First-in-human study of AMG 193, an MTA-cooperative PRMT5 inhibitor, in patients with MTAP-deleted solid tumors: results from phase I dose exploration.

BACKGROUND: Homozygous deletion of methylthioadenosine phosphorylase (MTAP) occurs in ∼10%-15% of solid tumors. AMG 193, a CNS-penetrant methylthioadenosine-cooperative protein arginine methyltransferase 5 (PRMT5) inhibitor, selectively induces synthetic lethality in MTAP-deleted tumor cells. Here, we report results of the completed monotherapy dose exploration evaluating AMG 193 in patients with MTAP-deleted solid tumors. PATIENTS AND METHODS: In this first-in-human, multicenter, open-label, phase I study, patients with advanced CDKN2A-deleted and/or MTAP-deleted solid tumors received AMG 193 orally [once (o.d.) or twice (b.i.d.) daily] continuously in 28-day cycles. Primary objectives were safety and tolerability assessed by dose-limiting toxicities and determination of the maximum tolerated dose; secondary objectives included pharmacokinetics and preliminary antitumor activity measured by RECIST v1.1. RESULTS: As of 23 May 2024, 80 patients in dose exploration received AMG 193 at doses 40-1600 mg o.d. or 600 mg b.i.d. The most common treatment-related adverse events were nausea (48.8%), fatigue (31.3%), and vomiting (30.0%). Dose-limiting toxicities were reported in eight patients at doses ≥240 mg, including nausea, vomiting, fatigue, hypersensitivity reaction, and hypokalemia. The maximum tolerated dose was determined to be 1200 mg o.d. Mean exposure of AMG 193 increased in a dose-proportional manner from 40 mg to 1200 mg. Among the efficacy-assessable patients treated at the active and tolerable doses of 800 mg o.d., 1200 mg o.d., or 600 mg b.i.d. (n = 42), objective response rate was 21.4% (95% confidence interval 10.3% to 36.8%). Responses were observed across eight different tumor types, including squamous/non-squamous non-small-cell lung cancer, pancreatic adenocarcinoma, and biliary tract cancer. At doses ≥480 mg, complete intratumoral PRMT5 inhibition was confirmed in paired MTAP-deleted tumor biopsies, and molecular responses (circulating tumor DNA clearance) were observed. CONCLUSIONS: AMG 193 demonstrated a favorable safety profile without clinically significant myelosuppression. Encouraging antitumor activity across a variety of MTAP-deleted solid tumors was observed based on objective response rate and circulating tumor DNA clearance.

Modified Rapid Emergency Medicine Score-Lactate (mREMS-L) performance to screen non-anticipated 30-day-related-mortality in emergency department.

BACKGROUND: The aim of this study was to compare the ability to predict 30-day in-hospital mortality of lactate versus the modified Rapid Emergency Medicine Score (mREMS) versus the arithmetic sum of the mREMS plus the numerical value of lactate (mREMS-L). METHODS: A prospective, multicentric, emergency department delivery, pragmatic study was conducted. To determine the predictive capacity of the scales, lactate was measured and the mREMS and mREMS-L were calculated in adult patients (aged>18 years) transferred with high priority by ambulance to the emergency department in five hospitals of Castilla y Leon between 1 January 2020 and 31 December 2021. The area under the receiver operating characteristic (ROC) curve of each of the scales was calculated in terms of mortality for 30 days. RESULTS: A total of 5371 participants were included, and the in-hospital mortality rate at 30 days was of 11.4% (615 cases). The best cut-off point determined in the mREMS was 7.0 points (sensitivity of 67% and specificity of 84%), and for lactate, the cut-off point was 1.4 mmol/L (sensitivity of 88% and specificity of 67%). Finally, the combined mREMS-L showed a cut-off point of 7.9 (sensitivity of 83% and a specificity of 83%). The area under the ROC curve of the mREMS, lactate and mREMS-L for 30-day mortality was 0.851, 0.853, and 0.903, respectively (p < 0.001 in all cases). CONCLUSIONS: The new score generated, mREMS-L, obtained better statistical results than its components (mREMS and lactate) separately.

Comparative study of isotherm parameters of lead biosorption by two wastes of olive-oil production.

Batch isotherm studies were carried out on a laboratory scale: (i) to investigate the effectiveness to remove lead of two wastes (olive stone (OS) and olive tree pruning (OTP)), untreated and chemically treated; and (ii) to examine the applicability of various adsorption isotherms to fit the experimental data. Results from tests were analyzed using seven equilibrium isotherm correlations (Langmuir, Freundlich, Dubinin-Radushkevich, Temkin, Redlich-Peterson, Sips, and Toth equations). The sum of the squares of the errors was determined for each isotherm and the Langmuir equation provided the best fit. Chemical treatments increased the biosorption properties of these materials. The maximum biosorption capacities were: 6.33, 49.13, 14.83, and 38.93 mg g(-1) for untreated OS, HNO3-OS, H2SO4-OS, and NaOH-OS, respectively, and 26.72, 86.40, 72.78, and 123.80 mg g(-1) for untreated OTP, HNO3-OTP, H2SO4-OTP, and NaOH-OTP, respectively. Finally, the loss of mass for each waste (13.9, 14.3, and 36.8% for HNO3-OS, H2SO4-OS, and NaOH-OS and 35.1, 27.5, and 46.7% for HNO3-OTP, H2SO4-OTP, and NaOH-OTP, respectively) was taken into account and an effectiveness coefficient was determined for each adsorbent material.

Cognitive plasticity as a moderator of functional dependency in elderly patients hospitalized for bone fractures.

INTRODUCTION: Bone fractures in older adults involve hospitalization and surgical intervention, aspects that have been related to loss of autonomy and independence. Several variables have been studied as moderators of how these patients recover. However, the implications of cognitive plasticity for functional recovery have not been studied to date. OBJECTIVE: The present study analyzes the relationship between cognitive plasticity--defined as the capacity for learning or improved performance under conditions of training or performance optimization--and functional recovery in older adults hospitalized following a bone fracture. PATIENTS AND METHODS: The study comprised 165 older adults who underwent surgery for bone fractures at a hospital in southern Spain. Participants were evaluated at different time points thereafter, with instruments that measure activities of daily life (ADL), namely the Barthel Index (BI) and the Lawton Index, as well as with a learning potential (cognitive plasticity) assessment test (Auditory Verbal Learning Test of Learning Potential, AVLT-LP). RESULTS: Results show that most of the participants have improved their level of independence 3 months after the intervention. However, some patients continue to have medium to high levels of dependency and this dependency is related to cognitive plasticity. CONCLUSION: The results of this study reveal the importance of the cognitive plasticity variable for evaluating older adults hospitalized for a fracture. They indicate a possible benefit to be obtained by implementing programs that reduce the degree of long-term dependency or decrease the likelihood of it arising.

PLP1 gene analysis in 88 patients with leukodystrophy.

Pelizaeus-Merzbacher disease (PMD) is caused in most cases by either duplications or point mutations in the PLP1 gene. This disease, a dysmyelinating disorder affecting mainly the central nervous system, has a wide clinical spectrum and its causing mutations act through different molecular mechanisms. Eighty-eight male patients with leukodystrophy were studied. PLP1 gene analysis was performed by the Multiplex Ligation-dependent Probe Amplification technique and DNA sequencing, and, in duplicated cases of PLP1, gene dosage was completed by using array-CGH. We have identified 21 patients with mutations in the PLP1 gene, including duplications, short and large deletions and several point mutations in our cohort. A customized array-CGH at the Xq22.2 area identified several complex rearrangements within the PLP1 gene region. Mutations found in the PLP1 gene are the cause of PMD in around 20% of the patients in this series.

Reduced serum progranulin level might be associated with Parkinson's disease risk.

BACKGROUND AND PURPOSE: Common genetic variants (rs5848 and rs646776) have been reported as regulators of blood progranulin (GRN) levels in healthy individuals. METHODS: To assess the influence of rs5848 and rs646776 polymorphisms in both serum GRN level and risk for common neurodegenerative diseases, we studied 304 patients with Parkinson's disease (PD), 217 individuals with Alzheimer's disease, 131 subjects with mild cognitive impairment, and 126 controls. RESULTS: The mean concentration of GRN in the serum of patients with PD (319.6 ng/ml) was significantly lower than that of controls (371.5 ng/ml; P = 0.009), whereas there were no significant differences between other groups. Rs646776 minor allele carriers had lower serum GRN levels in each of the four subgroups. There was no correlation between rs5848 genotypes and serum GRN concentrations. Genotype frequencies of both polymorphisms did not differ between groups. CONCLUSION: Reduced circulating GRN levels might be associated with PD risk by pathogenic factors different from rs5848 and rs646776 polymorphisms.

Cognitive plasticity, cognitive functioning and quality of life (QoL) in a sample of young-old and old-old adults in southern Spain.

BACKGROUND AND AIMS: The present study was designed to assess the differences in cognitive plasticity, cognitive functioning and quality of life (QoL) in young-old and old-old adults, and to determine whether variables related to QoL can predict cognitive plasticity in old age. METHODS: The study population consisted of 215 people living in sheltered accommodation for elderly people in southern Spain. Participants were divided into two groups according to age: young-old aged (between 65 and 80 years) and old-old (81 and above). Participants were assessed by means of cognitive performance tests, a QoL questionnaire, and the auditory verbal learning test-learning potential (AVLT-LP) as a measure of cognitive plasticity. RESULTS: No significant differences were found in cognitive plasticity between the young-old and old-old adults, although the former performed better on immediate and sustained verbal recall. Likewise, no significant inter-group differences arose in most of the QoL variables. However, differences in cognitive plasticity did appear as a function of the level of cognitive functioning of the old adults, and cognitive functioning has been shown to be the best predictor of cognitive plasticity in old age. CONCLUSIONS: Differences in cognitive plasticity between young-old and old-old adults only appear when the cognitive functioning of individuals is taken into account, rather than their age group. The variables cognitive functioning, social integration and education level appear to be the best predictors of cognitive plasticity in old age.

COVID-19 personal protective equipment (PPE) contamination in coastal areas of Granada, Spain.

The use of disposable personal protective equipment (PPE) as a control measure to avoid transmission against COVID-19 has generated a challenge to the waste management and enhances plastic pollution in the environment. The research aims to monitor the presence of PPE waste and other plastic debris, in a time interval where the use of face mask at specific places was still mandatory, on the coastal areas of Granada (Spain) which belongs to the Mediterranean Sea. Four beaches called La Rijana, La Charca, La Rábita and Calahonda were examined during different periods. The total amount of sampled waste was 17,558 plastic units. The abundance, characteristics and distribution of PPE and other plastic debris were determined. Results showed that the observed amount of total plastic debris were between 2.531·10-2 and 24.487·10-2 units per square meter, and up to 0.136·10-2 for PPE debris, where face masks represented the 92.22 % of the total PPE debris, being these results comparable to previous studies in other coastal areas in the world. On the other hand, total plastic debris densities were in the range from 2.457·10-2 to 92.219·10-2 g/m2 and densities were up to 0.732·10-2 for PPE debris. PPE debris supposed 0.79 % of the weight of total waste and the 0.51 % of total items. Concerning non-PPE plastic waste: cigarettes filters, food containers and styrofoam were the most abundant items (42.95, 10.19 and 16.37 % of total items, respectively). During vacation periods, total plastic debris amount increased 92.19 % compared to non-vacation periods. Regarding type of beaches, the presence of plastic debris was significantly higher on touristic/recreational than in fishing beaches. Data showed no significant differences between accessible and no-accessible beaches, but between periods with restrictive policy about mask face use and periods with non-restrictive policy data suggest significant differences between densities (g/m2) for PPE litter. The amount of PPEs debris is also correlated with the number of cigarettes filters (Person's r = 0.650), food containers (r = 0.782) and other debris (r = 0.63). Finally, although interesting results were provided in this study, further research is required to better understand the consequences of this type of pollution and to provide viable solutions to this problem.

On the use of plastic precursors for preparation of activated carbons and their evaluation in CO2 capture for biogas upgrading: a review.

In circular economy, useful plastic materials are kept in circulation as opposed to being landfilled, incinerated, or leaked into the natural environment. Pyrolysis is a chemical recycling technique useful for unrecyclable plastic wastes that produce gas, liquid (oil), and solid (char) products. Although the pyrolysis technique has been extensively studied and there are several installations applying it on the industrial scale, no commercial applications for the solid product have been found yet. In this scenario, the use of plastic-based char for the biogas upgrading may be a sustainable way to transform the solid product of pyrolysis into a particularly beneficial material. This paper reviews the preparation and main parameters of the processes affecting the final textural properties of the plastic-based activated carbons. Moreover, the application of those materials for the CO2 capture in the processes of biogas upgrading is largely discussed.

Recovery, separation and production of fuel, plastic and aluminum from the Tetra PAK waste to hydrothermal and pyrolysis processes.

The establishment of a method of separation of materials from Tetra Pak waste to obtain products for use as raw material, fuel or other purposes was investigated in this study. First, the feasibility of hydrothermal treatment for the production of a solid fuel (hydrochar) and solid fraction formed by polyethylene and aluminum, called composite was analyzed. The results indicated that hydrothermal treatment performed at 240 °C yield the formation of hydrochar with good properties for its use as fuel and a composite of polyethylene and aluminum. The best conversion and separation of the cardboard and polyethylene/aluminum were obtained using 120 min as operating time. Then, the recovery of the aluminum fraction from the composite by using spent olive oil waste was studied. A partial separation of the composite layers (polyethylene and aluminum) was accomplished with improved aluminum purity for higher operating temperatures. Finally, the operating conditions of the pyrolysis process for the production of a solid (char) and high purity composite (aluminum) were optimized. The characterization results indicated that both char and aluminum resulting from the pyrolysis of the Tetra Pak at 400 °C still have a significant amount of polyethylene while higher purity levels of aluminum can be obtained at temperatures equal of higher than 500 °C.

Effectiveness of suboccipital muscle inhibition combined with interferential current in patients with chronic tension-type headache: a randomised controlled clinical trial.

INTRODUCTION: Manual therapy has been shown to reduce self-reported symptoms in patients with chronic tension-type headache (CTTH). However, simultaneous application of suboccipital muscle inhibition and interferential current has not previously been investigated. This study evaluates the effectiveness of combined treatment with suboccipital muscle inhibition and interferential current compared to standard treatment for pain, disability, and headache impact in patients with CTTH. METHODS: Patients were randomly allocated to receive either standard treatment (n = 13) or the experimental treatment (n = 12), consisting of 20 minutes of suboccipital muscle inhibition plus interferential current twice weekly for 4 weeks. The primary outcome was improvement in pain, and secondary outcomes included improvement in headache-related disability and reduction in headache impact, which were assessed at baseline and at 4 weeks by a blinded rater. RESULTS: Statistical analysis showed improvements in the experimental treatment group at 4 weeks for headache-related disability (Neck Disability Index: Hedges' g = 1.01, P = .001; and Headache Disability Inventory: Hedges' g = 0.48, P = .022) and headache impact (6-item Headache Impact Test: Hedges' g = 0.15, P = .037) but not for self-reported pain (numerical rating scale: Hedges' g = 1.13, P = .18). CONCLUSIONS: Combined treatment with suboccipital muscle inhibition and interferential current in patients with CTTH did not significantly improve self-reported pain but did reduce disability and the impact of headache on daily life at 4 weeks. These improvements exceed the minimum clinically important difference, demonstrating the clinical relevance of our findings.

Usefulness of high b-value diffusion-weighted MRI in the diagnosis of Creutzfeldt-Jakob disease.

BACKGROUND: current diagnostic criteria of probable Creutzfeldt-Jakob disease (CJD) include a combination of clinical, EEG and analytic data. Recent data indicate that brain MRI including fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) sequences can be a valid and reliable tool for the diagnosis of CJD. We describe our experience with high b-value (3000s/mm(2)) diffusion-weighted imaging (DWI) in patients with probable or definite CJD and compare it with standard b-value (1000s/mm(2)) DWI. METHODS: we performed a retrospective analysis of patients admitted to our Hospital Service between 2002 and 2008 with a final diagnosis of probable or definite CJD. Patients were examined using either a 1.5 Tesla or a 3 Tesla MRI. The MRI protocol included T1-weigthed spin-echo sequences, T2-weighted fast spin-echo, FLAIR and DWI sequences with high b-value and standard b-value. RESULTS: during the study period there were 7 patients with probable or definite CJD. Only 3 patients (43%) showed changes on FLAIR sequence consistent with CJD. All the cases were detected with high b-value DWI, including 2 cases (28%) that would have been missed using standard b-value (1000s/mm(2)) DWI. In all the patients the changes were more conspicuous and extensive at high b-value DWI (b=3000s/mm(2)). CONCLUSION: our data indicate that high b-value DWI may improve the sensitivity of brain MRI for the diagnosis of CJD, allowing the detection of some cases that would have been overlooked by conventional sequences.

Environmental status of marine plastic pollution in Spain.

The excessive use of plastic in our society is causing a massive accumulation, since it is a non-biodegradable product and with still poor recycling rates. This effect can be observed in the seas, which more and more plastic waste are accumulating. The present work is a critical review, based on all currently available literature, that reports environmental status of marine plastic pollution, especially microplastic pollution, in Spain. The three Spanish water areas with the highest presence of plastics are the Alboran Sea, the Gulf of Alicante and the vicinity of Barcelona probably related to fishing and industrial activities and high population densities. With regard to microplastic contamination on beaches in Spain, annual monitoring by the Spanish government shows contamination along the entire coast of the country, with particularly high concentrations in the Canary Islands (between 800 and 8800 particles/m2 in spring). Between 40 and 50% of the particles analyzed were pellets and the main factors postulated for the distribution of these particles are marine currents and the geomorphological characteristics. With regards to biota, ingestion of microplastics by fish has been intensely confirmed and, important differences were observed between the locations of the sampling, being bogues (Boops boops) one of the fish species more studied in Spain. Finally, the work includes a revision of European and Spanish legislation about plastics and marine pollution and some strategies to reduce this kind of contamination in Spain.

An epigenetic mechanism for capecitabine resistance in mesothelioma.

Mesothelioma is an uncommon malignancy whose global incidence continues to rise. The therapeutic standard for advanced disease is intravenous pemetrexed and cisplatin. The anti-folate capecitabine is significantly less effective than pemetrexed. The balance between thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), and thymidine phosphorylase (TP) is critical to the efficacy of capecitabine. DNA from mesothelioma cell lines was bisulfite treated and examined by MS-PCR, RNA was obtained for real-time PCR analysis, and protein lysates were obtained for Western immunoblot analysis. Cytotoxicity was assessed by MTT assay, comparing 5-aza-CdR pretreated or untreated cells with 5'-deoxy-5-fluorouridine (DFUR), 5-FU, and pemetrexed. Finally bisulfite sequencing of the extracellular growth factor-1 (ECGF-1) gene was performed on 4 mesothelioma samples and pericardial tissue. One of the four cell lines tested (H290) was methylated for ECGF-1. This corresponded to a lack of TP expression by real-time PCR and Western immunoblot. Treatment with 1muM 5-aza-CdR increased TP mRNA and protein expression in H290. DFUR, the substrate for TP, showed increased cytotoxicity when delivered after 5-aza-CdR exposure in the methylated cell line. There was no difference in any of the unmethylated cell lines when cells were exposed to 5-FU or pemetrexed with or without 5-aza-CdR. Patient tumor samples revealed an increased number of methylated CpG sites in ECGF-1 compared to normal pericardium. Methylation of ECGF-1, leads to transcriptional silencing of TP and may explain the lack of any effect of capecitabine, especially when compared to pemetrexed.

Effectiveness of Cognitive Interventions in Older Adults: A Review.

(1) Introduction: With older adults, cognitive intervention programs are most often used for preventing or reversing a decline in cognitive functions, but it has been recently noted that there are insufficient high-quality research studies that report the effects of cognitive intervention on the cognitive functioning of older adults. (2) Objective: To analyze the available evidence concerning the effect of cognitive interventions for improving or maintaining the general cognitive status of older adults who present different cognitive levels. (3) Method: a review of studies published between 2010 and 2019 using the following databases: PubMed, PsycINFO, Cochrane, Google Scholar, ProQuest and Medline. (4) Results: We selected 13 systematic reviews and/or meta-analyses. The results showed that the cognitive intervention programs improved general cognitive functioning and specific cognitive functions regardless of the initial cognitive level; that cognitive decline was slowed in older persons with dementia; and there was improvement in activities of daily living. Regarding duration of the results, benefits were maintained for periods of 2 months to 5 years. (5) Conclusion: Cognitive interventions have proven effective for maintaining and/or improving cognitive functioning in older adults regardless of their initial cognitive status. Even so, there are few studies that follow up these results to see whether they are maintained in the long term and whether there is transfer to other skills of daily life. However, we were able to observe in the present review how the participants' cognitive level varied according to sociodemographic differences, and to identify which components of cognitive programs make them more effective. Based on the results found, we highlight the importance of designing cognitive intervention programs that meet these effectiveness criteria, in order to maximize the positive effects of such programs when working with a population of older adults.

Wisconsin Card Sorting Test-Learning Potential: Usefulness for Assessing Children with Autism Spectrum Disorder.

This study analyzes the Wisconsin Card Sorting Test-Learning Potential (WCST-LP) in children with Autism Spectrum Disorder (ASD) versus children with typical development (TD). Its main aim was to assess: the test's construct validity; the effect of IQ on its pretest and LP scores; and whether the WCST-LP held any relationship to cognitive/EF and social abilities. Participants were 105 children (43 with ASD/62 with TD). Results showed evidence of construct validity in an ASD population (improvements from pretest to posttest), that full IQ influenced pretest performance but did not affect LP, and that a relationship between LP and verbal and social abilities existed only in children with ASD. Conclusions indicate the appropriateness of the WCST-LP in ASD prognosis assessment.

Liquid Hot Water Pretreatment and Enzymatic Hydrolysis as a Valorization Route of Italian Green Pepper Waste to Delivery Free Sugars.

In this work, liquid hot water pretreatment (autohydrolysis) was used to improve enzymatic hydrolysis of a commonly consumed vegetable waste in Spain, Italian green pepper, to finally produce fermentable sugars. Firstly, the effect of temperature and contact time on sugar recovery during pretreatment (in insoluble solid and liquid fraction) was studied in detail. Then, enzymatic hydrolysis using commercial cellulase was performed with the insoluble solid resulting from pretreatment. The objective was to compare results with and without pretreatment. The results showed that the pretreatment step was effective to facilitate the sugars release in enzymatic hydrolysis, increasing the global sugar yield. This was especially notable when pretreatment was carried out at 180 °C for 40 min for glucose yields. In these conditions a global glucose yield of 61.02% was obtained. In addition, very low concentrations of phenolic compounds (ranging from 69.12 to 82.24 mg/L) were found in the liquid fraction from enzymatic hydrolysis, decreasing the possibility of fermentation inhibition produced by these components. Results showed that Italian green pepper is an interesting feedstock to obtain free sugars and prevent the enormous quantity of this food waste discarded annually.

Effectiveness of the "Mente Sana [Healthy Mind]" Cognitive Training Program for Older Illiterate Adults with Mild Cognitive Impairment.

Aging can lead to functional and cognitive alterations, sometimes limiting older adults in their social development, especially illiterate groups of older adults who receive poor attention from healthcare systems. In this context, the present investigation proposes the cognitive training program "MENTE SANA [HEALTHY MIND]" to improve the cognitive functions of illiterate older adults in Arequipa (Peru). It is a type of quasi-experimental research with a pre-test/post-test design with a homogenous control group. The sample was made up of adults 60 years old and above and of female gender. The Montreal Cognitive Assessment (MoCA) test was used to detect the level of cognitive decline in illiterate older adults. The 50-sessions program was applied to all the older adults with mild cognitive impairment that were selected for the study, on a daily basis. It was found that the tested group improved their cognitive functions compared to the control group. These results help to propose adapted cognitive training programs for illiterate people.

Effectiveness of suboccipital muscle inhibition combined with interferential current in patients with chronic tension-type headache: a randomised controlled clinical trial. / Efectividad de la inhibición suboccipital combinada con corriente interferencial en pacientes con cefalea tensional crónica: un ensayo clínico controlado aleatorizado.

INTRODUCTION: Manual therapy has been shown to reduce self-reported symptoms in patients with chronic tension-type headache (CTTH). However, simultaneous application of suboccipital muscle inhibition and interferential current has not previously been investigated. This study evaluates the effectiveness of combined treatment with suboccipital muscle inhibition and interferential current compared to standard treatment for pain, disability, and headache impact in patients with CTTH. METHODS: Patients were randomly allocated to receive either standard treatment (n = 13) or the experimental treatment (n = 12), consisting of 20 minutes of suboccipital muscle inhibition plus interferential current twice weekly for 4 weeks. The primary outcome was improvement in pain, and secondary outcomes included improvement in headache-related disability and reduction in headache impact, which were assessed at baseline and at 4 weeks by a blinded rater. RESULTS: Statistical analysis showed improvements in the experimental treatment group at 4 weeks for headache-related disability (Neck Disability Index: Hedges' g = 1.01, P = .001; and Headache Disability Inventory: Hedges' g = 0.48, P = .022) and headache impact (6-item Headache Impact Test: Hedges' g = 0.15, P = .037) but not for self-reported pain (numerical rating scale: Hedges' g = 1.13, P = .18). CONCLUSIONS: Combined treatment with suboccipital muscle inhibition and interferential current in patients with CTTH did not significantly improve self-reported pain but did reduce disability and the impact of headache on daily life at 4 weeks. These improvements exceed the minimum clinically important difference, demonstrating the clinical relevance of our findings.

[Usefulness of cognitive plasticity evaluation in the differential diagnosis of cognitive impairment and depression-induced pseudo-dementia]. / Utilidad de la evaluación de la plasticidad cognitiva en el diagnóstico diferencial del deterioro cognitivo y la pseudodemencia por depresión.

INTRODUCTION: A major challenge for gerontological research is to differentiate adequately between old adults with poor performance on cognitive tasks due to depression, and those who present cognitive impairment associated with dementia. In view of the fact that cognitive plasticity has already proved to be efficient in the diagnosis of age-associated cognitive impairment, mild cognitive impairment and dementia, the objective of this study is to investigate the possibility that it may also prove useful in the differential diagnosis of these two disorders. MATERIALS AND METHODS: A total of 50 old adults participated in the study. These completed the Positions Test (PT) and the Auditory Verbal Learning Test of Learning Potential (AVLT-LP) as measures of cognitive plasticity. Participants also undertook the Spanish version of Mini Mental State (MEC), Life Satisfaction Questionnaire (LSQ) and Geriatric Depression Scale (GDS). Socio-demographic data were also collected. RESULTS: With regard to cognitive plasticity, depressed old adults do not differ from those without depression. On the other hand, old adults with cognitive impairment present less cognitive plasticity than those without cognitive impairment. CONCLUSION: Cognitive plasticity appears to be a relevant variable in the differentiation between old people with low cognitive performance due to depression and old people with cognitive impairment.