayor riesgo de presentar cataratas (OR: 0,96; IC 95%: 0,85-1,08; p = 0,86, I2: 0%]. Asimismo, no se encontró una asociación significativa entre la diferencia de C-LDL intratratamiento entre las ramas de los estudios y el riesgo de cataratas. Conclusión. En nuestro análisis, la utilización de iPCSK9 no se asoció con un mayor riesgo de cataratas

Background: The marked decrease in LDL-C levels produced by the inhibitors of the plasma proprotein convertase subtilisin/kexin type 9 (iPCSK9) could be associated with an increased risk of cataracts. Methods: A meta-analysis was performed that included randomised clinical trials controlled with iPCSK9, alone, or in combination with other lipid-lowering drugs, which reported new cases of cataracts, by searching PubMed/Medline, databases of EMBASE and Cochrane Clinical Trials. A fixed-effect model was used, and a meta-regression was carried out evaluating the relationship between intra-treatment LDL-C and the risk of developing cataracts. Results: Five eligible studies of iPCSK9 including 83,492 patients were taken into account for the analysis, and 531 new cases of cataracts in iPCSK9 group vs. 532 in placebo group were diagnosed. The iPCSK9 therapy was not associated with an increased risk of cataracts [OR: 0.96, 95% CI: 0.85-1.08; P = .86, I2: 0%]. Likewise, no significant association was found between on-treatment LDL-C levels, differences between study arms, and new cases of cataracts. Conclusion: In this analysis, the use of iPCSK9 was not associated with an increased risk of cataracts

Métodos estadísticos alternativos y su aplicación a la investigación en Cuidados Intensivos / Alternative statistical methods and their application to research in intensive care setting

En los estudios de casos y controles anidados, el muestreo de los controles se hace habitualmente por densidad de incidencia y mediante emparejamiento. Con respecto a los casos control clásicos, son más eficientes, permiten el cálculo de la incidencia de la enfermedad y cuentan con más validez interna por la menor presencia de sesgo. Las técnicas de riesgos competitivos pueden usarse si se estudian diferentes tipos de eventos y nos centramos en el tiempo y el tipo del primer evento. El particionamiento recursivo es un tipo de análisis multivariante cuyo propósito es la construcción de algoritmos de clasificación, especialmente útiles cuando hay un gran número de variables predictoras con relaciones complejas con el evento objeto de estudio

In nested case-control studies, sampling of controls is usually done by density of incidence and pairing. With regard to the classic control cases studies, nested ones are more efficient, allow the calculation of the incidence of the disease and they have more internal validity due to the lower presence of bias. Competitive risks techniques can be used if we study different types of events and focus on the time and type of the first event. Recursive partitioning is a type of multivariate analysis whose purpose is the construction of classification algorithms, and it is especially useful when there are a large number of predictive variables with complex relationships with the event

La rúbrica en el examen oral de Traumatología y Ortopedia / The rubric in the oral exam in Traumatology and Orthopaedics

OBJETIVO: Conocer si el uso de la rúbrica para el examen oral de Traumatología y Ortopedia aporta información sobre competencias transversales. TIPO DE ESTUDIO: Experimental con un grupo control. MATERIAL Y MÉTODOS: Grupo control: 67 alumnos calificados globalmente mediante examen oral. Grupo intervención: 68 alumnos valorados con rúbrica que contiene las dimensiones: conocimiento teórico, precisión en la terminología, concreción en el lenguaje y uso de fuentes adicionales de información. RESULTADOS: Existe diferencia entre las calificaciones del grupo control (mediana 9, RIC: 9, 9) y el experimental (mediana 7,63, RIC: 6,48, 8,54). En el grupo experimental, la calificación más alta se obtiene en la pregunta propuesta por el profesor y la más baja en la elegida por el alumno. Precisión y concreción han alcanzado un 72 y un 70% del máximo posible. El conocimiento teórico ha conseguido el 76,26%. Se observa un efecto monotonía de las calificaciones del grupo control a partir del alumno evaluado en décimo lugar. CONCLUSIONES: Utilizar rúbrica influye en la calificación final del alumno. La precisión y la concreción en la exposición alcanzan un mínimo del 70% de la valoración adscrita

AIM: To find out if the use of the rubric for the oral examination of Traumatology and orthopaedics provides information on cross-disciplinary skills. STUDY TYPE: Experimental with a control group. MATERIAL AND METHODS: Control Group: 67 students globally qualified by oral examination. Intervention Group: 68 students evaluated with a scoring rubric that comprises the dimensions: Theoretical knowledge, precision in the terminology, accuracy in the language, and the use of additional information sources. RESULTS: There was a significant difference between the results of the control group (median 9, IQR: 9.9) and the experimental group (median 7.63, 95% CI: 6.48 - 8.54). In the experimental group, the higher qualification is obtained in the question proposed by the teacher and the lower one in the question chosen by the student. Precision and specificity were 72% and 70% of the maximum, respectively. Theoretical knowledge achieved 76.26%. A monotony effect is observed in the scores of the control group after the tenth evaluated student. CONCLUSIONS: The use of a rubric influences the final assessment of the student. The precision and accuracy achieved a minimum of 70% of the assigned valuation

Is it necessary to alter anticoagulation therapy for tooth extraction in patients taking direct oral anticoagulants?

Background: The number of patients using direct oral anticoagulants (DOACs) instead of vitamin K antagonists (VKA) is increasing and there is limited data on the safety of tooth extractions in patients taking DOACs. The aim of this study was to compare the amount of bleeding (AOB) and postoperative complications after tooth extractions between patients taking VKAs and patients taking DOACs without altering the anticoaguation therapy. Material and Methods: The study consisted of four groups: Direct thrombin inhibitor group, factor Xa inhibitor group, warfarin group and a control group. A single tooth was extracted in each patient and routine coagulation test values were recorded prior to extraction. AOB was measured for 20 minutes after tooth extraction. The patients were evaluated on 2nd and 7th days after extraction for bleeding. Status of bleeding was classified as no bleeding, mild bleeding controlled by gauze pads, moderate bleeding controlled by hemostatic agents and severe bleeding required hospitalization. Analysis of variance, chi square test and correlation analysis were used for statistical analysis of data. Results: A total of 84 patients (48 male, 36 female) were included in this study. The mean age of patients was 57 (38-87) years. Mean AOB was 1388.6±913.0, 1909.29±1063.1, 3673±1415.4, 1593.33±672.5 mg for direct thrombin inhibitor, factor Xa inhibitor, warfarin and control groups respectively. Mean AOB was significantly higher for warfarin group, compared to other groups (p=0.001). No bleeding was occurred in control group on 2nd and 7th postextraction days and no bleeding was occurred in direct thrombin inhibitor group on 7th postextraction day. The number of bleeding events among groups was not statistically significant on 7th postextraction day (p=0.251). Conclusions: Patients taking warfarin had more bleeding compared to patients taking direct oral anticoagulants after tooth extractions. In patients taking direct oral anticoagulants simple tooth extractions can be safely carried out without altering the anticaogulant regimen with the use of local hemostatic agents (AU)

No disponible

Utilización del plasma rico en plaquetas en el tratamiento de la patología del manguito de los rotadores. ¿Qué hay demostrado científicamente? / Use of platelet-rich plasma in the treatment of rotator cuff pathology. What has been scientifically proven?

Objetivo. Obtener una visión objetiva de las evidencias científicas y/o clínicas actuales sobre el uso de plasma rico en plaquetas (PRP) en el tratamiento de la patología del manguito de los rotadores. Método. Revisión sistemática en Pubmed e identificación de estudios que evalúen la eficacia de PRP en el tratamiento de la patología del manguito de los rotadores desde 2013 hasta la actualidad. Los datos se agrupan según el tipo de estudio (laboratorio, clínico o metaanálisis); se obtienen datos sobre el diseño del estudio, la patología tratada y los resultados clínicos. Resultados. Se han analizado 35 artículos: 10 estudios de laboratorio, 17 estudios clínicos y 8 metaanálisis. Mientras que los estudios de laboratorio observan resultados positivos o parcialmente positivos para el uso de PRP, el 70,6% de los estudios clínicos y el 75% de los metaanálisis no encuentran diferencias estadísticamente significativas entre el grupo con PRP y el grupo control. Discusión. Los resultados positivos de los estudios de laboratorio tienen una baja traslación a los estudios clínicos. No hay concordancia entre los escasos resultados positivos observados en los diferentes estudios clínicos, habiéndose observado incluso resultados contradictorios. Conclusiones. No existen evidencias científicas y/o clínicas sólidas para el uso de PRP en el tratamiento de la patología del manguito de los rotadores en la práctica clínica habitual (AU)

Purpose. To analyze the current scientific and/or clinical evidence supporting the use of platelet-rich plasma (PRP) in the treatment of rotator cuff pathology. Methods. After a systematic review in PubMed, studies assessing PRP efficacy in the treatment of rotator cuff pathology published since 2013 to date were identified. Data were grouped based on type of study (laboratory, clinical or meta-analysis); accordingly study design, pathology treated and clinical outcomes were summarized. Results. Thirty five articles have been analyzed: 10 laboratory studies, 17 clinical assays and 8 meta-analyses. While laboratory studies report positive or partially positive results for the use of PRP, 70.6% of clinical studies and 75% of meta-analysis found no statistically significant differences between the PRP group and the control group. Discussion. The positive results of laboratory studies do not translate well to clinical practice. There is no concordance among the few positive results reported in the clinical studies, and even some contradictory effects have been reported. Conclusions. There is no solid scientific and/or clinical evidence supporting the use of PRP in the treatment of rotator cuff pathology in routine clinical practice (AU)

Amplitud de distribución eritrocitaria en pacientes con enfermedad pulmonar obstructiva crónica y en sujetos sanos / Red blood cell distribution width in patients with chronic obstructive pulmonary disease and healthy subjects

Introducción. La enfermedad pulmonar obstructiva crónica (EPOC) incrementa el riesgo de enfermedad cardiovascular (ECV). La amplitud de distribución eritrocitaria (ADE) se considera un potente factor de predicción de la evolución de los pacientes con ECV. Objetivos. Analizar los valores de ADE de pacientes con EPOC y compararlos en relación al estado clínico, ecocardiográfico, nutricional y analítico de los pacientes. Por otra parte, nos propusimos analizar el efecto del consumo de tabaco sobre los valores de ADE de sujetos sanos. Métodos. En el estudio se incluyeron 175 pacientes con EPOC estabilizados y 210 sujetos sanos. Se registraron y se compararon las características demográficas, clínicas, nutricionales, ecocardiográficas y analíticas, y los valores de ADE. Resultados. Los valores de ADE fueron más altos en el grupo de pacientes con EPOC que en el grupo control (15 ± 2,3% vs. 13,8 ± 2,5%, p < 0,001). Los valores de ADE de los pacientes con EPOC mostraron una correlación positiva con las concentraciones de PCR (r = 0,27, p < 0,001), las concentraciones de albúmina (r = 0,23, p = 0,04) y la presencia de disfunción ventricular derecha (DVD) (r = 0,24, p = 0,001), hipertensión pulmonar (HAP) (r = 0,1, p = 0,02) y ECV (r = 0,24, p = 0,02). El análisis de regresión logística para variables múltiples sugirió una relación independiente de la presencia de ECV (4,3; IC 95%: 1,3-11; p = 0,01) y de DVD (3,1; IC 95%: 1,7-8,3; p = 0,02) con valores elevados de ADE en los pacientes con EPOC. En la población sana, el análisis solo mostró una correlación significativa entre la ADE y la duración del consumo de tabaco (r = 0,57, p < 0,001). Conclusión. En pacientes con EPOC, la ADE se asocia de manera independiente con la ECV y la DVD. En la población sana, la ADE también se asocia con el consumo de tabaco

Background. Chronic obstructive pulmonary disease (COPD) increases the risk of cardiovascular disease (CVD). Red blood cell distribution width (RDW) is accepted as a powerful predictor of outcomes in patients with CVD. Aims. To study RDW in patients with COPD, and to compare the value of this measurement with clinical, echocardiographic, nutritional and laboratory status. Secondly, we aimed to determine the effect of smoking on RDW values in healthy subjects. Methods. One hundred and seventy-five patients with stable COPD and 210 healthy controls were enrolled in the study. Demographic, clinical, nutritional status, echocardiographic, and laboratory characteristics, RDW values were recorded and compared. Results. RDW values were higher in the COPD group than in controls (15 ± 2.3% vs. 13.8 ± 2.5%, p < 0.001). In COPD patients, RDW levels positively correlated with CRP levels (r = 0.27, P < .001), albumin levels (r = 0.23, P = .04), right ventricular dysfunction (RVD) (r = 0.24, P = .001), pulmonary hypertension (PAH) (r = 0.1, P = .02), and presence of CVD (r = 0.24, P = .02). In multivariable logistic regression suggested that presence of CVD (4.3; 95% CI: 1.3 to 11; P = .01), and presence of RVD (3.1; 95% CI: 1.7 to 8.3; P = .02) were independently related to elevated RDW levels in COPD patients. In the healthy population, correlations analysis showed only a significant correlation between RDW and cigarette smoking years (r = 0.57, P < .001). Conclusion. RDW is independently associated with CVD and RVD in patients with COPD. In the healthy population, RDW is also associated with smoking status

Patrones nutricionales en centros penitenciarios de la Comunidad de Madrid: eficacia de la educación nutricional / Nutritional standards in prisons in Madrid: the effectiveness of nutritional education

Fundamentos: Una alimentación y estilo de vida adecuados son fundamentales para la prevención de la malnutrición, que afecta a grupos de riesgo como los presos. Métodos: Se evaluaron los conocimientos de nutrición, mediante un cuestionario ad hoc, de 53 reclusos en Aranjuez y Valdemoro, y de 45 sujetos control. Se valoró la eficacia de la educación nutricional en los presos. Transcurridas 5 semanas de la intervención nutricional se les volvió a administrar el cuestionario. Los resultados fueron analizaron con el software SPSS. Resultados: Se observaron diferencias en el estilo de vida (tabaco y deporte) de los presos respecto al grupo control, así como diferencias significativas en conceptos de nutrición. Se obtuvo un mejor resultado en el segundo cuestionario, pero no aparecieron diferencias significativas entre el antes y después del taller nutricional. Conclusiones: La población reclusa tiene mayor hábito deportivo y tabáquico. Sus conocimientos en nutrición son inferiores a los de la población control. Es necesaria una labor educativa nutricional para reforzar sus conocimientos (AU)

Background: An appropriate diet and lifestyle is essential to prevent malnutrition, which affects risk groups such as prisoners. Methods: Prisoners nutrition knowledge was evaluated by and ad hoc questionnaire in 53 inmates of Aranjuez or Valdemoro, and in 45 controls. The effectiveness of an intervention based on nutritional education was assessed in prisioners. 5 weeks after the intervention, the questionnaire was handed in again. Data was analyzed using SPSS statistical software. Results: Differences between lifestyle (tobacco and sport) of prisoners and the control group were observed. Regarding nutrition aspects, significant differences appeared between inmates and the control group. Despite obtaining better results in the second questionnaire, no significant differences were found before and after the nutritional workshop. Conclusions: The inmate population has a greater habit when it comes to sports and smoking. Their knowledge in nutrition is lower than the control population. Nutritional educational effort is required to strengt hen their knowledge (AU)