Factors associated with depression in patients undergoing rehabilitation for chronic pain: a cross-sectional analytical study at a referral hospital in Peru.

Despite the well-known impact of depression on patients with chronic pain and its association, few studies have evaluated its related factors in Physical Medicine and Rehabilitation settings. The objective of the present study was to assess the factors associated with depression in adult patients undergoing rehabilitation for chronic pain at Hospital Rebagliati (HNERM) in Peru. A cross-sectional analytical study was conducted between June and August 2023, involving 212 adult patients with chronic pain undergoing rehabilitation at HNERM. Data were collected through a survey, including sociodemographic information, pain characteristics, and depression assessment using the Patient Health Questionnaire-9 (PHQ-9). Statistical analysis included descriptive statistics and generalized linear models to identify factors associated with depression. Among 212 participants, 17.9% had a depression diagnosis based on the PHQ-9 (cutoff score: 10 points). Factors associated with a higher frequency of depression included a time since pain diagnosis of 3-6 months [adjusted prevalence ratios (aPR): 1.15, 95% confidence interval (CI): 1.04-1.27], severe pain (aPR: 1.17, 95% CI: 1.04-1.32), comorbidities (for 1: aPR: 1.21, 95% CI: 1.08-1.35; for 2: aPR: 1.17, 95% CI: 1.06-1.29; for ≥3: aPR: 1.27, 95% CI: 1.10-1.47), use of ≥2 medications for pain management (aPR: 1.27, 95% CI: 1.13-1.42), and receipt of psychological therapy (aPR: 1.26, 95% CI: 1.09-1.46). Nonpharmacological interventions did not show an association with an increased prevalence of depression. These findings underscore the significance of adopting a comprehensive approach to chronic pain management, including the screening, assessment, and treatment of associated depression.

Benthic algae stimulate leaf litter decomposition in detritus-based headwater streams: a case of aquatic priming effect?

In detritus-based ecosystems, autochthonous primary production contributes very little to the detritus pool. Yet primary producers may still influence the functioning of these ecosystems through complex interactions with decomposers and detritivores. Recent studies have suggested that, in aquatic systems, small amounts of labile carbon (C) (e.g., producer exudates), could increase the mineralization of more recalcitrant organic-matter pools (e.g., leaf litter). This process, called priming effect, should be exacerbated under low-nutrient conditions and may alter the nature of interactions among microbial groups, from competition under low-nutrient conditions to indirect mutualism under high-nutrient conditions. Theoretical models further predict that primary producers may be competitively excluded when allochthonous C sources enter an ecosystem. In this study, the effects of a benthic diatom on aquatic hyphomycetes, bacteria, and leaf litter decomposition were investigated under two nutrient levels in a factorial microcosm experiment simulating detritus-based, headwater stream ecosystems. Contrary to theoretical expectations, diatoms and decomposers were able to coexist under both nutrient conditions. Under low-nutrient conditions, diatoms increased leaf litter decomposition rate by 20% compared to treatments where they were absent. No effect was observed under high-nutrient conditions. The increase in leaf litter mineralization rate induced a positive feedback on diatom densities. We attribute these results to the priming effect of labile C exudates from primary producers. The presence of diatoms in combination with fungal decomposers also promoted decomposer diversity and, under low-nutrient conditions, led to a significant decrease in leaf litter C:P ratio that could improve secondary production. Results from our microcosm experiment suggest new mechanisms by which primary producers may influence organic matter dynamics even in ecosystems where autochthonous primary production is low.

Cognitive dysfunction, diabetes mellitus 2 and arterial hypertension: Sequelae up to one year of COVID-19.

BACKGROUND: Covid symptoms reflect its multisystem nature, in addition to its positive relationship between the severity of the condition and the severity of the long COVID. OBJECTIVE: To identify the factors associated with the prevalence of SEQUELAE DUE TO COVID-19 one year after their hospital discharge due to severe pneumonia. METHOD: Longitudinal, analytical, prospective and comparative study. 71 covid-19 pneumonia survivors were followed. Two telephone interviews were conducted to each patient; the first at 5 months of discharge and the second at 12 months from the mentioned date. We included questions of 40 symptoms, in addition to the questioning of diabetes mellitus and/or systemic hypertension with a mentioned onset during the hospitalization or after hospital discharge due to COVID-19. RESULTS: Of the 37 patients without complications and without comorbidities prior to hospitalization, 11 (29.7%) developed arterial hypertension during or after discharge and 17 (45.9%) developed diabetes mellitus before five months. Short-term memory loss was an upward sequel in the two measurements, 24.3% and 41.9% respectively. CONCLUSIONS: Type 2 diabetes mellitus and high blood pressure detected at five months was temporary and reversed in many cases at twelve months. It will be important to deepen the study of brain damage and cognitive dysfunction, characterized by memory loss.

Validity of an Instrument to Detect Cheating Confirmed by the Elicited Emotional Reactions.

Cheating forms part of a complex emotional and cognitive process. However, although a relatively mundane phenomenon, instruments to evaluate cheating and its effects socially are scarce. This paper presents a five-stage approach aimed at providing validity to an instrument designed to assess cheating - specifically, its detection, and emotional reactions towards it once detected. An instrument was designed after (1) reviewing the relevant literature on cheating, in order to (2) design a bank of stimuli, (3) formulate a Delphi panel to judge the most coherent and pertinent ones, and (4) perform three pilot studies to adjust the final version of the instrument. Results from Stages 1 to 4 show that content validity was achieved for the Instrument for Detecting Cheating and its Emotional Reactions (INDETRAE, in Spanish: Instrumento para la Detección de Trampa y sus Reacciones Emocionales). Stimuli were grouped into five categories of 18 different scenarios, for a total of 90 vignettes: meaning, the INDETRAE is a 5-category, vignette-based questionnaire consisting of contrasting social cost-benefit scenarios, where the cheating situation affects an undefined, a first or a third person, and also a neutral category with no cheating. In Stage 5, several chi-squared tests (p < 0.0005) revealed significant differences between categories, proving that the instrument can indeed be used to detect cheating and to identify differentiated emotional reactions - for example, anger when there was detriment to a third person as opposed to neutral situations, or glad when there was a case of cheating which benefited the first person. The last stage counts as the first approximation to support construct validity of the INDETRAE. The most important contribution of this work consists in developing an instrument to detect cheating, confirmed by the resulting emotional reactions, which therefore demonstrate its validity.

Coronavirus Disease 2019 in Patients With End-Stage Kidney Disease on Hemodialysis in Guatemala.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is public health concern across the world. Data on the epidemiology among patients on hemodialysis in Latin America and low- and middle-income countries are limited. METHODS: Using electronic medical records from the second largest dialysis network in Guatemala, we performed a retrospective analysis of all adult patients on hemodialysis with the diagnosis of COVID-19 to estimate incidence of infection and to describe the demographics, comorbidities, and outcomes. We stratified incidence rate by region. We reviewed data from May 1 to July 31, 2020, with outcome data ascertained up to August 28, 2020. RESULTS: Of 3201 patients undergoing hemodialysis, 325 patients were diagnosed with COVID-19 (incidence rate 102/1000 patients on hemodialysis, compared with 3/1000 in the general population). Incidence was higher in the Central region (207/1000) and lowest in the Southeast region (33/1000), and unlike in the general population, the incidence was lower in Guatemala City. The mean age of patients diagnosed with COVID-19 was 51.1 years (standard deviation [SD] 14.8 years), and 84 (25.8%) were female. The median length of hospital stay was 12 days (interquartile range [IQR] 10-16 days). Two hundred twenty-nine (69.8%) of the patients recovered, 90 patients died (27.7%), and 6 (1.8%) patients were still in the hospital at the time of last follow-up. CONCLUSION: The incidence of diagnosed COVID-19 in Guatemalan patients on hemodialysis was much higher than reported in the general population, with outcomes similar to those described in high-income countries. Rural regions had higher incidence rates than the major metropolitan area.

Preclinical safety evaluation of amphotericin A21: A novel antifungal.

Safety studies are essential in drug development. This study evaluates the safety of Amphotericin A21 (AmB-A21), a derivative of amphotericin B with antifungal therapeutic potential. We performed a chronic toxicity study, a targeted organ study and a dermal irritation test. To evaluate chronic toxicity, 18 male adult rats were treated orally with AmB-21 (2 mg/kg) for 26 weeks. The effects on body-weight and animal health were measured, and haematological, clinical chemistry and histopathological tests were conducted on various organs. In the target organ toxicity study, male adult rats received a daily oral dose of AmB-21 (2 mg/kg) for 6 and 17 weeks; testicle histology and testosterone levels were then evaluated. For the dermal irritation study, AmB-21 (200 and 1000 mg/kg) was placed on the skin of adult male rabbits; macroscopic and microscopic studies, as well as haematological and clinical chemistry tests were then conducted. The chronic toxicity study revealed that AmB-21 caused testicle damage, and the testicle-targeted study showed structural alterations and changes in testosterone levels at 17 weeks. However, these alterations were no longer observed 8 weeks after discontinuation of treatment, and the testes showed very similar characteristics to those in the control group. The dermal irritation study showed skin thickening and reddening in rabbits treated with 2000 mg of AmB-A21 after 14 days of exposure. This same group also showed changes in liver enzymes, renal parameters and platelet levels. Based on our results, we consider AmB-21 to be a potential candidate for safe, long-term antifungal treatment given its reduced side effects.