Parameterization of electrotherapy interventions in physiotherapy for pelvic floor dysfunctions: a systematic review.

OBJECTIVE: To determine which parameters of the currents used with electrotherapy in pelvic floor dysfunctions are more appropriate for the proposed objectives regarding the relief of the symptomatology of certain clinical conditions. MATERIAL AND METHODS: A systematic review was performed in CENTRAL, PubMed/MEDLINE and PEDro databases. The risk of bias and methodological quality in the included studies was assessed using the ROBINS-I, JADAD and PEDro scales, respectively. STUDY SELECTION: The review included randomized controlled trials, with adult patients aged 18 years or older, that incorporated the use of electrical currents in the conservative treatment of pelvic floor dysfunctions. RESULTS: After meeting the evaluation and inclusion-exclusion criteria, 14 articles were selected following the PRISMA guidelines. CONCLUSIONS: There is a certain lack of homogeneity in the choice of the parameters of the electrotherapy currents used in pelvic floor dysfunctions. There is evidence supporting the effectiveness of neuromuscular electrostimulation in pelvic floor muscle re-education due to its functional improvements, as well as the application of analgesic electrical current therapy such as TENS for the modulation of clinical conditions involving pain.

A modified commercial gas chromatograph for the continuous monitoring of the thermal degradation of sunflower oil and off-line solid phase extraction gas-chromatography-mass spectrometry characterization of released volatiles.

A homemade flow cell attached to a commercial Gas Chromatograph equipped with a Flame Ionization Detector (FID) has been designed for the continuous monitoring of volatile compounds released during heating edible oils. Analytical parameters such as mass of sample, temperature and flow rates have been optimized and the obtained results have been compared with the corresponding thermographs from standard TG systems. Results show that under optimum conditions, the profiles of volatiles released upon heating are comparable to the profiles of TG curves, suggesting that the FID based system could be an alternative to TGA. Additionally, volatiles have been retained in a Lichrolut EN(®) resin, eluted and analyzed by Gas Chromatography-Mass Spectrometry. In this case, forty five compounds have been identified (acids, alcohols, alkanes, aldehydes, ketones and furans) and compared with the FID signals, working both in air or nitrogen atmosphere. It has been concluded that the oxidative thermal degradation is prevented in the presence of a nitrogen atmosphere.

Optimization of pressurized liquid extraction of inositols from pine nuts (Pinus pinea L.).

Pressurized liquid extraction (PLE) has been used for the first time to extract bioactive inositols from pine nuts. The influence of extraction time, temperature and cycles of extraction in the yield and composition of the extract was studied. A quadratic lineal model using multiple linear regression in the stepwise mode was used to evaluate possible trends in the process. Under optimised PLE conditions (50°C, 18 min, 3 cycles of 1.5 mL water each one) at 10 MPa, a noticeable reduction in extraction time and solvent volume, compared with solid-liquid extraction (SLE; room temperature, 2h, 2 cycles of 5 mL water each one) was achieved; 5.7 mg/g inositols were extracted by PLE, whereas yields of only 3.7 mg/g were obtained by SLE. Subsequent incubation of PLE extracts with Saccharomyces cerevisiae (37°C, 5h) allowed the removal of other co-extracted low molecular weight carbohydrates which may interfere in the bioactivity of inositols.

Programa de Atención Integral al Enfermo Mental en las prisiones españolas (paiem ). Valoración tras cuatro años de funcionamiento / Comprehensive Care Program for the Mentally ill in spanish prisons (paiem ). Assessment after four years operation

Objetivo: Evaluar el programa de atención integral a los enfermos mentales (PAIEM) implantado desde hace 3 años en las prisiones españolas, con el fin de mejorar su funcionamiento y resultados. Metodología: Estudio descriptivo de los datos recogidos en un cuestionario anónimo cumplimentado por los miembros del equipo PAIEM de los centros penitenciarios. Se obtuvieron distribuciones de frecuencia de todas las variables acerca de hechos, actitudes, opiniones, experiencias, situaciones y procesos del PAIEM. Resultados: Han respondido el 91,2% de los equipos del PAIEM. Psicólogos, educadores, médicos y trabajadores sociales son los profesionales que colaboran más activamente en el PAIEM (73%-84%) y los que con más frecuencia ejercen como tutores. Los enfermos mentales se ubican habitualmente en módulos ordinarios (80%). Las actividades más utilizadas para su rehabilitación psicosocial son autocuidados (73%) y educación para la salud, preparación para la vida diaria y habilidades sociales con más del 60%. Las intervenciones con las familias son básicamente por contacto telefónico (79%). En el análisis bivariante se demuestra que los PAIEM que mejor funcionan son los que tienen una buena coordinación con el resto de los equipos técnicos, los que preparan la derivación con más de seis meses previos a la libertad y en los que las ONG’s tramitan las derivaciones. Más del 71% de los profesionales observan mejoras en carencias y discapacidades en más de la mitad de los enfermos y están mayoritariamente satisfechos (3,4/5) de su participación, aunque reconocen mayor carga de trabajo. Conclusiones: Las actividades del PAIEM son adecuadas, en especial en las fases de detección precoz, estabilización y rehabilitación y menos en la fase de reincorporación social que mejora cuando interviene el tercer sector en las derivaciones del enfermo a la red sociosanitaria extrapenitenciaria (AU)

Objective: To assess the comprehensive care program for the mentally ill in prison (PAIEM), which has been implemented for 3 years in Spanish prisons with the aim of improving processes and results. Methods: Descriptive study of the data gathered from an anonymous questionnaire completed by members of the PAIEM team in prisons. Frequency distributions were obtained of all the variables relating to facts, attitudes, opinions, experiences, situations and processes of the PAIEM. Results: 91.2% of the PAIEM teams responded. Psychologists, educators, doctors and social workers were the professionals that collaborated most actively in the PAIEM (73%-84%) and were the ones to act most frequently as tutors. The mentally ill are usually located in ordinary modules (80%). The most commonly used activities for their psycho-social rehabilitation are self care (73%), education for health, preparation for daily life and social skills (more than 60%). Interventions with families are basically by telephone (79%). Bivariate analysis showed that the PAIEMs that operate most effectively are those that coordinate well with other technical teams, that prepare referral more than six months prior to release and ones where the NGOs process the referrals. Over 71% of the professionals observed improvements of disabilities and needs in over half the patients more than half of the professionals involved are satisfied (3.4/5) with their participation, although they acknowledge that there is a greater work load. Conclusions: The activities of the PAIEM are adequate, especially in the phases of early detection, stabilisation and rehabilitation and less so in the social incorporation phase, which improves when the third sector intervenes in referrals of patients to the social health care network outside prison (AU)

Physical activity increases the bioavailability of flavanones after dietary aronia-citrus juice intake in triathletes.

Control and triathlete volunteers (n=8 and n=15, respectively) were given 400 mL and 200 mL of aronia-citrus juice (AC-juice), respectively. The 24h urine samples were hydrolysed to determine the flavanones concentration by UPLC-QqQ-MS/MS. The flavanones metabolites in both groups of volunteers were glucuronides, sulfates, and sulfo-glucuronides, and the total excretion of flavanones increased fivefold in the triathletes compared with the control volunteers. The increase of ninefold in the homoeriodictyol of triathletes compared to control volunteers may suggest the overactivation of the microbiota metabolism caused by physical exercise. No differences concerning the bioavailability were detected between men and women in controlboth groups. The AC-juice could provide synergistic effects on health due to the increase in the bioavailability of flavanones, avoiding the deleterious effects caused by the overdosage of nutritional supplements.

[Assessment of the nutritional status of a group of people older than 50 years by means of dietary and body composition parameters]. / Evaluación del estado nutricional de un grupo de adultos mayores de 50 años mediante parámetros dietéticos y de composición corporal.

OBJECTIVE: To assess the nutritional status of elder adults by means of dietary and body composition parameters. METHODOLOGY: The sample comprised 49 adults, older than 50 years (23 men and 26 women) with a mean age of 54.84±4.56 years, working at a private university. The body composition was analyzed by using anthropometric parameters. The energy and nutrients intake was gathered by means of a registry of all the foods and beverages consumed during 3 days that was filled-up by each (previously instructed) participant and estimating the amounts through photographic models. Total energy requirements were estimated by the Harris-Benedict and FAO/WHO calculations. RESULTS: The body mass index was similar (p=0.018) in both men and women (26.1±1.9 and 24.4±2.8 kg/m²). The percentage of fat obtained by anthropometrics was 29.6±3.6 and 36.8±3.1% (p=0.000) in men and women, respectively. The level of physical activity was very light to light. Daily energy intake was appropriate for total energy demands when these were calculated by the calculations proposed by FAO/WHO. The caloric profile indicated an unbalance with high proteins and lipids and low carbohydrates intake. As for the micronutrients, the diets assessed indicated a deficient intake of folic acid and vitamins D and E, in both genders, and zinc and selenium also in women. CONCLUSIONS AND RECOMMENDATIONS: We have found overweight problems according to the BMI and the waist circumference, and obesity according to the body fat percentage, with the potential risk for the development of an associated complication. It would be advisable to improve the quality of the diets consumed by increasing the amount of some micronutrients and fiber, and by promoting an increase in the physical activity.

The profile of fatty acids in frontal cortex of rats depends on the type of fat used in the diet and correlates with neuropeptidase activities.

The kind of fat in the diet modifies the profile of fatty acids in brain and also affects aminopeptidase activities in tissues. Although modifications in brain fatty acids, neurotransmitters, or enzymes due to dietary fat composition have been reported, no direct relationship has yet been described between specific brain fatty acid changes and neuropeptide metabolism following the fat composition of the diet. We investigated the lipid profile and some neuropeptidase activities in the frontal cortex of adult male rats after a period in which diets were supplemented with fatty acids differing in their degrees of saturation such as fish oil (rich in polyunsaturated fatty acids, PUFAs), olive oil (rich in monounsaturated fatty acids, MUFAs), and coconut oil (rich in saturated fatty acids, SAFAs). It is observed that the diet composition affects fatty acid distribution in the brain. Although there is no change of global aminopeptidase/neuropeptidase, their activities in the brain correlate positively or negatively with the dietary fat composition. It is hypothesized that fatty acid in the diet modifies membrane fluidity, peptidases tertiary structure, and therefore, the availability and function of neuropeptides. The present results support the notion that cognitive functions may be modulated depending on the type of fat used in the diet.

Creatine feeding does not enhance intramyocellular glycogen concentration during carbohydrate loading: an in vivo study by 31P- and 13C-MRS

The main aim of this study was to examine the hypothesis that creatine (Cr) feedingenhances myocellular glycogen storage in humans undergoing carbohydrateloading. Twenty trained male subjects were randomly assigned to have their dietssupplemented daily with 252 g of glucose polymer (GP) and either 21 g of Cr (CRGP,n=10) or placebo (PL-GP, n=10) for 5 days. Changes in resting myocellularglycogen and phosphocreatine (PCr) were determined with Magnetic ResonanceSpectroscopy (13C- and 31P-MRS, respectively). After CR-GP, the levels of intramyocellularglycogen increased from 147 ± 13 (standard error) mmol·(kg wet weight-1)to 172 ± 13 mmol·(kg wet weight)-1, while it increased from 134 ± 17 mmol·(kg wetweight)- to 182 ± 17 mmol·(kg wet weight)-1 after PL-GP; the increments in intramyocellularglycogen concentrations were not statistically different. The increment inthe PCr/ATP ratio after CR-GP (+ 0.20 ± 0.12) was significantly different comparedto PL-GP (- 0.34 ± 0.16) (p<0.05). The present results do not support the hypothesisthat Cr loading increases muscle glycogen storage (AU)

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Atherosclerosis prevention by a fish oil-rich diet in apoE(-/-) mice is associated with a reduction of endothelial adhesion molecules.

Dietary intake of long-chain n-3 polyunsaturated fatty acids (PUFA) reduces the risk for atherosclerosis. Here we examine the effect of a fish oil (FO)-rich diet on the development of atherosclerotic lesions in apolipoprotein E-deficient (apoE(-/-)) mice, which are vulnerable because of their high plasma cholesterol and triacylglycerol levels, focusing on the expression of endothelial adhesion molecules. Mice were fed semi-purified diets containing 5% corn oil (CO), rich in n-6 PUFA or menhaden oil as FO, rich in long-chain n-3 PUFA and 0.15% cholesterol after reaching 4 weeks of age, and they were killed when they were 4 weeks, 12 weeks, 18 weeks or 24 weeks old. Oxidative stress in plasma and aortic tissue was not increased in mice fed the FO-rich diet, despite its high peroxidizability index. A reduction of stenosis and intrusion at the aortic root, a decrease in the surface area of atherosclerotic lesions at the aorta and a decrease in P-selectin, vascular cellular adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) expression were observed in FO-fed mice compared to CO-fed mice. It seems likely that the reduced expression of VCAM-1 and ICAM-1 could be transcriptionally regulated by nuclear factor-kappaB in the aortic root. The protective effect of FO against atherosclerosis was more evident at early ages. In conclusion, FO reduces adhesion molecule expression in lesions in apoE(-/-) mice. Because these molecules are involved in lesion progression the effect of FO may explain the observed decrease in atherogenesis.

Creatine feeding does not enhance intramyocellular glycogen concentration during carbohydrate loading: an in vivo study by 31P- and 13C-MRS.

The main aim of this study was to examine the hypothesis that creatine (Cr) feeding enhances myocellular glycogen storage in humans undergoing carbohydrate loading. Twenty trained male subjects were randomly assigned to have their diets supplemented daily with 252 g of glucose polymer (GP) and either 21 g of Cr (CR-GP, n = 10) or placebo (PL-GP, n = 10) for 5 days. Changes in resting myocellular glycogen and phosphocreatine (PCr) were determined with Magnetic Resonance Spectroscopy (13C- and 31P-MRS, respectively). After CR-GP, the levels of intramyocellular glycogen increased from 147 +/- 13 (standard error) mmol x (kg wet weight(-1)) to 172 +/- 13 m mol x (kg wet weight)(-1), while it increased from 134 +/- 17 mmol x (kg wet weight)(-) to 182 +/- 17 mmol x (kg wet weight)(-1) after PL-GP; the increments in intramyocellular glycogen concentrations were not statistically different. The increment in the PCr/ATP ratio after CR-GP (+ 0.20 +/- 0.12) was significantly different compared to PL-GP (- 0.34 +/- 0.16) (p < 0.05). The present results do not support the hypothesis that Cr loading increases muscle glycogen storage.

Marked hypofrontality in clozapine-responsive patients.

Previous data show that the effects of clozapine on regional brain activity are different from those of other antipsychotic agents. It seemed of interest to study the brain activity patterns after treatment with clozapine, since this drug might correct basal deficits directly related to schizophrenia or instead induce changes that would in some way compensate distant abnormalities. In order to study the activity pattern resulting from clozapine treatment we have used FDG-PET and statistical parametric mapping (SPM) to explore the functional status of patients after chronic treatment with this drug, We compared their metabolic activity with normal controls and neuroleptic-naive (NN) patients, with the aim to identify if a reversion of pre-existing deficits or a induction of different changes was the result of clozapine administration. We compared metabolic patterns in 23 treatment-resistant (TR) patients after 6 months of treatment with clozapine, eighteen healthy subjects, and 17 NN schizophrenia patients. After treatment with clozapine, TR patients showed a clear hypofrontality and caudate hypometabolism in comparison with both the controls and NN patients, and also a lower thalamic activity than the healthy controls. In conclusion, our results support a preferential role for prefrontal regions and their subcortical connections in the mechanism of action of clozapine, resulting in a clearly hypofrontal state as compared to both controls and schizophrenia patients without previous treatment.

[The influence of human milk and various artificial formulae commercially available in Spain on the fatty acid status of infants in the first two months of life]. / Perfil de ácidos grasos a los dos meses de vida en niños alimentados con lactancia materna frente a varias fórmulas artificiales disponibles comercialmente en España.

OBJECTIVE: To evaluate changes in the fatty acid composition of red blood cell phospholipids in breast-fed infants compared with those in infants fed with different formulas (conventional, omega -6-enriched formula, omega -6- and omega -3-enriched formula and nucleotide-enriched formula). METHODS: Thirty-seven healthy term infants were randomly assigned to one of five different feeding groups. Weight, length, head circumference, and arm circumference were assessed at 7 and 60 days of age. The fatty acid composition of the infants' red blood cell phosphatidylcholine (PC) and phosphatidylethanolamine (PE) were analyzed at these ages. RESULTS: The anthropometric variables studied showed no changes among the different groups. At 60 days old, arachidonic acid concentration (20:4 omega -6) was lower in non-omega -6 enriched formula-fed groups compared with that in the breast-milk fed group (4.03, 3.68 and 5.15 vs 7.20 g/100 g of fatty acids). Docosahexaenoic acid concentration (22:6omega -3) in both PC and PE clearly decreased in the non-omega -3 formula-fed groups compared with that in the breast-milk fed group (PC: 0.72 vs 2.82 g/100 g of fatty acids and PE: 5.15 vs 7.73 g/100 g of fatty acids). CONCLUSIONS: This study demonstrates differences in the fatty acid composition of red blood cell phospholipids between breast-milk fed infants and those fed with any of the artificial formulas available on the Spanish market. These data provide evidence of the influence of diet on certain essential fatty acids in the body.

Tratamiento de la neuralgia posherpética con colorpuntura / Treatment of post-herpetic neuralgia with colourpuncture

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Effects of dietary supplementation with fish oil, lard, or coconut oil on oxytocinase activity in the testis of mice.

Oxytocin (OT), locally synthesized in the testis, is involved in androgen biosynthesis. The use of polyunsaturated fatty acids (e.g., fish oil) in the diet may improve the fertilizing ability in mammals. Cystinyl aminopeptidase (oxytocinase) activity plays a major role regulating the functional status of OT. Sex steroids and the type of the fatty acid used in the diet modify aminopeptidase activities in serum. In the present study, the authors compared the effect of a fish oil supplemented diet with two other diets supplemented with saturated oils (lard and coconut) on oxytocinase activity in the testis of mice. The enzymatic activity was determined fluorometrically using cystinyl-beta-naphthylamide as substrate. The results demonstrated higher levels of oxytocinase activity in mice fed the diet supplemented with fish oil than in those that were fed diets containing lard or coconut oils. The testicular functions in which OT is involved may be attenuated by the use of fish oil in the diet.

Polyunsaturated fatty acid deficiency during dietary treatment of very long-chain acyl-CoA dehydrogenase deficiency. Rescue with soybean oil.

Nutritional management of very long-chain acyl-CoA dehydrogenase (VLCAD) deficiency is based on the avoidance of fasting and substitution of medium-chain triglycerides for long- and very long-chain triglycerides. We report two cases of this disease, which developed omega-6 essential fatty acid deficiency after three and five months from the beginning of nutritional therapy (SHS product: Monogen). This alteration could be especially dangerous in these patients owing to their possible susceptibility to the development of pigmentary retinopathy. The incorporation of linoleic acid as 3-4% of total caloric intake supported as soybean oil ameliorates this deficiency. We wish to remark on this early complication in the nutritional management of VLCAD deficiency and the possibility of rescue by the incorporation of soybean oil into the diet.

Analysis of the volatile components of Argyranthemum adauctum (Link.) Humphries by gas chromatography-mass spectrometry.

The volatile constituents of the essential oil of Argyranthemum adauctum (Link.) Humphries extracted by steam distillation have been studied by GC-MS. A total of 60 compounds have been identified representing the 89.8% of the oil. The major constituents were found to be beta-pinene (27.4%) and santolinatriene (22.6%). This is the first report on the chemical compounds of the oil of this species.

Analysis of Origanum vulgare volatiles by direct thermal desorption coupled to gas chromatography-mass spectrometry.

Volatile components of samples of a population of Spanish Origanum vulgare have been analyzed by direct thermal desorption coupled to GC-MS. The method is fast and reliable and requires a low amount of sample, allowing analysis of leaves and flowers from a single individual plant. Volatile yield is highly variable among individual plants and concentration also presents a high variation for most Origanum volatile compounds, linalool being the main component in most samples. Statistical analyses are applied in order to find patterns in composition data.

[Comparative study between different conjunctival tissue adhesives]. / Estudio comparativo entre diferentes adhesivos conjuntivales.

PURPOSE: To evaluate efficacy and clinical and histopathological tolerance of a new acrylic tissue adhesive (ADAL-2) compared to sutures (Vicryl) and other available tissue adhesives (Tisuacryl) for their use in conjunctival surgery. METHODS: This was an experimental study performed in New Zealand albino rabbits with conjunctival dissection and closure by ADAL-2. Groups treated with Vicryl and Tisuacryl were compared regarding efficacy, clinical, and histological tolerance at 7, 28 and 42 days. RESULTS: Efficacy was similar in the three methods of conjunctival repositioning evaluated. Tolerance to ADAL-2 was similar to that of Vicryl suture and tolerance to ADAL-2 was superior to that to Tisuacryl. Histopathological results with ADAL-2 and Tisuacryl are similar. CONCLUSIONS: ADAL-2 tissue adhesive is an efficient and very well tolerated alternative for conjunctival closure in ophthalmic surgery.