Differential responses to lithium in hyperexcitable neurons from patients with bipolar disorder.

Bipolar disorder is a complex neuropsychiatric disorder that is characterized by intermittent episodes of mania and depression; without treatment, 15% of patients commit suicide. Hence, it has been ranked by the World Health Organization as a top disorder of morbidity and lost productivity. Previous neuropathological studies have revealed a series of alterations in the brains of patients with bipolar disorder or animal models, such as reduced glial cell number in the prefrontal cortex of patients, upregulated activities of the protein kinase A and C pathways and changes in neurotransmission. However, the roles and causation of these changes in bipolar disorder have been too complex to exactly determine the pathology of the disease. Furthermore, although some patients show remarkable improvement with lithium treatment for yet unknown reasons, others are refractory to lithium treatment. Therefore, developing an accurate and powerful biological model for bipolar disorder has been a challenge. The introduction of induced pluripotent stem-cell (iPSC) technology has provided a new approach. Here we have developed an iPSC model for human bipolar disorder and investigated the cellular phenotypes of hippocampal dentate gyrus-like neurons derived from iPSCs of patients with bipolar disorder. Guided by RNA sequencing expression profiling, we have detected mitochondrial abnormalities in young neurons from patients with bipolar disorder by using mitochondrial assays; in addition, using both patch-clamp recording and somatic Ca(2+) imaging, we have observed hyperactive action-potential firing. This hyperexcitability phenotype of young neurons in bipolar disorder was selectively reversed by lithium treatment only in neurons derived from patients who also responded to lithium treatment. Therefore, hyperexcitability is one early endophenotype of bipolar disorder, and our model of iPSCs in this disease might be useful in developing new therapies and drugs aimed at its clinical treatment.

Effectiveness of therapeutic physical exercise in the treatment of patellofemoral pain syndrome: a systematic review.

[Purpose] The aim of this study was to analyze the effectiveness of conservative treatment of patellofemoral pain syndrome with physical exercise. [Subjects and Methods] A computer-based review conducted of four databases (PubMed, the Cochrane Library, PEDro, and the University Library) was completed based on the inclusion criteria of patellofemoral pain syndrome patients treated with physical exercise methods and examination with self-reported pain and/or functional questionnaires. [Results] The findings of ten clinical trials of moderate to high quality were evaluated to determine the effectiveness of physical exercise as conservative management for patellofemoral pain syndrome. [Conclusion] The intervention programs that were most effective in relieving pain and improving function in patellofemoral pain syndrome included proprioceptive neuromuscular facilitation stretching and strengthening exercises for the hip external rotator and abductor muscles and knee extensor muscles.

Test-Retest Reliability of Ultrasonographic Measurements from the Rectus Femoris Muscle 1-5 Years after Anterior Cruciate Ligament Reconstruction in the Ipsilateral and Contralateral Legs: An Observational, Case-Control Study.

About 40% of traumatic injuries in sports are related to the knee. Of these, 33% require arthroscopic surgery. The rehabilitative ultrasound imaging technique is a simple method to obtain objective real-time results on the state and measurement of the musculoskeletal tissue and its use can represent an important change in the process of functional diagnosis and recovery of these injuries. The aim was to quantify the differences in the thickness, muscle contraction time, and muscle relaxation time of the rectus femoris muscle between individuals with knee arthroscopy and healthy individuals and to verify the reliability of the inter-examiner measurements in these ultrasound variables. An observational case-control study with individuals (18−60 years aged) who underwent surgery for anterior cruciate ligament through knee arthroscopy a year or more before. A total of 38 subjects were divided into 2 groups, case and control. Ultrasound measurements were taken of the following outcomes: thickness at rest and contraction, muscle contraction time, and muscle relaxation time of the rectus femoris muscle. Excellent inter-examiner reliability was obtained for all ultrasound measurements (ICC3.3 > 0.90). No significant changes were found in the rate of contraction or rest of the rectus femoris muscle. On the other hand, if significant changes in the thickness of the rectus femoris muscle were found between control and case group. Arthroscopic surgery for anterior cruciate ligament reconstruction does not appear to modify function but does modify the thickness of the rectus femoris muscle on ultrasound examination. Ultrasound appears to be a reliable tool for the study of these measurements in the rectus femoris muscle.

[Scientific Evidence on Preventive Interventions in Childhood Obesity]. / Evidencia científica sobre intervenciones preventivas en obesidad infantil.

INTRODUCTION: The increasing prevalence of obesity or overweight at all ages, their associated morbidity and mortality associated, and the increased perception of the problem by the society have generated several hypotheses in response to the scientific and the international community. OBJECTIVE: Investigate the preventive interventions in childhood obesity so far. METHODS: Integrative review during the study period from April 2013 to November 2014. The MEDLINE international database was used, including PubMed, the Cochrane Library (Issue 4 2002), the national database Isooc (CSIC) national database, as well as the Internet. The review included health articles published in Spanish and English between 1990 and 2014 that focused on or included education, prevention, diagnostic, and treatment of obesity interventions. RESULTS: Of the 726 articles identified, 34 of most relevant (peer reviewed) were selected. It was noted that there is limited generisable evidence on interventions that could be implemented in Primary Care or referral services available, although numerous studies suggest that improvements in the overweight are possible. CONCLUSIONS: Despite the abundant literature and that many institutions place childhood obesity as one of the priorities of Public Health, we face the paradox that the evidence on cost-effectiveness of prevention interventions is sparse. Knowing these gaps in knowledge should lead to filling them with rigorous and well-designed studies.

[Familial incidence of bilateral anorchia. Study of three siblings (author's transl)]. / Incidencia familial de anorquismo bilateral. Estudio de tres hermanos.

Three siblings consulted because of hypogonadism. Physical examination revealed absence of secondary sexual characteristics and infantile genitalia. Increased serum concentrations of LH and FSH were found with abnormal high response to the stimulus with 100 Ug LH-RH. Plasma testosterone concentrations were 0.7, 0.5, and 0.3 ng/ml, respectively; no change in these values was observed after administering 5.000 UI HCG per day during 1 week. Patients underwent a laparotomy but no testicular tissue remnants were found. Whether vascular anomalies, trauma, infectious processes or other factors are responsible is not known. The possibility that genetic abnormalities could be involved in the pathogenesis of this entity is suggested.

Scientific evidence on preventive interventions in childhood obesity / Evidencia científica sobre intervenciones preventivas en obesidad infantil

ABSTRACT Introduction: The increasing prevalence of obesity or overweight at all ages, their associated morbidity and mortality associated, and the increased perception of the problem by the society have generated several hypotheses in response to the scientific and the international community. Objective: Investigate the preventive interventions in childhood obesity so far. Methods: Integrative review during the study period from April 2013 to November 2014. The MEDLINE international database was used, including PubMed, the Cochrane Library (Issue 4 2002), the national database Isooc (CSIC) national database, as well as the Internet. The review included health articles published in Spanish and English between 1990 and 2014 that focused on or included education, prevention, diagnostic, and treatment of obesity interventions. Results: Of the 726 articles identified, 34 of most relevant (peer reviewed) were selected. It was noted that there is limited generalisable evidence on interventions that could be imple mented in Primary Care or referral services available, although numerous studies suggest that improvements in the overweight are possible. Conclusions: Despite the abundant literature and that many institutions place childhood obesity as one of the priorities of Public Health, we face the paradox that the evidence on cost-effectiveness of prevention interventions is sparse. Knowing these gaps in knowledge should lead to filling them with rigorous and well-designed studies.

RESUMEN Introducción: El incremento en la prevalencia de obesidad y/o sobrepeso en todas las edades, la morbimortalidad asociada a dichas situaciones y la mayor percepción del problema en la sociedad han generado distintas hipótesis de respuesta científica y de la comunidad internacional. Objetivo: Investigar las intervenciones preventivas realizadas en obesidad infantil hasta el momento. Métodos: Revisión integradora de la literatura durante el periodo de estudio: abril de 2013 a noviembre de 2014. Se utilizó la base de datos internacional MEDLINE, a través de PubMed, The Cochrane Library (número 4 de 2002) y la base de datos nacional Isooc (CSIC) e internet. Se incluyeron en la revisión los trabajos de salud desarrollados entre 1990 y 2014, que se centraban o incluían intervenciones de educación, prevención, diagnóstico y tratamiento de la obesidad (en idiomas inglés y español). Resultados: Se seleccionaron los 34 registros más relevantes (peer review) de 726 artículos identificados. Se constata que hay poca evidencia generalisable sobre intervención que pueda llevarse a cabo en atención primaria o en los servicios de referencia disponibles, aunque numerosos estudios indican que las mejoras en el sobrepeso son posibles. Conclusiones: A pesar de la abundante literatura y de que numerosas instituciones sitúan la obesidad infantil como una de las prioridades de salud pública, nos enfrentamos a la paradoja de que el coste-efectividad de las intervenciones preventivas es escaso. Constatar estas lagunas en el conocimiento debe llevar a completarlas con estudios rigurosos y bien diseñados.

Educación para la salud en primeros auxilios dirigida al personal docente del ámbito escolar / Health education in first aid for school teaching staff / Educação para a saúde em primeiros socorros dirigida ao pessoal docente de âmbito escolar

Introducción: La formación en primeros auxilios es fundamental para toda aquella persona que pueda verse implicada en situaciones que requieran una actuación basada en estos conocimientos. Este estudio se dirige a docentes de un colegio, como responsables de alumnos a su cargo, y a todas aquellas personas que visitan el centro, por la posibilidad de presenciar accidentes que requieran actuaciones basadas en el conocimiento en primeros auxilios. Objetivos: Valorar el incremento en el nivel de conocimientos sobre primeros auxilios en el profesorado, posterior a una intervención educativa. Metodología: Se realiza un estudio de intervención, con un grupo de 15 docentes. Se recoge información sobre el conocimiento en primeros auxilios antes y después de la intervención educativa. Resultados: La media de respuestas acertadas obtenidas antes de la intervención educativa es del 38.6%, y asciende después de la intervención al 76.2%. Conclusiones:Hay un notable aumento en los conocimientos adquiridos, con una media de diferencia del 37.6%, lo cual confirma que hubo cambio en el nivel de información adquirida.

Introduction: Training in first aid is fundamental for every person who might be involved in a situation requiring the use of this knowledge. This study is aimed at teachers who are responsible for students and visitors to the school, and who might witness accidents that require a response informed by knowledge of first aid. Objectives: To assess the improvement in first aid knowledge among teaching staff after an educational intervention. Methodology: Intervention study on a group of 15 teachers. Information on knowledge of first aid was collected before and after the educational intervention. Results: The percentage of correct answers obtained before the educational intervention was 38.6%, and 76.2% after the intervention. Conclusions: There was a notable increase (37.6%) in first aid knowledge which confirms the positive impact of the intervention.

Introdução: A formação em primeiros socorros é fundamental para toda a pessoa que possa ver-se implicada em situações que requerem uma atuação baseada nestes conhecimentos. Este estudo dirige-se a docentes de uma escola, como responsáveis de alunos a seu cargo e a todas aquelas pessoas que visitam o centro, na possibilidade de presenciarem acidentes que requerem atuações baseadas no conhecimento sobre primeiros socorros. Objetivos: Valorizar o incremento no nível de conhecimentos sobre os primeiros socorros no pessoal docente, posterior a uma intervenção educativa. Metodologia: Realizou-se um estudo de intervenção, com um grupo de 15 docentes. Recolheu-se a informação sobre o conhecimento em primeiros socorros antes e depois da intervenção educativa. Resultado: Sa média de respostas corretas obtidas antes da intervenção educativa é de 38.6%, e ascende depois da intervenção a 76.2%. Conclusõeshá: Um aumento notável nos conhecimentos adquiridos, com uma média de diferença de 37.6%, o qual confirma que houve mudança no nível de informação adquirida.

Proceso de atención de enfermería ante un paciente diagnosticado de diabetes mellitus tipo 2 / Nursing Care Process to a patient diagnosed with type 2 diabetes mellitus

Introducción: La Diabetes Mellitus tipo 2 se caracteriza por desarrollaren el paciente un déficit no absoluto de insulina así como una importante resistencia a la misma (insulino-resistencia) debido principalmente a una alteración de los is lotes pancreáticos de Langerhans.Objetivo: Estudiar la intervención de enfermería a una paciente, diagnosticada de DM tipo II en nuestra consulta de atención primaria en laciudad de Córdoba. Metodología: Aplicación del Proceso de Atención de Enfermería ante elsiguiente caso clínico: Mujer de 89 años, viuda, vive con su hija que es su cuidadora informal principal. Su vivienda carece de ascensor y presenta una rampa que no cumple con la normativa legal vigente en la actualidad. Resultados: Encontramos que los diagnósticos (NANDA) alterados en nuestra paciente eran: Deterioro de la movilidad y Patrón respiratorio ineficaz, tras lo cual planteamos los resultados (NOC)-intervenciones(NIC) correspondientes. Conclusión principal: La vigilancia de este tipo de pacientes crónicoses minuciosa, ya que se les realizan controles periódicos de glucemia, constantes vitales, test doppler y monofilamento. Ante este último, obtuvimosen el último control una puntuación: 1, (Pie de riesgo). Además,realizamos frecuentemente Educación Para la Salud. Resulta primordial transmitirles tranquilidad y confianza.

Introduction: Diabetes Mellitus, Type 2 is characterized by the patient develop a non-absolute insulin deficiency and significant resistance to it (insulin resistance), mainly due to disruption of the pancreatic islets of Langerhans. Objective: To study nursing intervention to a patient diagnosed with type II DM in our primary care clinic in the city of Córdoba. Methodology: We applyed the Nursing Process to the following case: This woman is 89 years old and widow. She lives with her daughter who is his main carer casual. Her house has no elevator and a ramp that does not meet the legal regulations currently in force. Results: We found several diagnoses (NANDA) were altered in our patient: Impaired mobility and ineffective breathing pattern, after which we propose the appropriate Results –Interventions. Main conclusion: The monitoring in this type of chronic patients is thorough, since they make regular checks of blood glucose, vital signs, and doppler test monofilament. Before this last, we obtained in last control your the following score: 1 (risk foot). Also, we often offered them Health Education. It is essential to convey them calm and confidence.