Immediate effects of TECAR therapy on lower limb to decrease hypertonia in chronic stroke survivors: a randomized controlled trial.

PURPOSE: To analyze immediate effects of TECAR therapy (TT) to reduce lower limb hypertonia and improve functionality in chronic post-stroke. MATERIALS AND METHODS: It is a single-blind randomized controlled clinical trial. A total of 36 chronic stroke survivors were divided into two groups. The experimental group received a single 30-minute session of TT with functional massage (FM) on lower limb. The control group received a single 30-minute session sham treatment of TT plus FM. The primary outcome measure was hypertonia (Modified Ashworth Scale, MAS). Secondary outcomes were gait speed (4-Meter Walk-Test), standing knee-flexion (Fugl-Meyer Assessment Scale IV-item), change in weight bearing ankle dorsiflexion (Ankle Lunge Test, ALT), and functional lower limb strength (5-Times Sit-to-Stand Test). All measurements were performed at baseline, immediately and 30-minutes after treatment. RESULTS: There was a group-time interaction in MAS-knee (p = 0.044), MAS-ankle (p = 0.018) and ALT (p = 0.016) between T1 and T0 (p<.0001) and T2 and T0 (p<.0001) for the experimental group. There was a significant increase in ALT between T1 and T0 (p = 0.003) in the control group. CONCLUSIONS: A single session of TT performed at the same time as FM immediately reduces plantar-flexors and knee-extensor muscle hypertonia and increases change in weight bearing ankle dorsiflexion in chronic stroke survivors.

Capacitive and resistive electric transfer (TECAR) therapy may improve ankle mobility in stroke survivors.TECAR therapy may improve knee mobility in post-stroke.TECAR therapy may reduce lower limb muscle tone in stroke survivors.TECAR therapy could be used in combination with physiotherapy as a safe technique for the immediate reduction of hypertonia in stroke survivors.

Increased Severity of Mycoplasma pneumoniae Infections in Spanish Children.

BACKGROUND: Since the end of 2023, an elevated incidence and severity of Mycoplasma pneumoniae infections among children in Asia has been noted. Subsequently, this trend was observed in several European countries although limited data are currently available. We conducted a national study to delineate the ongoing M. pneumoniae outbreak in our country. METHODS: A multicenter retrospective observational study was conducted across 32 hospitals in Spain, encompassing patients under 18 years old hospitalized for M. pneumoniae infection from January 2023 to March 2024. Infection was confirmed by positive polymerase chain reaction and/or by 2 serological tests. RESULTS: A total of 623 children were included, with 79% of cases diagnosed in the final 3 months of the study period. Pneumonia was the most common diagnosis (87%). Respiratory symptoms were present in 97% of cases, with 62% requiring oxygen supplementation and 14% requiring admission to the pediatric intensive care unit (PICU). Risk factors for PICU admission included the presence of neurological symptoms, hypoxemia and a history of prematurity. Children admitted to the PICU exhibited significantly higher neutrophil counts upon admission. CONCLUSIONS: We have observed a notable increase in hospital admissions, including PICU support by up to 14%, due to M. pneumoniae infection in our country since November 2023, indicative of a more severe clinical course associated with this pathogen.

Immediate Effects of TECAR Therapy on Gastrocnemius and Quadriceps Muscles with Spastic Hypertonia in Chronic Stroke Survivors: A Randomized Controlled Trial.

BACKGROUND: The aim of this study was to assess changes in muscle properties after a single session of capacitive and resistive energetic transfer (TECAR) therapy on spastic gastrocnemius and quadriceps muscles in chronic post-stroke. METHODS: A total of 36 chronic stroke survivors with lower limb hypertonia were enrolled in a double-blind randomized controlled trial. The experimental group (n = 18) received a single 30 min session of TECAR therapy in combination with functional massage (FM) on the gastrocnemius and quadriceps muscles. The control group (n = 18) received a sham treatment of TECAR therapy (without electrical stimulation) in combination with real FM. The primary outcome was muscle tone of the lower limb muscles assessed with the Modified Ashworth Scale (MAS). The secondary outcomes were goniometric degrees of the MAS (goniometer), neuromuscular properties of the gastrocnemius/quadriceps (myotonometer), and passive range of motion (inclinometer). All measurements were performed at baseline (T0), immediately after treatment (T1), and at 30 min post-treatment (T2) by a blinded assessor. RESULTS: The MAS score ankle dorsiflexion significantly decreased at T0-T1 (p = 0.046), and the change was maintained at T0-T2 (p = 0.019) in the experimental group. Significant improvements were noted in the passive range of motion for knee flexion (p = 0.012) and ankle dorsiflexion (p = 0.034) at T2. In addition, knee flexion improved at T1 (p = 0.019). CONCLUSION: A single session of Tecar therapy at the same time with FM on the gastrocnemius and rectus femoris immediately reduces muscle tone and increases the passive range of motion of both ankle and knee in chronic stroke survivors. There were no significant changes in the neuromuscular properties measured with myotonometer.

A Case of Hemorrhagic Myositis Associated With Prophylactic Heparin Use in Dermatomyositis.

Dermatomyositis (DM) is a rare systemic autoimmune disease that is associated with inflammation of the skin and muscles. It typically presents with weakness of the proximal muscles along with characteristic skin lesions such as Gottron's papules and heliotrope rash. One of the most feared complications of this disease is the appearance of spontaneous hemorrhagic myositis, as most reported cases are fatal. The mechanism or risk factors of this condition have not been elucidated; however, prophylactic anticoagulation has been correlated with it in previous case reports, although idiopathic hemorrhagic myositis may also be present. We present a case of spontaneous intramuscular hemorrhage (SIH) in a recently diagnosed DM patient. A 59-year-old Hispanic male with a medical history of recently diagnosed prostate cancer and DM presented to the emergency department (ED) due to worsening anemia. His previous hemoglobin (Hgb) was 9 g/dl, but repeated laboratory tests revealed a level of 6.5 g/dl and later 5.5 g/dl at the ED. On admission, the patient was afebrile, tachycardic, and normotensive, with no overt sign of gastrointestinal bleeding. The physical exam revealed an ecchymosis on the right medial aspect of the thigh, and a digital rectal exam was negative. Computer tomography (CT) of the abdomen and pelvis without contrast was ordered due to suspicion of a retroperitoneal hematoma, revealing an interval development of a right groin complex fluid collection of up to 6 cm, concerning a possible hematoma. The patient did not have any previous vascular procedures in the area but was exposed to deep vein thrombosis (DVT) prophylaxis during the previous admission. Vascular surgery was consulted, and the recommendation was made to proceed with conservative management. On the third day, the patient developed new-onset, left-sided pleuritic chest pain. Upon examination, significant swelling and tenderness were noted in his left pectoral region, which was not present on admission. A CT chest without contrast was ordered due to concerns of underlying hematomas, revealing bilateral thickening of the pectoralis muscles, more on the right side, with a fluid collection of 2.5 cm × 1.3 cm. In addition, there was thickening of the right lateral chest wall muscles in the posterior right trapezius or supraspinatus muscles, most likely from intramuscular hemorrhage. The patient was transferred to the step-down unit for close monitoring. Conservative management was continued with as-needed transfusions for three days until hemoglobin stabilized at 9.8 mg/dL. Once stable, the patient was resumed on steroids and immunosuppressive therapy with posterior resolution of the SIH. SIH has been reported in DM, particularly more prominent in those with anti-MDA-5 antibodies. A case series and literature review showed 60.9% mortality within six months in those presenting with SIH, with a poorer prognosis (80% mortality) in those with deep muscle bleeding versus superficial (25%). There is currently no consensus on the treatment approach, and arterial embolization has not been proven effective. In our patient, conservative management with close surveillance and frequent transfusions helped achieve hemodynamic stability. Clinicians should be more aware of these rare but life-threatening complications in patients presenting with DM.

At the Heart of the Diagnosis: A Case of Systemic Lupus Erythematosus Presenting as Cardiac Tamponade.

Systemic lupus erythematosus (SLE) is a heterogenous, systemic disease characterized by the production of pathogenic autoantibodies against nuclear antigens. Although the most common cardiac manifestation of SLE is pericardial effusions, their progression to cardiac tamponade is rare and has an incidence between 1-3%. We describe a case of a 42-year-old Hispanic woman who presented with severe shortness of breath, vague chest pain, and hemodynamic compromise secondary to cardiac tamponade. The patient's underlying etiology of cardiac tamponade was attributed to a new diagnosis of SLE based on the 2019 European Alliance of Associations for Rheumatology/American College of Rheumatology classification (EULAR/ACR) criteria for SLE. The patient's treatment consisted of a pericardial window and immunosuppressive therapy with corticosteroids, Mycophenolate, and hydroxychloroquine. This case aims to increase awareness of SLE as a possible differential diagnosis of cardiac tamponade in the appropriate clinical setting.

Assessment of the 4-meter walk test test-retest reliability and concurrent validity and its correlation with the five sit-to-stand test in chronic ambulatory stroke survivors.

BACKGROUND: The 4-meter walk test (4-MWT) is a widely used measure to assess gait speed in the elderly but has not been validated for stroke survivors to date. OBJECTIVES: To assess the test-retest reliability and concurrent validity of the 4-MWT compared to the 10-meter walk test (10-MWT) as a measure of gait speed in chronic post-stroke. SECONDARY OUTCOME MEASURE: to assess the correlation of both gait measures with the 5 times sit-to-stand test (5TSTS). METHODS: A cross-sectional observational study was conducted. Reliability was assessed by intraclass correlation coefficient (ICC2,1), standard error of measurement (SEM) and minimal detectable change (MDC-95%). Bland & Altman analysis was used to quantify agreement between the 4-MWT and the 10-MWT. Two consecutive walking trials of the 4-MWT and 10-MWT followed by 5TSTS were performed all on the same day. A single researcher made all measurements. RESULTS: Thirty-six chronic ambulatory post-stroke (average age 58.56 ± 11.28 years) were analyzed at their self-selected walking speed with a dynamic start. The 4-MWT showed excellent concurrent validity and test-retest reliability: ICC2.1 = 0.991 (95% CI: 0.983, 0.996); SEM= 0.032 and MDC- 95% = 0.090 m/second) with a strong positive correlation with the 10-MWT (r = 0.957, p < 0.001). The Bland & Altman analysis showed a concordance of -0.05 m/second bias (p = 0.039) (95% limits of agreement: 0.20 to -0.29 m/second). The paired t-test showed no statistically significant difference in the mean of both walking tests (p < 0.091). However, there was only moderate correlation between the two gait assessments and the 5TSTS. CONCLUSIONS: This study indicates excellent test-retest reliability concurrent validity and strong correlation between 4-MWT and 10-MWT with a dynamic start at comfortable speed. The 4-MWT could be used as a measure of gait speed in both outpatients and home settings in chronic ambulatory stroke survivors.

Forgetting Details in Visual Long-Term Memory: Decay or Interference?

Two main explanations for memory loss have been proposed. On the one hand, decay theories consider that over time memory fades away. On the other hand, interference theories sustain that when similar memories are encoded, they become more prone to confusion. The interference is greater as the degree of similarity between memories increases, and as the number of similar traces increases too. To reduce interference, the pattern separation process allows the brain to separate similar memories and build detailed memory representations that are less easily confused. Nonetheless, with time, we tend to remember more general aspects of experiences, which also affects our ability to discriminate. We present the results of one experiment in which brain activity was recorded by EEG while two groups of healthy participants performed a visual memory discrimination task. This task assesses the ability to differentiate new but similar information from previously learned information and thus avoid interference. Unlike previous studies, we used a paradigm that was specifically designed to assess the impact of the number of items (2 or 6) of each category stored in memory, as well as the time elapsed after the study phase (20 min or 24 h), on recognition memory for objects. Behaviorally, our results suggest that mnemonic discrimination is not modulated by the passage of time, but by the number of stored events. ERP results show a reduced amplitude in posterior regions between 500 and 700 ms when comparing short and long delays. We also observe a more positive activity in a centro-posterior region in the 500-700 ms window at retrieval when participants store more items. Interestingly, amplitudes for old hits and similar false alarms were greater than amplitudes for correctly rejected new items between 500 and 700 ms. This finding indicates that a recollection-based process operates in both true and false recognition. We also found that the waveforms for correct rejections of similar lures and the waveforms for correct rejections of new items were comparable.

Síndrome de Hamman - rich: Reporte de caso / Hamman-Rich Syndrome: case report

Resumen La neumonía intersticial aguda, también conocida como síndrome de Hamman-Rich, se caracteriza por la presencia de insuficiencia respiratoria aguda, hallazgo imagenológico de infiltrados difusos bilaterales del parénquima pulmonar y daño alveolar difuso en histopatología pulmonar. Es una patología con una mortalidad mayor al 50% debido a la falta de una terapia específica más allá del manejo sintomático y soporte ventilatorio. Se expone el caso de un paciente masculino de 56 años quien se presenta con síntomas respiratorios inespecíficos, deterioro progresivo de la oxigenación y hallazgo de opacidades en vidrio esmerilado difusas bilaterales. Además, biopsia pulmonar en la que se evidencia daño alveolar difuso en fase fibroproliferativa en quien se descarta proceso infeccioso, enfermedades autoinmunes y toxicidad medicamentosa, por lo que se hace el diagnóstico. Recibió manejo con pulsos de metilprednisolona con recuperación completa del cuadro. MÉD.UIS.2021;34(3): 103-8.

Abstract Acute interstitial pneumonitis, also known as Hamman Rich syndrome, characterised by acute respiratory failure, bilateral lung infiltrates on radiographs and diffuse alveolar damage (DAD) on lung histopathology, is an exclusion diagnosis which requires a complete study of other possible etiologies of DAD. It is a pathology with a mortality greater than 50% due to not having a specific therapy beyond symptomatic management and ventilatory support. We present a case of a 56 year old male with respiratory symptoms, who has progressive worsening oxygen levels and bilateral ground glass opacities on chest images. Lung biopsy with diffuse alveolar damage, infection, autoimmune diseases, and drug adverse reaction were ruled out. Managed with mechanical ventilation and high dose systemic corticoids with complete recovery. MÉD.UIS.2021;34(3): 103-8.

The Immediate Effect of Informational Manual Therapy for Improving Quiet Standing and Bodily Pain in University Population.

BACKGROUND: The Informational Manual Therapy (IMT) is a therapeutic touch. This study aims to assess the effect of IMT on quiet standing, pain and health status in university population. METHODS: An experiment was conducted on subjects utilizing a comparative paired analysis both before and after the intervention. One IMT session was performed on 57 healthy individuals aged from 18 to 65 years. The primary outcome was quiet standing assessed by the Satel 40 Hz stabilometric force platform. Secondary outcomes were bodily pain assessed by the 36-Item Short Form Survey (SF-36) and health status by EQ-5D-3L. The primary outcome was evaluated before and immediately after treatment. RESULTS: The individuals were divided into 3 age groups, 18-35 (52.6%), 35-50 (29.8%) and 51-65 (17.6%). Statistically significant differences were immediately observed after the session ended when comparing the pre-post quiet stance scores in a number of length parameters: L, Lx, Ly and stabilometry amplitude on Y-axis with eyes open and closed. Significant differences were also found when testing bodily pain (SF-36) and anxiety (5Q-5D-3L). CONCLUSION: One session of IMT produced positive effects when testing quiet standing with eyes open and eyes closed, as well as a significant reduction in pain and anxiety for those tested. Further research is suggested.

Hemorragia alveolar por montelukast: reporte de caso / Montelukast-induced alveolar hemorrhage: report of a case

RESUMEN La hemorragia alveolar difusa es un hallazgo clínico patológico, consecuencia de una lesión en la microcirculación pulmonar que se presenta con sintomatología inespecífica e incluso en pacientes asintomáticos. Se diferencian tres diagnósticos histopatológicos, siendo la capilaritis el más común y secundario a patologías autoinmunes. Se presenta el caso de un paciente, con hallazgo imagenológico y en lavado broncoalveolar, compatible con hemorragia alveolar difusa en quien se descartó como causa, enfermedades autoinmunes e infecciosas; durante la anamnesis, se identificó inicio reciente de montelukast, con relación temporal, respuesta a suspensión, cambio imagenológico y escalas de probabilidad de reacción adversa de Naranjo que apoya el diagnóstico.

ABSTRACT Diffuse alveolar hemorrhage is a pathological finding, defined as a consequence of a lesion in pulmonary microcirculation which occurs with non-specific symptoms, and sometimes it may show no symptoms. Three histopathological diagnoses are to be differentiated. The most common is capillary inflammation, which is secondary to autoimmune conditions. We present the case of a patient with image studies and bronchoalveolar lavage compatible with diffuse alveolar hemorrhage, in whom autoimmune and infectious causes were ruled out. The history of the patient indicated recent use of montelukast, being this time-related with the patient's clinical condition. The patient responded when the drug was withheld, image studies showed particular findings, and results in the Naranjo ADR scale supported the diagnosis.

Alteraciones en funciones cognitivas en mujeres maltratadas: revisión sistemática y meta-análisis / Alterações nas funções cognitivas em mulheres maltratadas: revisão sistemática e meta-análise / Alterations in cognitive functions in battered women: systematic review and meta-analysis

El presente estudio ha tenido como objetivo realizar una revisión sistemática y meta-análisis sobre alteraciones en funciones cognitivas en mujeres maltratadas. Se ha contado con una muestra inicial de 643 registros obtenidos de las bases de datos: Medline, ERIC, PsycInfo, CNAIL, Proquest y Scielo. Su análisis llevó a la retención de 12 artículos sobre los que se ha centrado el estudio. Los resultados de la síntesis cualitativa indican que la atención, lenguaje, memoria, habilidades visoespaciales, función ejecutiva, velocidad motora y rendimiento educativo se encuentran alteradas en las mujeres maltratadas, con mayor evidencia de deterioro en las áreas de atención, memoria y funciones ejecutivas. Los resultados del meta-análisis sugieren presencia de daño cerebral en estas mujeres y una especial afectación de la memoria y funciones ejecutivas. Estos resultados avalan la existencia de alteraciones en funciones cognitivas en las mujeres que han sido víctimas de maltrato.

O objetivo deste estudo foi realizar uma revisão sistemática e meta-análise das alterações nas funções cognitivas em mulheres agredidas. Para arealização do estudo, foi utilizada uma amostra inicial de 643 registos nas bases de dados: Medline, ERIC, PsycInfo, CNAIL, Proquest e Scielo. O procedimentode seleção levou à retenção de 12 artigos nos quais o estudo se centrou. Os resultados da síntese qualitativa indicam que a atenção, a linguagem, a memória, as habilidades visuoespaciais, a função executiva, a velocidade motora e o desempenho educacional estão alterados em mulheres agredidas, com maior evidência de deterioração nas áreas de atenção, memória e funções executivas.Os resultados da meta-análise sugerem a presença de dano cerebral nessas mulheres e um comprometimento especial da memória e das funções executivas. Estes resultados sustentam a existência de alterações nas funções cognitivas das mulheres vítimas de abuso.

The present study aimed to perform a systematic review and meta-analysis on alterations in cognitive functions in battered women. We selected an initial sample of 643 records obtained from the databases: Medline, ERIC,PsycInfo, CNAIL, Proquest and Scielo. Following the study selection procedureled to the retention of 12 articles on which the study has focused. The results of the qualitative synthesis indicate that attention, language, memory, visuospatial skills, executive function, motor speed and educational performance are altered in battered women, with greater evidence of deterioration in the areas of attention, memory and executive functions. The results of the meta-analysis suggest presence of brain damage in these women and a special affectation of the memory and executive functions. These results support the existence of alterations in cognitive functions in women who have been victims of abuse.

Screening for Sex Chromosome Aneuploidy by Cell-Free DNA Testing: Patient Choice and Performance.

OBJECTIVE: To study patient choice regarding testing for sex chromosome aneuploidy (SCA) and the performance of cell-free DNA (cfDNA) screening for SCA. METHODS: Patient choice regarding screening for SCA and factors influencing this choice were evaluated in a single center. In a subsequent two-center study, cases that screened positive for SCA were analyzed to determine the positive predictive value (PPV) for each SCA. RESULTS: In all, 1,957 (61.9%) of the 3,162 patients undergoing cfDNA testing opted for SCA screening. Regression analysis demonstrated that independent predictors of a patient's decision for SCA were earlier gestational age, spontaneous conception, and cfDNA chosen as a primary method of screening. A total of 161 cases screened positive for SCA and follow-up data were available for 118 (73.3%). Forty-six of the 61 cases of 45,X were false-positive results and 15 were concordant with the fetal karyotype (PPV = 24.6%). Seventeen of the 22 cases of 47,XXX were false positive and 5 concordant (PPV = 22.7%). Eleven of the 30 cases of 47,XXY were false positive and 19 concordant (PPV = 63.3%). All 5 cases of 47,XYY were correctly identified, thus yielding a PPV of 100%. CONCLUSION: More than half of the patients undergoing cfDNA aneuploidy screening also opted for SCA testing, but they were less likely to do so in the presence of an increased risk of trisomy. SCAs involving the X chromosome had a lower PPV than those involving the Y chromosome.

Principal Approaches to Understanding Occupation and Occupational Science Found in the Chilean Journal of Occupational Therapy (2001-2012).

BACKGROUND: The progression of occupational science in Chile is documented in the main scientific publication of the field, the Chilean Journal of Occupational Therapy (RChTO). OBJECTIVE: Identify approaches to understanding and applying occupation and occupational science as elucidated in the RChTO. METHODOLOGY: A systematic qualitative review of the journal (2001-2012) identified articles elucidating an approach to understanding and application operationally defined as references to specific authors, theories, models/paradigms, definitions, and other fields that support approaches to O/OS. RESULTS: The study identified two main approaches. The first considers occupation/occupational science from a practical perspective or as a means to explain human behavior; the second considers occupation/occupational science as an object of study. Each approach is further divided into categories. CONCLUSION: This study provides a novel perspective on regional use of occupational science concepts. These findings contribute to our understanding of this science in context and to recognition of the cultural relevance of these scientific concepts.

Iron(II) Complexes with Scorpiand-Like Macrocyclic Polyamines: Kinetico-Mechanistic Aspects of Complex Formation and Oxidative Dehydrogenation of Coordinated Amines.

The Fe(II) coordination chemistry of a pyridinophane tren-derived scorpiand type ligand containing a pyridine ring in the pendant arm is explored by potentiometry, X-ray, NMR, and kinetics methods. Equilibrium studies in water show the formation of a stable [FeL]2+ complex that converts to monoprotonated and monohydroxylated species when the pH is changed. A [Fe(H-2L)]2+ complex containing an hexacoordinated dehydrogenated ligand has been isolated, and its crystal structure shows the formation of an imine bond involving the aliphatic nitrogen of the pendant arm. This complex is low spin Fe(II) both in the solid state and in solution, as revealed by the Fe-N bond lengths and by the NMR spectra, respectively. The formation rate of [Fe(H-2L)]2+ in aqueous solutions containing Fe2+ and L (1:1 molar ratio) is strongly dependent on the pH, the process being completed in times that range from months in acid solutions to hours in basic conditions. However, detailed kinetic studies show that those differences are caused, at least in part, by the effect of pH on the rate of formation of the unoxidized [FeL]2+ complex. In this sense, the protonation of the donor atoms in the pendant arm of the scorpiand ligand leads to the formation of protonated species resistant to oxidative dehydrogenation. Complementary studies in acetonitrile solution indicate that the initial stage in the oxidative dehydrogenation process is the oxidation of the starting complex to form a [FeL]3+ complex, which then undergoes disproportionation into [Fe(H-2L)]2+ and [FeL]2+. Experiments starting with Fe(III) have allowed us to determine that disproportionation occurs with first order kinetics both in water and acetonitrile solutions. However, whereas a significant acceleration is observed in water when the pH is increased, no effect of the addition of acid or base on the rate of disproportionation is observed in acetonitrile. Oxidative dehydrogenation of the Fe(II) complex formed in experiments starting with an Fe(III) salt is slower than that occurring when an Fe(II) salt is used, an observation that can be explained in terms of the formation of two different Fe(III) complexes, one of them with a structure unable to evolve directly toward the product of oxidative dehydrogenation.

Normative Data of the Story and Six-Object Memory Recall Tests in Older Spanish Adults: NEDICES Population-Based Cohort.

OBJECTIVE: We provide normative data for the story and six-object recall tasks, stratified by age and education in a large population-based cohort of older Spanish adults. METHOD: The sample consisted of 2,581 participants without dementia (age range: 67-98 years) from different socioeconomic areas of central Spain. Normative data are presented in percentile ranks and divided into four overlapping age tables with different midpoints. RESULTS: Spearman correlations and shared variances were calculated to evaluate the effects of sociodemographic variables on both tasks. Our findings showed that age and education influence the scores in the story and six-object recall tasks, whereas sex had null effect on story recall and an almost negligible on object recall, respectively. CONCLUSION: The norms presented herein are important for the correct interpretation of scores in the story and six-object recall tasks when assessing older adults in Spain.

"Encierro sobre el encierro" aislamiento por tuberculosis. Centro penitenciario Medellín Colombia / "Confinement on the confinement" isolation for tuberculosis. Penitentiary center Medellín Colombia

Introducción: Las personas privadas de la libertad diagnosticadas con tuberculosis son aisladas para evitar el contagio a otros internos y a los guardianes, a esta situación los participantes le dan significados que pueden ayudar en el diseño de programas para el control de la tuberculosis en centros penitenciarios. Objetivo: Comprender el significado que las personas privadas de la libertad, le dan al aislamiento a que se deben someter durante el tratamiento de la tuberculosis. Metodología: Se utilizó la investigación cualitativa con enfoque etnográfico, se realizaron 14 entrevistas y 400 horas de observación. Se llevó diario de campo. Hallazgos: Las personas privadas de la libertad diagnosticadas con tuberculosis son llevadas a un lugar de aislamiento que favorece la curación y al mismo tiempo genera discriminación. El aislamiento es considerado un "encierro sobre el encierro". Este trae consecuencias físicas, socio-culturales y psicológicas. Para disminuir el impacto buscan distracción y cuando ven síntomas de recuperación lo toman con paciencia. Conclusión: El aislamiento se ve desde dos perspectivas: la comodidad y tener que soportar el encierro y la discriminación. Genera conflictos y alteraciones en la salud física y mental.

Introduction: Deprived of freedom persons, diagnosed with tuberculosis are isolated to prevent transmission to other inmates or guards, this situation gives meanings that can help in designing programs to control tuberculosis in prisons. Objective: To understand the meaning that deprived freedom people give to isolation, which they must be submitted in the treatment of tuberculosis. Methodology: qualitative research with ethnographic approach was used, 14 interviews and 400 hours of observation were performed. Field diary was carried. Findings: Jailed persons diagnosed with tuberculosis are taken to a place of isolation that promotes healing and at the same time generates discrimination. The isolation is considered a "lock on the closure." This brings physical, socio-cultural and psychological consequences. To reduce the impact of persons deprived of liberty they seek distraction and when they see signs of recovery take it easy. Conclusions: isolation is seen from two perspectives: the comfort and having to endure the confinement and discrimination. Generates conflicts and alteration in the physical and mental health.

Trapping a Highly Reactive Nonheme Iron Intermediate That Oxygenates Strong C-H Bonds with Stereoretention.

An unprecedentedly reactive iron species (2) has been generated by reaction of excess peracetic acid with a mononuclear iron complex [Fe(II)(CF3SO3)2(PyNMe3)] (1) at cryogenic temperatures, and characterized spectroscopically. Compound 2 is kinetically competent for breaking strong C-H bonds of alkanes (BDE ≈ 100 kcal·mol(-1)) through a hydrogen-atom transfer mechanism, and the transformations proceed with stereoretention and regioselectively, responding to bond strength, as well as to steric and polar effects. Bimolecular reaction rates are at least an order of magnitude faster than those of the most reactive synthetic high-valent nonheme oxoiron species described to date. EPR studies in tandem with kinetic analysis show that the 490 nm chromophore of 2 is associated with two S = 1/2 species in rapid equilibrium. The minor component 2a (∼5% iron) has g-values at 2.20, 2.19, and 1.99 characteristic of a low-spin iron(III) center, and it is assigned as [Fe(III)(OOAc)(PyNMe3)](2+), also by comparison with the EPR parameters of the structurally characterized hydroxamate analogue [Fe(III)(tBuCON(H)O)(PyNMe3)](2+) (4). The major component 2b (∼40% iron, g-values = 2.07, 2.01, 1.95) has unusual EPR parameters, and it is proposed to be [Fe(V)(O)(OAc)(PyNMe3)](2+), where the O-O bond in 2a has been broken. Consistent with this assignment, 2b undergoes exchange of its acetate ligand with CD3CO2D and very rapidly reacts with olefins to produce the corresponding cis-1,2-hydroxoacetate product. Therefore, this work constitutes the first example where a synthetic nonheme iron species responsible for stereospecific and site selective C-H hydroxylation is spectroscopically trapped, and its catalytic reactivity against C-H bonds can be directly interrogated by kinetic methods. The accumulated evidence indicates that 2 consists mainly of an extraordinarily reactive [Fe(V)(O)(OAc)(PyNMe3)](2+) (2b) species capable of hydroxylating unactivated alkyl C-H bonds with stereoretention in a rapid and site-selective manner, and that exists in fast equilibrium with its [Fe(III)(OOAc)(PyNMe3)](2+) precursor.

Erythrocyte membrane polyunsaturated fatty acid (pufa) levels in a sample of patients with schizophrenia and relation with clinical and progression variables.

INTRODUCTION: Previous studies have shown that erythrocyte cell membranes in patients with schizophrenia contain considerably less omega-3 fatty acids, particularly EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), reflecting the lower levels present in neuronal and central nervous system membranes. This phenomenon, linked to genetic, metabolic, or dietary factors, has been associated with the development of schizophrenia and the risk of developing and the severity of metabolic syndrome. METHODS: This study is an observational study conducted in a sample of 31 patients with schizophrenia treated at the Mataró Mental Health Center (Barcelona). Its aim was to relate the erythrocyte levels of omega 3 with the clinical severity of schizophrenia and dietary habits. EPA (eicosapentaenoic acid), DHA (docosahexaenoic acid) and other membrane lipid levels were determined, as well as psychopathology, cognitive, and social functioning measures, previous evolution, and finally a survey of dietary habits. RESULTS: Our results did not show a statistically significant correlation between erythrocyte omega-3 levels and psychopathological and clinical severity variables. Higher, statistically significant, levels were found in the group of women and in subjects with more days of admission to the day hospital. In contrast, lower values were obtained in subjects treated with long-acting antipsychotics and in sunflower oil consumers. CONCLUSIONS: Despite not being able to demonstrate our working hypothesis, significant correlations were found that were consistent with published findings in the current literature. The need for studies with larger samples and groups of healthy controls is postulated.

[Considerations on the new Chilean law about rights and duties of patients]. / Reflexiones en torno a la ley N° 20.584 y sus implicancias para la investigación biomédica en Chile.

After years of discussion by the Chilean legislature, the Law Nº 20.584, which regulates health care related rights and duties of people, entered into force in Chile in October 2012. This bill represents an important step in the recognition and protection of health care related rights, welfare, dignity and duties of persons. It also intends to protect potential participants in clinical research. However such protective measures include explicit prohibitions such as the review of clinical records or the inclusion of people with mental or psychological handicaps as research participants. We herein discuss the implications of this law in medical research.

Correlation between the molecular structure and the kinetics of decomposition of azamacrocyclic copper(ii) complexes.

The formation of copper(ii) complexes with symmetrical dinucleating macrocyclic ligands containing two either monomethylated () or trimethylated () diethylenetriamine (Medien or Me3dien) subunits linked by pyridine spacers has been studied by potentiometry. Potentiometric studies show that has larger basicity than as well as higher stability of its mono- and binuclear complexes. The crystal structures of ·6HCl (), [Cu2(L1)Cl2](CF3SO3)2 (), [Cu2(L1)(OH)](ClO4)3·3H2O () and [Cu(L1)](ClO4)2 () show that adopts different coordination modes when bound to copper(ii). Whereas in , each copper(ii) is bound to one Medien subunit and to one pyridine group, in each metal center is coordinated to one 2,6-di(aminomethyl)pyridine moiety (damp) and to one aminomethyl group. The mononuclear complex shows pseudo-octahedral coordination with two weakly coordinated axial nitrogens. Kinetic studies indicate that complex decomposition is strongly dependent on the coordination mode of . Upon addition of an acid excess, all the species except [Cu2(L1)](4+) convert very rapidly to an intermediate that decomposes more slowly to copper(ii) and a protonated ligand. In contrast, [Cu2(L1)](4+) decomposes directly without the formation of any detectable intermediate. These results can be rationalized by considering that the crystal structures are maintained in solution and that the weakest Cu-N bonds are broken first, thus indicating that kinetic measurements on complex decomposition can be used to provide information about structural reorganizations in the complexes. In any case, complete decomposition of the complexes takes place in a maximum of two kinetically resolvable steps. However, minor changes in the structure of the complexes can lead to drastic changes in the kinetics of decomposition and the complexes decompose with polyphasic kinetics in which up to four different steps associated with the successive breaking of the different Cu-N bonds can be resolved.