Ultrasound-Guided Percutaneous Needle Electrolysis in Dancers with Chronic Soleus Injury: A Randomized Clinical Trial.

Damage to intramuscular tendons is very common in sports injuries, specifically in soleus muscle injuries. This study sought to compare the effects of applying ultrasound- (US-) guided percutaneous needle electrolysis (PNE) in combination with an eccentric exercise program on pain and functionality in dancers with chronic soleus injury, located in the central tendon. Thirty dancers with injured central tendon of the soleus muscle were randomly allocated to a PNE group (n = 10), an eccentric exercise group (n = 10), or a combined group (n = 10). Pain, ankle dorsiflexion range of motion (DROM), endurance, the heel raise test, the DFOS questionnaire, and the minimal clinically important difference (MCID) were analyzed at baseline and after treatment (four weeks). Over half (52%) of the dancers had a chronic soleus muscle injury. Variables for pain, DROM, the heel rise test, ADL, technique, DFOS total, and DFOS-subjective variables showed significant differences (P < 0.05) in pretreatment and posttreatment in all groups, whereas no significant differences were observed between intervention groups. However, the combined group showed a higher percentage of changes compared to the other groups, and these dancers had greater perceived changes (MCID = 4.70 ± 1.42). The conclusion of the study was that dancers with chronic soleus injury, located in the central tendon, treated with a combination of US-guided PNE and an eccentric exercise program displayed improved outcomes compared to the application of PNE therapy or eccentric exercise alone. The US-guided PNE, combined with an eccentric exercise program, is a useful therapeutic tool for the treatment of chronic soleus injury, located in the central tendon. The trial is registered with NCT04042012.

Percutaneous Application of Galvanic Current in Rodents Reverses Signs of Myofascial Trigger Points.

An increase in the spontaneous release of acetylcholine (ACh) at the motor endplate is directly related to the generation of myofascial trigger points (MTrPs). In this study, percutaneous electric fields were applied to an animal model of MTrPs with high levels of spontaneous ACh release. All experiments were performed on Swiss mice and Sprague Dawley rats. For evaluating the spontaneous neurotransmission, intracellular recordings were performed, and the frequency of miniature endplate potentials was evaluated. Electromyographic recordings were also conducted to evaluate the endplate noise. Finally, the number and strength of local twitch responses (LTR) were evaluated using ultrasound recordings. The protocols used for the electric currents were 0.4 mA for five seconds and four repetitions (protocol 1), 1.5 mA for five seconds and three repetitions (protocol 2), and 3 mA for three seconds and three repetitions (protocol 3). After a subcutaneous injection of neostigmine (NTG), a great increase was observed in the frequency of mEPPs, together with an elevated endplate noise. Protocols 2 and 3 were the most effective. Protocol 3 could completely reverse the action of NTG at both three hours and 24 hours, respectively. The application of percutaneous currents produced both an increase in the number (144%) and in the speed (230% faster) of LTR compared with dry needling. In conclusion, higher doses of electrical current are more effective for decreasing MTrPs findings in an animal model.

Percutaneous Needle Electrolysis Reverses Neurographic Signs of Nerve Entrapment by Induced Fibrosis in Mice.

Nerve entrapments such as carpal tunnel syndrome are the most common mononeuropathies. The lesional mechanism includes a scarring reaction that causes a vascular compromise. The most effective treatment is surgery, which consists of removing the scarred area, thus reverting the vascular impairment. In the present study, a more conservative therapeutic approach has been undertaken to release the nerve by means of galvanic current (GC) applied with a needle: percutaneous needle electrolysis (PNE). For this purpose, a mouse model of sciatic nerve entrapment has been created using albumin coagulated by glutaraldehyde (albumin 35% and glutaraldehyde 2% volume applied, 10 µl). After two weeks, a fibrous reaction was obtained which entrapped the nerve to the extent of causing atrophy of the leg musculature (14.7%, P < 0.05 compared to the control leg). Ultrasound imaging confirmed that the model's image was compatible with that of nerve entrapment in patients. To quantify the degree of entrapment, nerve conduction recordings were made. The amplitude (peak-to-peak) of the compound muscle action potential (CMAPs) decreased by 32.2% (P < 0.05), and the proximal latency increases by 17.7% (P < 0.05, in both cases). In order to release the sciatic nerve, PNE was applied (1.5 mA for 3 seconds and 3 repetitions; 1.5/3/3) by means of a solid needle in the immediacy of perineural fibrosis before and 5 minutes after the application of GC, and the proximal latency shows a decrease of 16% (P < 0.05). The recovery of CMAPs amplitude was about 48.7% (P < 0.05). Three weeks later, the CMAPs amplitude was almost completely recovered (94.64%). Therefore, with the application of GC by means of a solid needle, the sciatic nerve was definitively released from its fibrous entrapment.

Tósigos y antídotos en la literatura cervantina: sobre los venenos en la España tardorrenacentista / “Tosigos” and antidotes in Cervantine literature: on the poisons in the late Renaissance Spain

Los textos cervantinos constituyen una interesante fuente para el estudio de la sociedad española tardorrenacentista. Nosotros hemos abordado las obras de Cervantes desde la óptica de la toxicología, analizando el uso de agentes tóxicos y venenosos, fundamentalmente alucinógenos y narcóticos en el ámbito de la práctica de la brujería y hechicería (ungüentos de brujas, filtros de amor, pócimas venenosas, etc.), así como las menciones a las hipotéticas sustancias dotadas de acción alexifármaca, como la verbena (Verbena officinalis), el cuerno de unicornio, las piedras bezoares o el castóreo. Las obras cervantinas en las que se hace referencia a estos preparados son las novelas El Quijote, La Galatea, Viaje del Parnaso y cuatro Novelas Ejemplares (La española inglesa, El licenciado Vidriera, El celoso extremeño y El coloquio de los perros), así como en las comedias Pedro de Urdemalas, La entretenida y El laberinto del amor. Entre los agentes tóxicos de origen herbal citados expresamente por Cervantes en el contexto analizado se encuentran el beleño (Hyoscyamus niger / albus), el tabaco (Nicotiana tabacum), la adelfa (Nerium oleander), el tártago (Euphorbia lathyris), el ruibarbo (Rheum officinale, Rumex alpinus) y, de forma enmascarada, el opio (Papaver somniferum). En relación con el resto de preparados dotados de actividad tóxica, Cervantes no identifica sus ingredientes, aunque, a tenor de la sintomatología descrita por el autor, podrían ser plantas de la familia de las solanáceas, como el beleño, el solano, la datura, la belladona o la mandrágora. Con respecto a los tóxicos minerales, únicamente hay referencias a los efectos del mercurio o azogue. El Dioscórides comentado por Andrés Laguna pudo ser la fuente técnica utilizada por Cervantes para documentarse en esta materia (AU)

Cervantine texts are an interesting source for the study of Spanish late Renaissance society. We have studied the works of Cervantes from the toxicology viewpoint, analyzing the use of toxic and poisonous substances, essentially hallucinogenic and narcotic agents in the field of witchcraft and sorcery practice (witches ointments, love filters, poisonous potions, etc.), as well as references to hypothetical substances endowed with alexipharmic action, as the vervain (Verbena officinalis), unicorn horn, bezoar stones or castoreum. Cervantine works which refers to these preparations are the novels Don Quixote, The Galatea, Voyage to Parnassus and four Exemplary Novels (The Spanish-English Lady, The Licentiate of Glass, The Jealous Extremaduran and The Colloquy of the Dogs), as well as the comedies Pedro de Urdemalas, The Amusing Woman and The Labyrinth of Love. Toxic agents of herbal origin mentioned explicitly by Cervantes in the analyzed context include the henbane (Hyoscyamus niger / albus), tobacco (Nicotiana tabacum), oleander (Nerium oleander), spurge (Euphorbia lathyris), rhubarb (Rheum officinale, Rumex alpinus), and masked way, opium (Papaver somniferum). In relation to the rest of preparations endowed with toxic activity, Cervantes does not identify its ingredients, though, within the meaning of the symptoms described by the author, they could be plants of the Solanaceae family, as the henbane, nightshade, jimsonweed, belladonna or mandrake. Concerning toxic minerals, only there are references to the effects of mercury (“azogue”). The Dioscorides commented by Andrés Laguna could be the technical font used by Cervantes to document in this matter (AU)

An historical view of the pineal gland and mental disorders.

Since Classical Antiquity numerous authors have linked the origin of some mental disorders to physical and functional changes in the pineal gland because of its attributed role in humans as the connection between the material and the spiritual world. The pineal organ was seen as a valve-like structure that regulated the flow of animal spirits through the ventricular system, a hypothesis that took on more vigour during the Middle Ages and the Renaissance. The framework for this theory was "the three cells of the brain", in which the pineal gland was even called the "appendix of thought". The pineal gland could also be associated with the boom, during this period, of certain legends about the "stone of folly". But the most relevant psychopathological role of this organ arrived with Descartes, who proposed that it was the seat of the human soul and controlled communications between the physical body and its surroundings, including emotions. After a period of decline during which it was considered as a mere vestigial remnant of evolution, the link between the pineal gland and psychiatric disorders was definitively highlighted in the 20th century, first with the use of glandular extracts in patients with mental deficiency, and finally with the discovery of melatonin in 1958. The physiological properties of melatonin reawakened interest in the relationship between the pineal gland and mental disorders, fundamentally the affective and sleep disorders, which culminated in the development of new pharmacological agents acting through melatonergic receptors (ramelteon and agomelatine).

Association of bone microarchitecture with parathyroid hormone concentration and calcium intake in men: the STRAMBO study.

UNLABELLED: OBJECTVIE: In the elderly, vitamin D deficit, low calcium intake, and impaired bone microarchitecture are associated with higher risk of hip fracture. We assessed the association of bone microarchitecture with calcium intake and serum concentrations of 25-hydroxycholecalciferol (25OHD) and parathyroid hormone (PTH) in men. DESIGN: Cross-sectional analysis was performed in 1064 men aged 20-87 years not taking vitamin D or calcium supplements. METHODS: Daily calcium intake was assessed using a food frequency questionnaire. Bone microarchitecture was assessed at distal radius and tibia by high-resolution peripheral quantitative computed tomography. We measured serum and urinary levels of biochemical bone turnover markers (BTMs). Statistical models were adjusted for age, weight, height, and glomerular filtration rate. RESULTS: In 500 men aged <65 years, lower 25OHD levels and low calcium intake were associated with lower trabecular volumetric bone mineral density (Dtrab) at the distal tibia, due to lower trabecular number (Tb.N). Low calcium intake was associated with lower cortical thickness (Ct.Th). Higher PTH level was associated with higher BTM levels. In 563 men aged ≥65 years, the highest PTH quartile was associated with lower Ct.Th (tibia), lower Dtrab (both sites), and lower Tb.N (radius) compared with the lowest quartile. Low calcium intake was associated with lower Tb.N and more heterogenous trabecular distribution. BTM positively correlated with the PTH concentration. CONCLUSION: In older men, elevated PTH concentration is associated with high bone turnover, poor trabecular microarchitecture (radius and tibia), and, at the distal tibia, lower Ct.Th. Low calcium intake is associated with lower Tb.N and more heterogenous trabecular distribution.

Use of dietary vitamin E and selenium (Se) to increase the shelf life of modified atmosphere packaged light lamb meat.

The aim of this work was to determine the increase in the shelf life of modified atmosphere packaged fresh lamb meat due to the effect of dietary vitamin E and selenium supplementation on colour and lipid oxidation. 128 lambs were fed on a concentrate with standard levels of vitamin E (C), a concentrate enriched with vitamin E (V), a concentrate with sodium selenite (S) and a concentrate enriched with both vitamin E and sodium selenite (VS). The lambs were slaughtered at 27.3±1.45 kg LW, and chops stored on MAP for 7, 9, 11 and 13 days. CIELab colour and TBARs were studied on these days. Use of dietary vitamin E extended the shelf life a further 4 days from the commercial sell-by date in terms of lightness, hue angle, metmyoglobin formation and lipid oxidation. Selenium could be used to increase the lightness of meat without vitamin E supplementation in lambs' diets.

Fiabilidad interobservador del test de movilidad pasiva accesoria intervertebral lumbar y su correlación con la galvanopalpación en sujetos sanos / Inter-observer reliability of the passive accessory intervertebral motion test and its correlation with the galvanic palpation in healthy subjects

Introducción El diagnóstico de fisioterapia de las disfunciones vertebrales es fundamental para clasificar las alteraciones musculoesqueléticas. La evaluación pasiva de la cantidad y la calidad del movimiento en los diferentes segmentos vertebrales guía la toma de decisiones en relación con el tratamiento de fisioterapia. Los objetivos del presente estudio son determinar la fiabilidad interobservador del test de movilidad pasiva accesoria posteroanterior intervertebral unilateral lumbar como test indicado para identificar sujetos con disfunción articular y analizar la corriente galvánica como herramienta diagnóstica en la identificación de disfunción articular en la columna lumbar con dicho test ortopédico. Material y método Dos fisioterapeutas expertos en fisioterapia manual realizaron el test en una muestra de 30 sujetos asintomáticos en los niveles L1-L5 (lado derecho e izquierdo), realizándose un total de 300 pruebas. Se determinó que un nivel lumbar estaba en disfunción basándose en una sensación final anormal, la calidad de la resistencia anormal y la posible aparición de dolor asociado al movimiento. Para determinar la utilidad diagnóstica de la corriente galvánica, otros dos fisioterapeutas realizaron galvanopalpación consecutivamente al test de movilidad en las articulaciones interapofisarias lumbares de los mismos sujetos asintomáticos. Resultados En el test de movilidad, el porcentaje de acuerdo fue del 86,3%. El índice kappa (k) mostró un acuerdo moderado (k=0,5). El test fue más fiable en los niveles lumbares L3-L4 y L4-L5. En la galvanopalpación el porcentaje de acuerdo fue del 83%. El k mostró un acuerdo moderado en la identificación de disfunción articular (k=0,41). La sensibilidad fue alta en el nivel lumbar L3-L4 y L4-L5 y baja en L1-L2; la especificidad fue elevada (82,7–96,3%) en toda la columna lumbar. Conclusiones La fiabilidad interobservador del test de movilidad es moderada (k=0,5). La galvanopalpación identifica disfunciones articulares, pero en la columna lumbar alta la sensibilidad es baja (AU)

Introduction The physical therapy diagnosis of a vertebral dysfunction is essential in order to classify musculoskeletal diseases. Passive assessment of quantity and quality of movement on the different vertebral segments guides the decision-making process relative to manual therapy treatment. The aims of this present study have been to determine the interobserver reliability of passive accessory intervertebral postero-anterior unilateral lumbar motion test as a test to identify subjects with joint dysfunction, and to analyze galvanic current as a diagnostic tool to identify joint dysfunction in the lumbar spine with the motion test. Material and methods Two physiotherapists, experts in manual therapy, carried out the test in 30 asymptomatic subjects at L1 to L5 levels (right and left sides), performing a total of 300 tests. To determine the diagnostic value of galvanic current, two other physiotherapists performed galvanic palpation consecutively to the motion test in lumbar zygapophysial joints in the same asymptomatic subjects. Results Percentage agreement was 86.3% for the motion test. The Kappa index showed substantial agreement (according to Landis and Koch, 1977) (k=0.5). PA accessory motion test was more reliable to identify symptomatic spinal L4-L5 and L5-S1 level. Regarding galvanic palpation, the agreement percentage was 83%. Kappa coefficient (k) showed moderate agreement for identification of joint dysfunction (k=0.41). Sensitivity was high in the lumbar level L3-L4 and L4-L5 and was low in L1-L2 level; specificity was high (82.7–96.3%) throughout the lumbar spine. Conclusions Interobserver reliability of the passive motion test is moderate (k=0.5). Galvanic palpation identifies joint dysfunction, however sensitivity is low in the upper lumbar spine (AU)

Phytotherapy and psychiatry: bibliometric study of the scientific literature from the last 20 years.

In diverse areas of therapy, including psychiatry, increasing interest in herbal medicine has been shown in recent years. Plants have a wide range of traditional uses, but only a few have been approved therapeutically. Moreover, to our knowledge, no bibliometric analyses on medicinal plants used in psychiatry have been carried out to date. We performed a bibliometric study on scientific publication related to phytotherapy in the psychiatry area during the period 1986-2006. Using the platform Embase.com, including the EMBASE and MEDLINE databases, we selected those documents including the descriptors plant*, herb*, phytotherapy*, phytomedicine*, pharmacognosy*, and psychiatry* (with all diagnostic criteria). The plants' indications were selected according to the PDR for Herbal Medicines. As a bibliometric indicator of the production, Price's Law was applied. Another indicator included was the national participation index (PI) for overall scientific production. A total of 21,409 original documents were obtained. Our data confirm a fulfillment of Price's Law related to scientific production on medicinal plants in Psychiatry. This was observed after we made a linear fit (y=135.08x-466.38; r=0.92) and another fit to an exponential curve (y=132.26e(0.1497x); r=0.99). The plants most widely mentioned in the psychiatric literature were St. John's wort (Hypericum perforatum L.; n=937) and ginkgo (Ginkgo biloba L.; n=694). The countries with the highest percentages of documents were the United States (29.44%), Germany (9.41%) and Japan (8.75%), and those with highest proportional PI were India (IPa=0.935) and China (IPa=0.721). Productivity on medicinal plants in the psychiatry area increased during the period 1986-2006. Nevertheless, documents about therapeutic herbs in this medical field are still relatively few in number.

Abordaje terapéutico de la epilepsia desde la perspectiva nutricional: situación actual del tratamiento dietético / Therapeutic approach to epilepsy from the nutritional view: current status of dietary treatment

Aproximadamente entre un 20-30 % de los pacientes epilépticos no responden adecuadamente al tratamiento farmacológico. En estos pacientes el tratamiento dietético se ha planteado como una alternativa terapéutica o como una herramienta coadyuvante. El objetivo del presente trabajo es realizar una revisión sobre las alternativas dietéticas disponibles en la actualidad en el tratamiento de la epilepsia (dieta cetogénica, dieta de Atkins, etc.). La dieta cetogénica ha sido la más utilizada y estudiada en este trastorno neurológico y por este motivo también es la que más modificaciones ha sufrido y la que más preguntas suscita en relación a su mecanismo de acción, su eficacia, sus efectos adversos, así como al protocolo más adecuado para llevarla a cabo. Son numerosos los estudios observacionales y revisiones que se han planteado sobre este tema y que avalan el efecto beneficioso de la dieta cetogénica. No obstante, son necesarios ensayos clínicos controlados aleatorizados y con mayores muestras poblacionales que confirmen dichos resultados, con el fin de conseguir un tratamiento dietético óptimo e individualizado en la epilepsia refractaria

Approximately 20%-30% of epilepsy patient do not respond adequately to drug treatment. In this population, a dietary treatment has been posed as a therapeutic alternative or coadjuvant tool. This present work has aimed to carry out a review on the dietary alternatives currently available to treat epilepsy (ketogenic diet, Atkins’ diet, etc.). The ketogenic diet has been used and studied the most in this neurological disorder. That is why it is also the one that has undergone the greatest change. Furthermore, this diet has caused the most controversy about its action mechanism, efficacy and adverse effects as well as about what would be the best protocol to carry it out. Many observational studies and reviews on this subject that support the beneficial effect of the ketogenic diet have been conducted. However, controlled, randomized clinical trials with larger population samples are needed to confirm these results in order to achieve an optimum and individualized dietary treatment in refractory epilepsy

Estrogen-dependent increase in bone turnover and bone loss in postmenopausal women with breast cancer treated with anastrozole. Prevention with bisphosphonates.

Aromatase inhibitors have demonstrated their superiority to tamoxifen as adjuvant therapy for early breast cancer in postmenopausal women, but are associated with an increased risk of fractures. The aim of our study was to analyze bone loss, bone turnover and their determinants in postmenopausal women treated with anastrozole. We investigated bone loss and bone turnover markers (BTM) in a prospective open cohort study of 118 postmenopausal women treated with anastrozole for an early hormone-dependent breast cancer. Women without osteoporosis were not treated and compared with an age-matched control group of 114 healthy women. Osteoporotic patients (T-scoreor=6 courses) and a marked antiestrogenic response--defined by a level of 17beta-estradiol50% between baseline and 1 year--were associated with greater bone loss. In multivariate model, women in the highest quartile of bone loss at the spine (>5.6% at 1 year) and hip (>4.9%) had a marked antiestrogenic response with OR of 10.4 [95% C.I. 1.9-57.2] (p=0.007) and 5.7 [1.3-25] (p=0.024) respectively. Among patients in the surveillance group, those with a normal T-score at both sites (n=46) had also a significant bone loss at spine -3.3+/-0.5% [-4.3 to -2.3], p<0.0001 and at the hip -2.9+/-0.6% [-4.1 to -1.7] p<0.0001. In osteoporotic women treated simultaneously with anastrozole and risedronate, bone loss was prevented at hip, and increased at the spine (+4.1+/-0.9% [2.3 to 5.9], p=0.008), and BTM decreased (-24%, -39% for CTX, p=0.003 and 0.001 vs. changes in the untreated group). Anastrozole increases bone turnover and induces an accelerated bone loss that is significantly related to the suppression of 17beta-estradiol production induced by aromatase inhibitor. The bisphosphonate risedronate prevents anastrozole induced bone loss.

[Therapeutic approach to epilepsy from the nutritional view: current status of dietary treatment]. / Abordaje terapéutico de la epilepsia desde la perspectiva nutricional: situación actual del tratamiento dietético.

Approximately 20%-30% of epilepsy patient do not respond adequately to drug treatment. In this population, a dietary treatment has been posed as a therapeutic alternative or coadjuvant tool. This present work has aimed to carry out a review on the dietary alternatives currently available to treat epilepsy (ketogenic diet, Atkins' diet, etc.). The ketogenic diet has been used and studied the most in this neurological disorder. That is why it is also the one that has undergone the greatest change. Furthermore, this diet has caused the most controversy about its action mechanism, efficacy and adverse effects as well as about what would be the best protocol to carry it out. Many observational studies and reviews on this subject that support the beneficial effect of the ketogenic diet have been conducted. However, controlled, randomized clinical trials with larger population samples are needed to confirm these results in order to achieve an optimum and individualized dietary treatment in refractory epilepsy.

La virtud de aquel precioso bálsamo: aproximación a El Quijote desde la vertiente de la psicofarmacología / The virtude of that precious balsam: approach to Don Quixote from the psychopharmacological perspective

La obra cumbre de la literatura española, El Quijote, constituye una fuente donde habitualmente beben los diferentes especialistas que pretenden conocer con mayor profundidad la sociedad renacentista tardía. Esta obra magistral de Miguel de Cervantes ha sido frecuentemente abordada desde la perspectiva psicopatológica para obtener un diagnóstico psiquiátrico de su principal personaje, Alonso Quijano. También son frecuentes los abordajes clínicos desde la traumatología y desde la terapéutica general (análisis de aceites, ungüentos, bálsamos y demás preparados de botica). Nosotros nos acercamos a El Quijote desde la vertiente de la psicofarmacología, un campo escasamente abordado. En el presente trabajo se estudian los remedios terapéuticos empleados en la época cervantina para el tratamiento de los locos y enajenados (sedantes, como el opio; evacuantes, como el eléboro; tónicos, irritantes y técnicas quirúrgicas, como las sangrías y fuentes) y se analizan las escasas e inespecíficas terapias, fundamentalmente de origen herbal, que Cervantes nos revela en su novela (bálsamos, purgantes y eméticos). Entre ellas cabe mencionar la raíz de ruibarbo (Rumex alpinus), las semillas de tártago (Euphorbia lathyris), la hierba de San Juan (Hypericum perforatum), ingrediente del aceite de Aparicio y el romero (Rosmarinus officinalis), ingrediente del célebre bálsamo de Fierabrás. También se analizan las posibles influencias científicas en que se pudo inspirar Cervantes en este campo, fundamentalmente las obras de Juan Huarte de San Juan Examen de ingenios para las ciencias y de Andrés Laguna Dioscorides, acerca de la materia medicinal y de los venenos mortíferos

The most outstanding novel of the Spanish literature, Don Quixote, represents the source to which the different specialists who intend to deepen their knowledge of the late Renaissance society usually address. This masterpiece of Miguel de Cervantes has been frequently approached from the psychopathological perspective to obtain a psychiatric diagnosis of its main character, Alonso Quijano. Also, other clinical approaches from the traumatological and general therapeutical view (oils, ointments, balms and other pharmacy preparations) have been frequent. We have tackled Don Quixote from the psychopharmacological perspective, a barely explored field. In this work, we intend to study the therapeutical cures used during the Cervantine time for the treatment of insane and mentally disturbed people (sedatives like opium, laxatives like hellebore, tonics, irritants and surgical techniques like bloodlettings and «fuentes») and we analyze the limited and unspecific therapies, mainly of herbal origin (balms, purgatives and emetics), which Cervantes reveals to us in his novel. Among them, rhubarb root (Rumex alpinus), seeds of spurge (Euphorbia lathyris), St. John's Wort (Hypericum perforatum), main ingredient of Aparicio's oil, and rosemary (Rosmarinus officinalis), primary component of the famous balsam of Fierabras, should be highlighted. We have also examined the possible scientific influences which might have inspired Cervantes in this field, mainly the works of Juan Huarte de San Juan The examination of men's wits and the one of Andres Laguna Dioscorides' materia medica

[The virtue of that precious balsam...: approach to Don Quixote from the psychopharmacological perspective]. / La virtud de aquel precioso bálsamo...: aproximación a El Quijote desde la vertiente de la psicofarmacología.

The most outstanding novel of the Spanish literature, Don Quixote, represents the source to which the different specialists who intend to deepen their knowledge of the late Renaissance society usually address. This masterpiece of Miguel de Cervantes has been frequently approached from the psychopathological perspective to obtain a psychiatric diagnosis of its main character, Alonso Quijano. Also, other clinical approaches from the traumatological and general therapeutical view (oils, ointments, balms and other pharmacy preparations) have been frequent. We have tackled Don Quixote from the psychopharmacological perspective, a barely explored field. In this work, we intend to study the therapeutical cures used during the Cervantine time for the treatment of insane and mentally disturbed people (sedatives like opium, laxatives like hellebore, tonics, irritants and surgical techniques like bloodlettings and <>) and we analyze the limited and unspecific therapies, mainly of herbal origin (balms, purgatives and emetics), which Cervantes reveals to us in his novel. Among them, rhubarb root (Rumex alpinus), seeds of spurge (Euphorbia lathyris), St. John's Wort (Hypericum perforatum), main ingredient of Aparicio's oil, and rosemary (Rosmarinus officinalis), primary component of the famous balsam of Fierabras, should be highlighted. We have also examined the possible scientific influences which might have inspired Cervantes in this field, mainly the works of Juan Huarte de San Juan The examination of men's wits and the one of Andres Laguna Dioscorides' materia medica.

Evaluation of the antinociceptive effect of Rosmarinus officinalis L. using three different experimental models in rodents.

The rationale of this investigation was to examine the antinociceptive effect of an ethanol extract of Rosmarinus officinalis (RO) aerial parts, using three different experimental models: acetic acid-induced writhing test and formalin test in mice; and a model of arthritic pain: "pain-induced functional impairment model in the rat (PIFIR model)". The antinociceptive efficacies were evaluated using several dose-response curves and time courses. The antinociceptive effects from RO extract were compared with the antinociceptive effect of either tramadol (TR: 3.16-50 mg/kg, i.p. in mice, and 1.0-31.62 mg/kg, i.p. in rats) or acetylsalicylic acid (AA: 31.62-562.32 mg/kg, p.o.). RO extract (10-300 mg/kg, p.o.) significantly (P < 0.001) reduced the number of writhing movement induced by the i.p. administration of acetic acid solution in a dose-dependent way (ED50 = 108.84 mg/kg, whereas, TR showed an ED50 = 12.38 mg/kg). In addition, RO extract (30-300 mg/kg) significantly (P < 0.001) inhibited licking and shaking behaviours in both early (neurogenic pain) and in the late (inflammatory pain) phases of the formalin test. These effects were like those produced by TR. Concerning the results using the PIFIR model, RO extract (30-3000 mg/kg, p.o.) like either TR or AA, produced a significant (P < 0.001) and dose-dependent antinociceptive response in rats (RO: ED50 = 222.78 mg/kg versus TR: ED50 = 11.06 mg/kg and AA: ED50 = 206.13 mg/kg). These results strongly suggest that aerial parts of RO possess antinociceptive and anti-inflammatory activity, and reinforce the use of this plant in folk medicine.

Associations of vitamin D status with bone mineral density, bone turnover, bone loss and fracture risk in healthy postmenopausal women. The OFELY study.

INTRODUCTION: Vitamin D status is considered as an important determinant of bone health but supplementation trials with vitamin D(3) have yielded conflicting results. The aim of this study was to investigate the associations between serum 25-hydroxyvitamin D (25-OH D), bone turnover markers, bone mineral density (BMD), radius bone loss and incidence of fracture in postmenopausal women. METHODS: 669 postmenopausal women (mean age: 62.2 years) belonging to a population-based cohort were followed prospectively for a median of 11.2 years. At baseline, 25-OH D levels, BMD, bone turnover markers and clinical risk factors of osteoporosis were assessed. BMD loss at the radius was estimated by annual measurements of BMD and all incident fractures which occurred in 134 women were confirmed by radiographs. RESULTS: 73% and 35% of women had serum 25-OH D levels below 75 and 50 nmol/l which correspond respectively to the median and lowest optimal values recently proposed for fracture prevention. 11% of women had levels below 30 nmol/l. Serum 25-OH D correlated modestly with intact PTH (r(2)=0.023, p<0.0001), but not with bone turnover markers or BMD at the hip and radius after adjustment for age. When levels of 25-OH D were considered as a continuous variable, there was no significant association between 25-OH D levels and radius BMD loss or fracture risk. After adjustment for age, there was no significant difference in incidence of fracture, BMD, radius BMD loss, bone turnover markers, grip strength and the percentage of fallers in the previous year between women with 25-OH D levels below or above 75, 50 or 30 nmol/l. CONCLUSIONS: In a population of home-dwelling healthy postmenopausal women with few of them with severe vitamin D deficiency, vitamin D status may not be an important determinant of bone health.

El papel de la medicina herbal ayurvédica en el descubrimiento de las propiedades neurolepticas de la reserpina: a propósito de la Rauwolfia serpentina y los orígenes de la era antipsicótica / The role of the ayurvedic herbal medicine in the discovering of neuroleptic properties of reserpine: Rauwolfia serpentina and the origins of antipsychotic era

En el presente trabajo se revisa el papel de la planta Rauwolfia serpentina en el origen de la denominada "era psicofarmacológica". Para ello, se ha sumarizado su empleo en la tradicional medicina ayurvédica, fundamentalmente en los trastornos mentales. En el clásico tratado hindú Charaka Samhita ya se hablaba de una forma de psicosis denominada Ounmaad, uno de cuyos remedios terapéuticos era la "planta de raíz de serpiente". La medicina científica se ocupó del estudio, durante la primera mitad del siglo XX, de las actividades farmacológicas de esta planta, destacando las propiedades sedantes e hipotensivas. Finalmente, se analiza el proceso de aislamiento de los alcaloides de la raíz de Rauwolfia, iniciado en la India, y que concluyó con el descubrimiento de la reserpina en los laboratorios suizos de Ciba. Con la reserpina, el arsenal farmacológico para el tratamiento de la esquizofrenia, sustentado únicamente en la clorpromazina, se vio sustancialmente implementado; permitiendo un gran avance en el manejo de los trastornos psiquiátricos (AU)

Tomato allergy in children and young adults: cross-reactivity with latex and potato.

BACKGROUND: Several studies have shown that allergy to natural rubber latex is associated with cross-reactivity to certain foods such as tomato and potato. The objective was to investigate the clinical and immunologic differences between a group of patients with clinical allergy to tomato and latex and another which had only clinical allergy to tomato. We also aimed to assess, in vitro, the relationship of tomato and latex allergens, which could explain the cross-reactivity. METHODS: Forty patients with histories of adverse reactions to tomato and IgE-mediated hypersensitivity were enrolled in the study. Tomato, latex, and potato components were analyzed by SDS-PAGE immunoblotting. CAP and immunoblot inhibition were used to study allergen cross-reactivity. RESULTS: Patients from group A had a mean age of 13.2 years, and in group B the mean age was 21.7 years. In group B, 9/10 patients belonged to the latex-fruits syndrome. All patients of both groups tolerated potato. Immunoblotting patterns obtained with patients' sera from pool A showed IgE-binding bands to tomato ranging from 44 to 46 kDa and a triple band at 67 kDa. For latex, there was a strong binding at 44 kDa, and potato showed a strong band of 44 kDa and a 67-kDa triple band. In pool B, the binding to the band of 44 kDa in latex and tomato was more intense than in pool A. In pool A, immunoblot inhibition with potato allergen showed an intense inhibition of the three allergens (potato, latex, and tomato); with latex, inhibition was partial and with tomato, a complete inhibition of tomato and latex was observed, and a partial inhibition of potato. In pool B, the inhibition pattern followed a similar tendency to pool A. The CAP inhibition confirmed the high rate of cross-reactivity between tomato, potato, and latex. CONCLUSIONS: In our study, tomato, potato, and latex showed a common band of 44-46 kDa probably corresponding to patatin. This protein could be implicated in the high cross-reactivity between tomato, latex, and potato observed in the immunoblot and CAP inhibition.

Absceso cerebral hiperdenso. A propósito de un caso / Hyperdense cerebral abscess. A case report

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Abordaje farmacológico de las recaídas en las adicciones / Pharmacological therapy of the reapses in the opiate addiction

La adicción es una enfermedad crónica, que requiere tratamiento durante la mayor parte de la vida del paciente y como tal, las recaídas y el incumplimiento terapéutico son hechos habituales. En las dos últimas décadas se ha avanzado notablemente en el conocimiento de las bases neuropsicobiológicas y farmacológicas de las adicciones, lo que ha permitido concluir que estamos ante una patología tratable. En la actualidad, se acepta que la fase más importante en la farmacoterapia de la dependencia es la que la que corresponde a la prevención de las recaídas. En este sentido, los antagonistas de los receptores opiáceos, en especial la naltrexona, constituye el avance más importante en esta fase preventiva. Su utilidad se ha demostrado en la prevención de la recaída a opiáceos y, más recientemente, en pacientes alcohólicos. De hecho, la naltrexona reduce en un 50 por ciento la tasa de recaídas y los individuos permanecen más tiempo abstinentes. Otros agentes utilizados en este campo son el acamprosato y los fármacos moduladores de la transmisión serotoninérgica, como la buspirona o los inhibidores selectivos de la recaptación de serotonina, fluoxetina y citalopram. Desafortunadamente, para otras dependencias (cocaína, cánnabis, anfetaminas, éxtasis, etc.) no existe un abordaje farmacológico específico, si bien se han empleado algunos de los fármacos comentados, así como antagonistas dopaminérgicos, con resultados poco significativos (AU)