Experiences of water immersion during childbirth: a qualitative thematic synthesis.

BACKGROUND: The increasing demand for childbirth care based on physiological principles has led official bodies to encourage health centers to provide evidence-based care aimed at promoting women's participation in informed decision-making and avoiding excessive medical intervention during childbirth. One of the goals is to reduce pain and find alternative measures to epidural anesthesia to enhance women's autonomy and well-being during childbirth. Currently, water immersion is used as a non-pharmacological method for pain relief. This review aimed to identify and synthesize evidence on women's and midwives' experiences, values, and preferences regarding water immersion during childbirth. METHODS: A systematic review and thematic synthesis of qualitative evidence were conducted. Databases were searched and references were checked according to specific criteria. Studies that used qualitative data collection and analysis methods to examine the opinions of women or midwives in the hospital setting were included. Non-qualitative studies, mixed-methods studies that did not separately report qualitative results, and studies in languages other than English or Spanish were excluded. The Critical Appraisal Skills Program Qualitative Research Checklist was used to assess study quality, and results were synthesized using thematic synthesis. RESULTS: Thirteen studies met the inclusion criteria and were included in this review. The qualitative studies yielded three key themes: 1) reasons identified by women and midwives for choosing a water birth, 2) benefits experienced in water births, and 3) barriers and facilitators of water immersion during childbirth. CONCLUSIONS: The evidence from qualitative studies indicates that women report benefits associated with water birth. From the perspective of midwives, ensuring safe water births requires adequate resources, midwives training, and rigorous standardized protocols to ensure that all pregnant women can safely opt for water immersion during childbirth with satisfactory results.

Cognitive Functioning in Adults with Phenylketonuria in a Cohort of Spanish Patients.

The early introduction of a low phenylalanine (Phe) diet has been demonstrated to be the most successful treatment in subjects with phenylketonuria (PKU), especially for preventing severe cognitive and neurological damages. However, it still concerns that even if treated in the first months of life with supplements and following a diet, they can show slight scores below people without PKU in neuropsychological assignments. We investigated 20 adults with classical PKU aged 19-48 years (mean age 29 years) and 20 heathy controls matched by age, gender, and years of education. Patients and controls were assessed with an extended neuropsychological battery, as well as psychological aspects and quality of life, also the last Phe level result was obtained. Results showed that the most affected cognitive domains are processing speed, executive functioning, memory, and also theory of mind, but very well-preserved verbal fluency, language, and visuospatial functioning. In quality of life, some significant results were seen specially in anxiety of Phe levels, anxiety of Phe levels during pregnancy, guilt if poor adherence to supplements, and if dietary protein restriction not followed. No significant results were obtained for the psychological variables. In conclusion, it has been shown that a combination of a low Phe diet, supplement intake, and keeping Phe levels in a low range seems appropriate to have the most normal and alike cognitive performance to persons without PKU.

Conditioning of desert sandy soil and investigation of the ameliorative effects of poultry manure and bentonite treatment rate on plant growth.

Soil is the base of any ecosystem since it conserves nutrients and water for plant roots including agriculture and plantations. In dry and semi-arid places across the world, including the UAE, sandy soils are common. Their fertility is extremely low, and production is hampered by a number of agronomic challenges. Soil conditioner sources like bentonite and chicken manure might be used to improve the poor sandy soil attributes and hence boost soil productivity. From November 2019 to March 2020, an experiment was conducted to investigate the growth rates of Bougainvillea following bentonite and chicken manure amendments to sandy soil taken from Lehbab, Dubai. Bougainvillea was evaluated for its plant height (cm), max length of primary branch (cm), the number of leaves per plant, number of secondary branches, shoot weight (g), root length (cm), root weight (g), root/shoot ratio, chlorophyll contents, and chlorophyll a* and b*. In this experiment, a complete randomized design (CRD) with five treatments was used (10 replications per treatment). According to the findings, bentonite and chicken manure additions considerably influence the productive properties of sandy soil, as indicated by Bougainvillea growth. Additionally, the research suggests that Bougainvillea may be efficiently planted with 10% bentonite and 15% chicken manure applied to sandy soil, resulting in the healthiest plants compared to other amendments.

Tryptophan-enriched diet or 5-hydroxytryptophan supplementation given in a randomized controlled trial impacts social cognition on a neural and behavioral level.

Understanding of emotions and intentions are key processes in social cognition at which serotonin is an important neuromodulator. Its precursor is the essential amino acid tryptophan (TRP). Reduced TRP availability leads to weaker impulse control ability and higher aggression, while TRP supplementation promotes confidence. In a double-blind placebo-controlled fMRI study with 77 healthy adults, we investigated the influence of a 4 week TRP enriched diet and an acute 5-hydroxytryptophan (5-HTP) intake on two social-cognitive tasks, a moral evaluation and an emotion recognition task. With 5-HTP, immoral behavior without negative consequences was rated as more reprehensible. Additionally, during story reading, activation in insula and supramarginal gyrus was increased after TRP intake. No significant effects of TRP on emotion recognition were identified for the whole sample. Importantly, emotion recognition ability decreased with age which was for positive emotions compensated by TRP. Since the supramarginal gyrus is associated with empathy, pain and related information integration results could be interpreted as reflecting stricter evaluation of negative behavior due to better integration of information. Improved recognition of positive emotions with TRP in older participants supports the use of a TRP-rich diet to compensate for age related decline in social-cognitive processes.

Music therapy and Sanfilippo syndrome: an analysis of psychological and physiological variables of three case studies.

INTRODUCTION: Mucopolysaccharidosis type III (MPS III) or Sanfilippo syndrome is a neurodegenerative disease caused by the accumulation of mucopolysaccharides in the body. As the symptoms are wide ranging, it is a challenge to provide a diagnosis and psychological treatment for affected children. METHOD: The main objective of this study was to describe a form of music therapy treatment applied to three children diagnosed with MPS III. The psychological variables were evaluated by an ad hoc observation recording template, and the physiological variables were measured with a digital meter before and after each session. The perception of the parents was also considered through a semi-structured interview. RESULTS: An improvement in the psychological variables was shown in all cases. Changes in the physiological variables were also noted, although they varied according to each child. The parents report some benefit of music therapy and they share difficulty in assessing the extent of benefits of the music therapy. DISCUSSION: Findings indicate that music therapy can be a useful form of treatment with multiple benefits for children with conditions such as MPS III or similar conditions. However, further research is needed in this area and in the development of specific ways of evaluating music therapy.

[Efficacy of hydrotherapy versus gym treatment in primary total knee prosthesis due to osteoarthritis: a randomized controlled trial].

BACKGROUND: Physiotherapy is postulated as an effective treatment after total knee arthroplasty (TKA). The objective of the study was to assess the efficacy of hydrotherapy versus gym kinesitherapy during the second phase of treatment in TKA patients, with regard to the improved gait test, pain, stiffness, joint balance, muscle strength and inflammation. METHODS: A controlled and randomized trial was carried out. TKA patients received a first rehabilitative phase (15 60-minutes sessions) at the gym. In the second phase (15 40-minute sessions), one group performed physiotherapy in a gym and another in a swimming pool. Different variables were assessed (basal, after 15 and after 30 ses-sions): functional capacity, pain and stiffness with WOMAC index, joint balance with goniometer; muscle strength with Lovett scale, and result of 6-minute gait test. RESULTS: A total of 115 patients participated, 59 (51.3%) in the gym group and 56 (48.7?%) in the pool group. After the second phase of re-habilitation, higher clinical improvements were observed in the pool group, with statistically significant differences in pain (p?=?0.005), stiffness (p?=?0.010), joint balance (p?=?0.027) and muscle strength (p?=?0.049) in the operated knee, and in the result of the 6-minute gait test (p?=?0.002). CONCLUSIONS: In TKA patients, hydrotherapy during the second phase of rehabilitative treatment was more effective than gym physiother-apy in terms of improved pain, stiffness, joint balance, muscle strength and gait testing.

Drops of Lactiplantibacillus plantarum CRL 759 culture supernatant attenuates eyes inflammation induced by lipopolysaccharide.

Anti-inflammatory effect of soluble secreted compounds of probiotic bacteria was widely demonstrated as therapy for different inflammatory diseases, but was not investigated in inflammatory eye disorders. The aim of this study was to determine whether Lactiplantibacillus plantarum CRL759 cell-free supernatant reduced inflammatory parameters and clinical signs in ocular inflammations. First, we evaluated the effect of L. plantarum CRL759 supernatant in vitro on human retinal cell line, ARPE-19 cells, stimulated with lipopolysaccharide (LPS). Then, we investigated in vivo its capacity to decrease inflammation by local administration on the eyes of mice with endotoxin induced inflammation. In vitro assays demonstrated that L. plantarum CRL759 supernatant reduced the production of interleukin (IL)-6, IL-8, nitric oxide and thiobarbituric acid reactive substances in LPS-stimulated ARPE-19 cells. Our in vivo data proved that L. plantarum supernatant significantly reduced the clinical score of endotoxin treated mice and diminished levels of tumour necrosis factor alpha, interferon gamma and protein concentration in aqueous humour. Histological examination showed reduction of infiltrating inflammatory cells in the posterior segment of the eyes. As far as we know, this is the first report showing that Lactobacillus spp. supernatant administered as drops reduces some parameters of ocular inflammation. This promising strategy is safe and could alleviate symptoms and signs of ocular inflammation in people that are refractories to the conventional therapies.

Disaccharide anthocyanin delphinidin 3-O-sambubioside from Hibiscus sabdariffa L.: Candida antarctica lipase B-catalyzed fatty acid acylation and study of its color properties.

Enzymatic lipophilization is an important process to extend the use of anthocyanins in lipidic media. In this work delphinidin 3-O-sambubioside (Dp3sam) isolated from Hibiscus sabdariffa L. flower was esterified with octanoic acid using Candida antarctica lipase B. The physical-chemical properties of the new lipophilic pigment were studied by UV-vis spectroscopy. Dp3sam with chloride, acetate and formate as counter ions were employed to study the lipophilization reaction. The hydrolysis of the reagent was avoided with a formate counter ion and the expected product was achieved with a noteworthy change of solubility. 1D and 2D NMR characterization of Dp3sam-C8 confirmed that the lipophilization took place at the primary alcohol of the glucoside moiety. Overall, the Dp3sam-C8 ester presents a stabilization of the quinoidal base (blue color) at neutral or moderate alkaline pH, which foresees a potential use of this pigment as a broad kind of industries on lipo-soluble formulations.

Latrodectus geometricus (Aranea: Theridiidae) envenoming: Rapid resolution of symptoms following F(ab')2 antivenom therapy.

The Brown Widow spider (Latrodectus geometricus) is an invasive species whose geographic range has been expanding worldwide. It is a relative species of the Black Widow and Red-backed spiders of the genus Latrodectus. Despite its broad geographic distribution cases of Brown Widow envenomation have rarely been documented. The venom of L. geometricus is similar to the venom of L. mactans with the primary venom component being alpha-latrotoxin, and consequent envenoming by L. geometricus to humans has resulted in symptoms similar to those reported for other Latrodectus spp. Specific FDA approved Latrodectus antivenom (IgG) available in North America has been effectively used in treating venom-induced symptoms following L. mactans envenoming. The patient reported here involved a confirmed L. geometricus envenoming who was efficaciously treated with an alternately available F(ab')2 antivenom from Mexico.

Sistema masculino transobturador ajustable (ATOMS(R)) como tratamiento de la incontinencia urinaria de esfuerzo secundaria a resección transuretral de la próstata / Adjustable transobturator male system (ATOMS(R)) as treatment of stress urinary incontinence secondary to transurethral resection of the prostate

Objetivos: Estudio de viabilidad para evaluar la eficacia y la seguridad del sistema masculino transobturador ajustable (ATOMS(R)) para la incontinencia urinaria de esfuerzo (IUE) masculina después de la resección transuretral de la próstata. Materiales y métodos: Se implantó ATOMS(R) a 20 pacientes con IUE causada por resección transuretral de la próstata con o sin radioterapia. La severidad de la incontinencia fue evaluada como leve (2 compresas/día), moderada (3-5 compresas/día) o severa (≥6 compresas/día), y se consideró paciente seco aquel sin compresas o con una compresa de seguridad al día. Se investigó el cambio en el recuento de compresas (pad-count) y en el peso de las compresas (pad-test), así como otros parámetros operatorios, la satisfacción del paciente con el procedimiento, y el número y grado de complicaciones (Clavien-Dindo). Resultados: La mediana de edad fue de 76,5 años. Cinco pacientes habían recibido radioterapia pélvica (3 por cáncer de próstata, 2 por cáncer rectal) y 2 (10%) habían tenido esfínter urinario artificial con erosión uretral y fallo mecánico, respectivamente. La IUE preoperatoria fue leve en 4 (20%), moderada en 7 (35%) y severa en 9 (45%). La mediana de relleno del sistema fue de 13,5 ml. La mediana de pad-test disminuyó de 375 ± 855 ml basal a 10 ± 31,5 ml y el pad-count, de 4 ± 3 a 0 ± 1,5 tras el ajuste (1 ± 3 rellenos). La IUE postoperatoria fue leve en 2 (10%) pacientes, moderada en uno (5%) y severa en 2 (10%). La tasa de satisfacción fue del 80%, igual para pacientes con o sin radioterapia previa. Ningún paciente tuvo retención urinaria al retirar el catéter. Hubo complicaciones en 3 (15%) casos, todas menores. Tras una mediana de seguimiento de 38,5meses no se ha retirado ningún sistema; 19 (95%) pacientes se consideran mejor que antes y 11 (55%) muchísimo mejor. Conclusión: Según la eficacia a corto plazo y la satisfacción del paciente, ATOMS(R) puede considerarse una alternativa realista para IUE después de la resección transuretral de la próstata, incluso en pacientes radiados. La ausencia de erosión uretral y la escasez de problemas hacen esta alternativa especialmente atractiva para pacientes con destreza disminuida, edad avanzada y tratamientos previos fallidos

Objectives: Feasibility study to evaluate efficacy and safety of Adjustable Transobturator Male System (ATOMS(R)) for male stress urinary incontinence (SUI) after transurethral resection of the prostate. Materials and methods: Twenty patients were implanted ATOMS(R) for SUI caused by transurethral resection of the prostate with or without radiotherapy. Incontinence severity was evaluated as mild (2 pads/day), moderate (3-5 pads/day) or severe (≥ 6pads/day), and dryness as none or one security pad/day. Changes in pad-test and pad-count after adjustment were investigated, together with operative parameters, patient satisfaction with the procedure, and number and grade of complications (Clavien-Dindo). Results: Median age was 76.5 years. Five patients received previous pelvic radiation (3 prostate, 2 rectal cancer) and 2 (10%) previous failed artificial urinary sphincter with urethral erosion and mechanical failure, respectively. Preoperative SUI was mild in 4 (20%), moderate in 7 (35%) and severe in 9 (45%). Median filling of the system was 13.5 ml. Median pad-test decreased from 375 ± 855 ml baseline to 10 ± 31.5 ml and pad-count from 4 ± 3 to 0 ± 1.5 after adjustment (1 ± 3 fillings). Postoperative SUI distribution was mild in 2 (10%), moderate in one (5%) and severe in 2 (10%). Satisfaction rate was 80%, equal for transurethral resection of the prostate with/without previous radiotherapy. No patient had urinary retention after catheter removal. Complications presented in 3 (15%) patients, all minor. After median 38.5mo follow-up no system has been removed, 19 (95%) self-considered better than before and 11 (55%) very much better. Conclusion: Based on short-term efficacy and patient satisfaction ATOMS(R) can be considered a realistic alternative for SUI after transurethral resection of the prostate, even after irradiation. Absence of urethral erosion and very limited problems make this alternative especially attractive for cases with diminished dexterity, advanced age and previous failed treatments

Adjustable transobturator male system (ATOMS®) as treatment of stress urinary incontinence secondary to transurethral resection of the prostate. / Sistema masculino transobturador ajustable (ATOMS®) como tratamiento de la incontinencia urinaria de esfuerzo secundaria a resección transuretral de la próstata.

OBJECTIVES: Feasibility study to evaluate efficacy and safety of Adjustable Transobturator Male System (ATOMS®) for male stress urinary incontinence (SUI) after transurethral resection of the prostate. MATERIALS AND METHODS: Twenty patients were implanted ATOMS® for SUI caused by transurethral resection of the prostate with or without radiotherapy. Incontinence severity was evaluated as mild (2 pads/day), moderate (3-5 pads/day) or severe (≥6pads/day), and dryness as none or one security pad/day. Changes in pad-test and pad-count after adjustment were investigated, together with operative parameters, patient satisfaction with the procedure, and number and grade of complications (Clavien-Dindo). RESULTS: Median age was 76.5years. Five patients received previous pelvic radiation (3 prostate, 2 rectal cancer) and 2 (10%) previous failed artificial urinary sphincter with urethral erosion and mechanical failure, respectively. Preoperative SUI was mild in 4 (20%), moderate in 7 (35%) and severe in 9 (45%). Median filling of the system was 13.5ml. Median pad-test decreased from 375±855ml baseline to 10±31.5ml and pad-count from 4±3 to 0±1.5 after adjustment (1±3fillings). Postoperative SUI distribution was mild in 2 (10%), moderate in one (5%) and severe in 2 (10%). Satisfaction rate was 80%, equal for transurethral resection of the prostate with/without previous radiotherapy. No patient had urinary retention after catheter removal. Complications presented in 3 (15%) patients, all minor. After median 38.5mo follow-up no system has been removed, 19 (95%) self-considered better than before and 11 (55%) very much better. CONCLUSION: Based on short-term efficacy and patient satisfaction ATOMS® can be considered a realistic alternative for SUI after transurethral resection of the prostate, even after irradiation. Absence of urethral erosion and very limited problems make this alternative especially attractive for cases with diminished dexterity, advanced age and previous failed treatments.

In vivo antimicrobial activity of silver nanoparticles produced via a green chemistry synthesis using Acacia rigidula as a reducing and capping agent.

INTRODUCTION: One of the main issues in the medical field and clinical practice is the development of novel and effective treatments against infections caused by antibiotic-resistant bacteria. One avenue that has been approached to develop effective antimicrobials is the use of silver nanoparticles (Ag-NPs), since they have been found to exhibit an efficient and wide spectrum of antimicrobial properties. Among the main drawbacks of using Ag-NPs are their potential cytotoxicity against eukaryotic cells and the latent environmental toxicity of their synthesis methods. Therefore, diverse green synthesis methods, which involve the use of environmentally friendly plant extracts as reductive and capping agents, have become attractive to synthesize Ag-NPs that exhibit antimicrobial effects against resistant bacteria at concentrations below toxicity thresholds for eukaryotic cells. PURPOSE: In this study, we report a green one-pot synthesis method that uses Acacia rigidula extract as a reducing and capping agent, to produce Ag-NPs with applications as therapeutic agents to treat infections in vivo. MATERIALS AND METHODS: The Ag-NPs were characterized using transmission electron microscopy (TEM), high-resolution TEM, selected area electron diffraction, energy-dispersive spectroscopy, ultraviolet-visible, and Fourier transform infrared. RESULTS: We show that Ag-NPs are spherical with a narrow size distribution. The Ag-NPs show antimicrobial activities in vitro against Gram-negative (Escherichia coli, Pseudomonas aeruginosa, and a clinical multidrug-resistant strain of P. aeruginosa) and Gram-positive (Bacillus subtilis) bacteria. Moreover, antimicrobial effects of the Ag-NPs, against a resistant P. aeruginosa clinical strain, were tested in a murine skin infection model. The results demonstrate that the Ag-NPs reported in this work are capable of eradicating pathogenic resistant bacteria in an infection in vivo. In addition, skin, liver, and kidney damage profiles were monitored in the murine infection model, and the results demonstrate that Ag-NPs can be used safely as therapeutic agents in animal models. CONCLUSION: Together, these results suggest the potential use of Ag-NPs, synthesized by green chemistry methods, as therapeutic agents against infections caused by resistant and nonresistant strains.

Evaluation of inositol phosphates in urine after topical administration of myo-inositol hexaphosphate to female Wistar rats.

AIMS: Previous studies demonstrated a remarkable increase of urinary InsP6 by topical administration. However, the methodology used for InsP6 analysis was not specific. The aim of this paper is to measure urinary inositol phosphates InsPs using more advanced methodologies and to compare the results with those obtained by the non-specific method. MATERIALS AND METHODS: We fed 12 female rats with a diet without InsP6 for 16days. Then, we administered a topical InsP6 gel at high doses for 7days (50mgInsP6/day) or at low doses for 28days (20mgInsP6/day). We measured urine levels InsPs using a nonspecific method (based on the ability of InsPs to complex Al3+) and levels of InsP6 by a specific method (using polyacrylamide gel electrophoresis). Identification of different InsPs was performed by MS. KEY FINDINGS: At baseline, after dietary deprivation of InsP6, rats only excreted InsP2 in their urine, and there was no detectable InsP6 or other InsPs. Rats given the high dose treatment for 7days had abundant urinary InsP6, but also had other InsPs in their urine; cessation of InsP6 administration led to decreased levels of urinary InsPs. Rats given the low dose treatment for 28days had increasing levels of urinary InsPs over time. The maximum urinary InsP6 was at 21days, after which InsPs excretion decreased. SIGNIFICANCE: We conclude that the skin can absorb InsP6 from a topical gel, and that InsP6 is excreted in the urine, along with other InsPs (InsP5, InsP4, InsP3, and InsP2).

Infrastructure and equipment for radiation oncology in the Spanish National Health System: analysis of external beam radiotherapy 2015-2020.

PURPOSE: Planning for radiation oncology requires reliable estimates of both demand for radiotherapy and availability of technological resources. This study compares radiotherapy resources in the 17 regions of the decentralised Spanish National Health System (SNHS). MATERIALS AND METHODS: The Sociedad Española de Oncología Radioterápica (SEOR) performed a cross-sectional survey of all Spanish radiation oncology services (ROS) in 2015. We collected data on SNHS radiotherapy units, recording the year of installation, specific features of linear accelerators (LINACs) and other treatment units, and radiotherapeutic techniques implemented by region. Any machine over 10 years old or lacking a multileaf collimator or portal imaging system was considered obsolete. We performed a k-means clustering analysis using the Hartigan-Wong method to test associations between the gross domestic regional product (GDRP), the number of LINACs per million population and the percentage of LINACs over 10 years old. RESULTS: The SNHS controls 72 (61%) of the 118 Spanish ROS and has 180 LINACs, or 72.5% of the total public and private resources. The mean rate of LINACs per million population is 3.9 for public ROS, and 42% (n = 75) of the public accelerators were obsolete in 2015: 61 due to age and 14 due to technological capability. There was considerable regional variation in terms of the number and technological capacity of radiotherapy units; correlation between GRDP and resource availability was moderate. CONCLUSION: Despite improvements, new investments are still needed to replace obsolete units and increase access to modern radiotherapy. Regular analysis of ROS in each Spanish region is the only strategy for monitoring progress in radiotherapy capacity.

Feeding broilers with dry whey powder and whey protein concentrate affected productive performance, ileal digestibility of nutrients and cecal microbiota community.

Dietary interventions are a common practice in the poultry industry to promote optimal performance and health of animals. Here, we aim at assessing the influence of supplementing broiler diets with dry whey powder (DWP) and whey protein concentrate (WPC) on nutrient coefficient of apparent ileal digestibility (CAID) and productive performance. Cecal microbiota composition was also determined using Illumina amplicon sequencing. Dietary treatments were control diet (no supplementation of DWP or WPC), 60-DWP (60 g/kg of DWP), and 80-WPC (80 g/kg of WPC). One-day-old male broilers were randomly assigned to one of three treatments, and housed in floor pens. In Trial 1, 90 1-day-old chicks were allocated to three pens/treatment, with 10 birds/pen, during 21 days for CAID evaluation. Diet 60-DWP increased Ca CAID (P=0.041), while diet 80-WPC improved Ca and P CAID (P<0.001 and 0.002, respectively) when compared with control diet. In Trial 2, 810 one-day-old chicks were allocated to nine pens/treatment, with 30 birds/pen, during 42 days. Feeding chickens with 60-DWP and 80-WPC increased their BW, average daily gain (ADG) and feed intake (FI) during the starter (P<0.001 for all variables) and grower-finisher periods (P<0.001 for BW and FI, and P=0.048 for ADG), and during the entire feeding period (P<0.05), when compared with control diet. Diets 60-DWP and 80-WPC reduced the feed conversion ratio of chickens during the starter period (P<0.001 and 0.003, respectively), while 60-DWP reduced this parameter during the entire feeding period (P=0.048), when compared to control diet. At day 42, cecal microbial communities of chickens that were fed with 60-DWP and 80-WPC differed from those fed with control diet (R=0.776, P=0.008; and R=0.740, P=0.008, respectively). The abundance of Bacteroides fragilis, Bacteroides spp., Escherichia coli/Shigella flexneri and Megamonas furniformis increased when 60-DWP and 80-WPC diets were offered, while the presence of Helicobacter pullorum decreased. Lactobacillus salivarius consistently increased in chickens with better feed conversion ratio, which were those fed with 60-DWP. The results obtained in the present study indicate that growth of chickens is improved by DWP and WPC supplementation because of a higher mineral digestibility, increased feed intake and modulation of cecal microbiota communities.

Cannabinoides para el tratamiento del trastorno por abuso de cannabis / Cannabinoids for the treatment of cannabis abuse disorder

Resumen INTRODUCCIÓN: El cannabis se erige como la droga ilícita más consumida en el mundo. Actualmente no existen alternativas farmacológicas específicas para el tratamiento de su adicción, por lo que se ha postulado la utilidad del uso de cannabinoides como herramienta terapéutica. Ellos actuarían principalmente a través de la disminución de síntomas de abstinencia y craving (deseo o compulsión por consumir), pero su efectividad aún no está clara. MÉTODOS: Para responder esta pregunta utilizamos Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud a nivel mundial, la cual es mantenida mediante búsquedas en múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, reanalizamos los datos de los estudios primarios, realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. RESULTADOS Y CONCLUSIONES: Identificamos siete revisiones sistemáticas que en conjunto incluyeron 15 estudios primarios, de los cuales cuatro corresponden a ensayos aleatorizados. Concluimos que el uso de cannabinoides podría resultar en poco o nulo aumento en la abstinencia al finalizar el tratamiento, y probablemente aumenta los efectos adversos.

Abstract INTRODUCTION: Cannabis stands as the most used illegal drug in the world. Currently there are no pharmacologic alternatives to treat its addiction, so the use of Cannabinoids has been postulated as a therapeutic tool. They would act mainly through decrease in abstinence and craving symptoms but its effectiveness remains unclear. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS: We identified seven systematic reviews including 15 studies, of which four were randomized trials. We concluded the use of cannabinoids might result in little or no increase in abstinence at the end of treatment, and it probably increases adverse effects.

Effects of a respiratory functional training program on pain and sleep quality in patients with fibromyalgia: A pilot study.

OBJECTIVE: To evaluate the effect of 8-week respiratory functional training program on pain tolerance, sleep, and urinary antioxidant and cortisol levels in 18 patients with fibromyalgia. METHODS: Participants underwent a 12-week intervention: 4 weeks as control and 8 weeks of breathing exercises. Pain tolerance assay was done by using an algometer, whereas sleep quality was evaluated by actigraphy and by the Pittsburgh Sleep Quality Index. Cortisol and antioxidant levels were determined using commercial assay kits. RESULTS: Increases in the pain tolerance threshold were detected in the occiput point after one month of intervention as well as in the low cervical and second rib points after one and two months. Actigraphy revealed a decrease in sleep latency, whereas sleep questionnaire showed improvements in sleep quality, sleep duration and sleep efficiency. No changes in cortisol and antioxidant levels were detected. CONCLUSION: The 8-week breathing exercise intervention reduced pain and improved sleep quality.

Intervención fisioterapéutica en el manejo de pacientes con artritis reumatoide: una revisión sistemática / Physiotherapy intervention in the management of rheumatoid arthritis patients: A systematic review

Objetivo: Realizar una revisión de la evidencia disponible y determinar el tratamiento fisioterapéutico para pacientes con artritis reumatoide. Estrategia de búsqueda: Se realizó la búsqueda de ensayos clínicos aleatorizados, publicados entre el año 2000 y el 2015 en las siguientes bases de datos: PubMed, ScienceDirect y Cochrane Library. Seguido de la evaluación de calidad metodológica con 2 escalas PEDro y SIGN. Los ECA debían incluir intervención fisioterapéutica (ejercicio físico, agentes físicos, telerrehabilitación o técnicas alternativas), ser aplicado en pacientes con artritis reumatoide y que midieran las siguientes variables: dolor, rigidez articular, funcionalidad y/o calidad de vida. Selección de estudios: Se incluyeron 28 ECA, de los cuales 21 eran intervenciones con ejercicio terapéutico, 5 agentes físicos, una técnica alternativa y una telerrehabilitación. Síntesis de resultados: La evidencia muestra que el ejercicio terapéutico tiene un impacto significativo en la capacidad funcional en funciones de la mano, movilidad y desplazamientos. El uso agentes físicos no mostró una diferencia significativa entre los grupos, pero sí al comienzo y final de la intervención. El uso de taichi como técnica alternativa evidencia mejoría tanto física como mental y una intervención de actividad física basada en Internet con supervisión individualizada, equipo de ejercicio y acompañamiento es eficaz como estrategia de intervención. Conclusiones: Desde la fisioterapia, hay diversas intervenciones para los pacientes con artritis reumatoide, dentro de los cuales el más utilizado y con mayores efectos positivos es el ejercicio terapéutico

Objective: To evaluate and critical review the available scientific evidence and determine the physical therapy treatment for patients with rheumatoid arthritis (RA) Search strategy: Systematic searches were conducted for randomized clinical trials (RCTs) published between 2000 and 2015 in the following databases: PubMed, ScienceDirect and Cochrane Library. Following the evaluation of methodological quality with two scales PEDro and SIGN. RCTs should include physiotherapy intervention (physical exercise, physical agents, tele-rehabilitation or alternative techniques), be applied in patients with RA and that measured the following variables: pain, stiffness, function and/or quality of life. Study selection: 28 RCTs were included; 21 correspond to interventions with therapeutic exercise, 5 with physical agents, 1 to alternative techniques and 1 tele-rehabilitation. Synthesis of results: Evidence shows that therapeutic exercise has a significant impact on functional capacity, especially in hand function, mobility and displacement. Physical agents showed no statistical difference between the groups, but does at the beginning and end of the intervention. The Taichi as an alternative and complementary to traditional intervention technique improves physical and mental condition. Finally, physical activity based on Internet with one supervision, exercise equipment and support is effective as an intervention strategy. Conclusions: Based on the results of this review can be established that since there are different physical therapy interventions for patients with RA, within which the most widely used and with greater positive effects is the therapeutic exercise

[Update on the treatment of RASopathies]. / Actualizacion del tratamiento de las rasopatias.

INTRODUCTION: The term 'RASopathies' covers a series of diseases that present mutations in the genes that code for the proteins of the RAS/MAPK pathway. These diseases include neurofibromatosis type 1, Noonan syndrome, Legius syndrome, LEOPARD syndrome, Costello syndrome and cardiofaciocutaneous syndrome. Involvement of the RAS/MAPK pathway not only increases predisposition to develop tumours, but also determines the presence of phenotypic anomalies and alterations in learning processes. AIM: To review the use of therapeutic strategies with mechanisms that have a selective action on RASopathies. DEVELOPMENT: The fact that the RAS pathway is involved in a third of all neoplasms has led to the development and study of different drugs at this level. Some of these pharmaceutical agents have been tested in RASopathies, mainly in neurofibromatosis type 1. Here we analyse the use of different antitarget treatments: drugs that act on the membrane receptors, such as tyrosine kinase inhibitors, in the mTOR pathway or MEK inhibitors. These latter have shown potential benefits in recent studies conducted on different RASopathies. CONCLUSIONS: Today, thanks to the results from the first studies conducted with MEK inhibitor based mainly on animal models, a number of promising clinical trials are being carried out.

TITLE: Actualizacion del tratamiento de las rasopatias.Introduccion. El termino 'rasopatias' agrupa una serie de enfermedades que presentan mutaciones en genes que codifican las proteinas de la via RAS/MAPK. Estas enfermedades incluyen la neurofibromatosis de tipo 1, el sindrome de Noonan, el sindrome de Legius, el sindrome LEOPARD, el sindrome de Costello y el sindrome cardiofaciocutaneo. La afectacion de la via RAS/MAPK no solo aumenta la predisposicion a desarrollar tumores, sino que tambien determina la presencia de anomalias fenotipicas y alteraciones en los procesos de aprendizaje. Objetivo. Revisar el papel del uso de estrategias terapeuticas con mecanismos de accion selectivo en las rasopatias. Desarrollo. El hecho de que la via RAS participe en un tercio de las neoplasias ha motivado el desarrollo y el estudio de distintos farmacos a este nivel. Algunos de estos farmacos han sido probados en las rasopatias, principalmente en la neurofibromatosis de tipo 1. Analizamos el uso de distintos tratamientos antidiana: farmacos que actuan en los receptores de membrana, como los inhibidores de la tirosincinasa, en la via mTOR o los inhibidores de MEK. Existe un potencial beneficio de estos ultimos en estudios recientes realizados en distintas rasopatias. Conclusiones. Actualmente, gracias a los resultados de los primeros trabajos desarrollados con inhibidor de MEK basados principalmente en modelos animales, se estan realizando multiples ensayos clinicos prometedores.

Validación de una entrevista para estudiar el proceso formativo de judokas de élite / Validation of an interview for study the process of formation of elite judokas

Con el objetivo de analizar el proceso de formación deportiva de los judokas españoles de élite, se diseñó una entrevista semiestructurada de 52 preguntas agrupadas en 6 dimensiones (entorno social, entorno deportivo, psicológica, técnico-táctica, condición física y otros aspectos). Se llevó a cabo un análisis cualitativo y cuantitativo mediante la valoración de 10 expertos. Se analizó la validez de contenido a través del coeficiente V de Aiken, estableciendo un intervalo de confianza del 99%, y el coeficiente de variación. Para conocer la fiabilidad se pasó la entrevista a judokas de alto nivel en dos momentos distintos y se analizó la consistencia interna por el método del Alfa de Cronbach (0,915) y la fiabilidad test-retest utilizando el coeficiente de correlación intraclase resultando 0,843 (p<0,01). La entrevista reúne suficientes propiedades como para ser considerada una herramienta válida y fiable para estudiar y analizar el proceso de formación de los judokas de élite (AU)

In order to analyze the process of sports training of the Spanish elite judokas, a semistructured interview of 52 questions grouped into 6 domains (social, sporting environment, psychological, technical and tactical, physical condition and other aspects) was designed. It was conducted a qualitative and quantitative analysis with 10 experts' valuation. The validity of content was analysed through the coefficient V Aiken, establishing a 99% confidence interval, and so the coefficient of variation was analyzed. To know reliability the interview was given to senior judokas in two different moments, and internal consistency was analysed by the Cronbach's alpha method (0.915) and so test-retest reliability by using the intraclass correlation coefficient resulting 0.843 (p < 0.01). The interview brings enough properties to be considered a valid and reliable tool to study and analyze the formation of elite judokas (AU)