Symptomatology and knowledge regarding pelvic floor dysfunctions and influence of gender stereotypes in female athletes.

Pelvic floor dysfunctions (PFD) are highly prevalent among females who do athletics, a sport requiring jumping, strength, and running. Although educational approaches are useful options, the educational need for this particular population remains unknown. The objective of the present study was to describe the level of knowledge regarding PFD and its relationship with symptomatology and gender stereotypes in female athletes in Spain. A total of 255 female athletes completed an anonymous online survey to explore their knowledge regarding urinary incontinence (UI), pelvic organ prolapse (POP), anal incontinence (AI), and sexual dysfunction (SexD), as well as their PFD symptoms and gender stereotyped beliefs related to sport. Educational level and sports characteristics (training volume, experience, and athletic modality) were also explored. Participants demonstrated a low level of knowledge in terms of POP (52.5%), AI (64.0%), and SexD (40%), but not for UI (70.8%). The proportion of PFD complaints was 63.5% for dyspareunia, 51.8% for urine leakage, 42.4% for pelvic pain, 17.3% for AI, and 9.0% for POP, with no associations with knowledge (p > 0.05). Lower knowledge about UI and SexD was related to greater gender stereotypes (p < 0.05) and rejection of professional healthcare (p = 0.010). As a conclusion, the level of knowledge about PFD was low in female athletes who train and compete in athletics in Spain, mainly with regard to sexual dysfunction. Although 63.5% of athletes had dyspareunia and 51.8% urinary leakages, symptomatology was not associated with level of knowledge. However, a lower level of knowledge was associated with more stereotyped beliefs and rejection of professional healthcare for PFD. These findings confirm the need to design appropriate educational interventions to disseminate information on all the types of PFD, particularly sexual contents. The potential influence of gender stereotypes makes it appropriate to include the gender perspective in these interventions.

Diferencias clínicas entre la amiloidosis cardiaca por transtirretina y la cardiopatía hipertensiva / Clinical differences between transthyretin cardiac amyloidosis and hypertensive heart disease

Introducción: Un porcentaje importante de pacientes finalmente diagnosticados de amiloidosis cardIaca por transtirretina (ATTR) fueron previamente diagnosticados de cardiopatía hipertensiva (CHTA), ya que ambas enfermedades suelen cursar con insuficiencia cardíaca (IC) con fracción de eyección preservada (ICFEp) e hipertrofia ventricular. Nuestros objetivos fueron evaluar las diferencias clínicas, electrocardiográficas y ecocardiográficas, y analizar si existe un pronóstico diferencial entre ambas entidades nosológicas. Material y métodos: Se incluyeron retrospectivamente todos los pacientes con CHTA a los que se solicitó una gammagrafía cardíaca con 99mTc-Difosfonatos (GDPD) y estudio de cadenas ligeras en sangre y orina para despistaje de ATTR en nuestro centro, en el periodo 2016-2021. Para el análisis, se excluyeron aquellos diagnosticados de otros tipos de amiloidosis. Resultados: Se analizaron un total de 72 pacientes: 33 fueron diagnosticados de ATTR y 39 de CHTA, finalmente. Los pacientes con ATTR presentaron mayores niveles de troponina I ultrasensible (TnI-US) y propéptido natriurético cerebral N-terminal (NT-ProBNP); en electrocardiograma (ECG) presentaron más frecuentemente patrón de seudoinfarto y alteraciones de la conducción; en ecocardiograma transtorácico (ETT) presentaron mayor grado de hipertrofia ventricular, disfunción ventricular izquierda y parámetros de peor función diastólica, con presiones de llenado más elevadas. En el seguimiento a 4 años, el grupo de ATTR mostró mayor necesidad de marcapasos (MCP), sin evidenciarse evidencias en cuanto a mortalidad, desarrollo de fibrilación auricular o más ingresos por IC. Conclusiones: En nuestra serie, los pacientes con ATTR presentaron diferencias clínicas, electrocardiográficas y ecocardiográficas respecto a aquellos con CHTA, con mayor riesgo necesidad de MCP en el seguimiento.(AU)

Introduction: A significant percentage of patients eventually diagnosed with cardiac transthyretin amyloidosis (TTRA) was previously diagnosed with hypertensive heart disease (HHD), since both conditions usually present with heart failure (HF) with preserved ejection fraction (HFpEF) and ventricular hypertrophy. Our objectives were to evaluate the clinical, electrocardiographic and echocardiographic differences, and to analyse whether there exists a differential prognosis between these two nosological entities. Materials and methods: We retrospectively included all patients with HHD for whom a cardiac scintigraphy with 99mTc-diphosphonate (GDPD) and a free light chains test in blood and urine were ordered for ATTR screening in our centre, in the period between 2016 and 2021. Those diagnosed with other types of amyloidosis were excluded from the analysis. Results: A total of 72 patients were analyzed: 33 were finally diagnosed with TTRA and 39 with CHTA. Patients with TTRA had higher levels of ultrasensitive troponin I (TnI-US) and N-terminal brain natriuretic propeptide (NT-ProBNP); in electrocardiography (ECG) they presented a pseudo-infarction pattern more frequently as well as conduction disturbances; in echocardiography (TTE) they presented a higher degree of ventricular hypertrophy, left ventricular dysfunction and worse diastolic function parameters, with elevated filling pressures. In the 4-year follow-up, the ATTR group showed greater need for pacemaker (PCM), with no evidence regarding mortality, development of atrial fibrillation (AF), or more admissions for heart failure (HF). Conclusions: In our series, patients with TTRA showed clinical, electrocardiographic and echocardiographic differences compared to patients with HHD, with increased risk of need for PCM.(AU)

[Clinical differences between transthyretin cardiac amyloidosis and hypertensive heart disease]. / Diferencias clínicas entre la amiloidosis cardiaca por transtirretina y la cardiopatía hipertensiva.

INTRODUCTION: A significant percentage of patients eventually diagnosed with cardiac transthyretin amyloidosis (TTRA) was previously diagnosed with hypertensive heart disease (HHD), since both conditions usually present with heart failure (HF) with preserved ejection fraction (HFpEF) and ventricular hypertrophy. Our objectives were to evaluate the clinical, electrocardiographic and echocardiographic differences, and to analyse whether there exists a differential prognosis between these two nosological entities. MATERIALS AND METHODS: We retrospectively included all patients with HHD for whom a cardiac scintigraphy with 99mTc-diphosphonate (GDPD) and a free light chains test in blood and urine were ordered for ATTR screening in our centre, in the period between 2016 and 2021. Those diagnosed with other types of amyloidosis were excluded from the analysis. RESULTS: A total of 72 patients were analyzed: 33 were finally diagnosed with TTRA and 39 with CHTA. Patients with TTRA had higher levels of ultrasensitive troponin I (TnI-US) and N-terminal brain natriuretic propeptide (NT-ProBNP); in electrocardiography (ECG) they presented a pseudo-infarction pattern more frequently as well as conduction disturbances; in echocardiography (TTE) they presented a higher degree of ventricular hypertrophy, left ventricular dysfunction and worse diastolic function parameters, with elevated filling pressures. In the 4-year follow-up, the ATTR group showed greater need for pacemaker (PCM), with no evidence regarding mortality, development of atrial fibrillation (AF), or more admissions for heart failure (HF). CONCLUSIONS: In our series, patients with TTRA showed clinical, electrocardiographic and echocardiographic differences compared to patients with HHD, with increased risk of need for PCM.

The Worsening of Heart Failure with Reduced Ejection Fraction: The Impact of the Number of Hospital Admissions in a Cohort of Patients.

BACKGROUND: Worsening heart failure (WFH) includes heart failure (HF) hospitalisation, representing a strong predictor of mortality in patients with heart failure with reduced ejection fraction (HFrEF). However, there is little evidence analysing the impact of the number of previous HF admissions. Our main objective was to analyse the clinical profile according to the number of previous admissions for HF and its prognostic impact in the medium and long term. METHODS: A retrospective study of a cohort of patients with HFrEF, classified according to previous admissions: cohort-1 (0-1 previous admission) and cohort-2 (≥2 previous admissions). Clinical, echocardiographic and therapeutic variables were analysed, and the medium- and long-term impacts in terms of hospital readmissions and cardiovascular mortality were assessed. A total of 406 patients were analysed. RESULTS: The mean age was 67.3 ± 12.6 years, with male predominance (73.9%). Some 88.9% (361 patients) were included in cohort-1, and 45 patients (11.1%) were included in cohort-2. Cohort-2 had a higher proportion of atrial fibrillation (49.9% vs. 73.3%; p = 0.003), chronic kidney disease (36.3% vs. 82.2%; p < 0.001), and anaemia (28.8% vs. 53.3%; p = 0.001). Despite having similar baseline ventricular structural parameters, cohort-1 showed better reverse remodelling. With a median follow-up of 60 months, cohort-1 had longer survival free of hospital readmissions for HF (37.5% vs. 92%; p < 0.001) and cardiovascular mortality (26.2% vs. 71.9%; p < 0.001), with differences from the first month. CONCLUSIONS: Patients with HFrEF and ≥2 previous admissions for HF have a higher proportion of comorbidities. These patients are associated with worse reverse remodelling and worse medium- and long-term prognoses from the early stages, wherein early identification is essential for close follow-up and optimal intensive treatment.

Improvement of left ventricular ejection fraction in patients with heart failure with reduced ejection fraction: Predictors and clinical impact / Impacto clínico a medio plazo de la mejoría de la fracción de eyección ventricular izquierda en pacientes con insuficiencia cardiaca con fracción de eyección reducida

Background A percentage of patients with heart failure with reduced ejection fraction (HFrEF) improve left ventricular ejection fraction (LVEF) in the evolution. This entity, defined for the first time in an international consensus as heart failure with improved ejection fraction (HFimpEF), could have a different clinical profile and prognosis than HFrEF. Our main aim was to analyze the differential clinical profile between the two entities, as well as the mid-term prognosis. Material-methods Prospective study of a cohort of patients with HFrEF who had echocardiographic data at baseline and follow-up. A comparative analysis of patients who improved LVEF with those who did not was made. Clinical, echocardiographic and therapeutic variables were analyzed, and the mid-term impact in terms of mortality and hospital readmissions for HF was assessed. Results Ninety patients were analyzed. Mean age was 66.5(10.4) years, with a male predominance (72.2%). Forty five patients (50%) improved LVEF (Group-1,HFimpEF) and forty five patients (50%) sustained reduced LVEF (Group-2,HFsrEF). The mean time to LVEF improvement in Group-1 was 12.6(5.7) months. Group-1 had a more favorable clinical profile: lower prevalence of cardiovascular risk factors, higher prevalence of de novo HF (75.6% vs. 42.2%; p<0.05), lower prevalence of ischemic etiology (22.2% vs. 42.2%; p<0.05), with less basal dilatation of the left ventricle. At the end of follow-up (mean 19(1) months) Group-1 had a lower hospital readmission rate (3.1% vs. 26.7%; p<0.01), as well as lower mortality (0% vs. 24.4%; p<0.01). Conclusion Patients with HFimpEF seem to have a better mid-term prognosis in terms of reduced mortality and hospital admissions. This improvement could be conditioned by the clinical profile of patients HFimpEF (AU)

Introducción Un porcentaje de pacientes con insuficiencia cardiaca y fracción de eyección reducida (IC-FEr) mejoran la fracción de eyección ventricular izquierda (FEVI) en la evolución. Esta entidad se ha definido por primera vez en un consenso internacional como insuficiencia cardiaca y fracción de eyección mejorada (IC-FEm), y podría tener un perfil y pronóstico diferente que IC-FEr. Nuestro objetivo fue analizar el perfil de ambas entidades y su pronóstico a medio plazo. Material y métodos Estudio prospective de una cohorte de pacientes con IC-FEr que tenían datos ecocardiográficos basales y en el seguimiento. Se hizo un análisis comparativo de pacientes con IC-FEm y pacientes con insuficiencia cardiaca y IC-FEpr. Se analizaron variables clínicas, ecocardiográficas y de tratamiento; el impacto clínico a medio plazo se analizó en términos de mortalidad y reingresos hospitalarios por insuficiencia cardiaca. Resultados Se analizaron 90 pacientes, edad media 66,5 (10,4) años (72,2% mujeres). La mitad de los pacientes mejoraron su FEVI, con un tiempo medio hasta la mejoría de 12,6 (5,7) meses. El grupo IC-FEm tenía un perfil clínico más favorable: menor proporción de factores de riesgo cardiovascular, prevalencia más elevada de IC-novo (75,6 vs. 42,2%; p < 0,05), y menor proporción de isquemia (22,2 vs. 42.2%; p < 0,05). Los pacientes con IC-FEm en el seguimiento a medio plazo tenían menor tasa de reingresos (3,1 vs. 26,7%; p < 0,01), y mortalidad (0 vs. 24,4%; p < 0,01). Conclusión Pacientes con IC-FEm parecen tener un mejor pronóstico en términos de mortalidad y reingresos hospitalarios por insuficiencia cardiaca (IC). Esta mejoría clínica podría estar condicionada por el perfil de los pacientes con IC-FEm (AU)

Improvement of left ventricular ejection fraction in patients with heart failure with reduced ejection fraction: Predictors and clinical impact.

BACKGROUND: A percentage of patients with heart failure with reduced ejection fraction (HFrEF) improve left ventricular ejection fraction (LVEF) in the evolution. This entity, defined for the first time in an international consensus as heart failure with improved ejection fraction (HFimpEF), could have a different clinical profile and prognosis than HFrEF. Our main aim was to analyze the differential clinical profile between the two entities, as well as the mid-term prognosis. MATERIAL-METHODS: Prospective study of a cohort of patients with HFrEF who had echocardiographic data at baseline and follow-up. A comparative analysis of patients who improved LVEF with those who did not was made. Clinical, echocardiographic and therapeutic variables were analyzed, and the mid-term impact in terms of mortality and hospital readmissions for HF was assessed. RESULTS: Ninety patients were analyzed. Mean age was 66.5(10.4) years, with a male predominance (72.2%). Forty five patients (50%) improved LVEF (Group-1,HFimpEF) and forty five patients (50%) sustained reduced LVEF (Group-2,HFsrEF). The mean time to LVEF improvement in Group-1 was 12.6(5.7) months. Group-1 had a more favorable clinical profile: lower prevalence of cardiovascular risk factors, higher prevalence of de novo HF (75.6% vs. 42.2%; p<0.05), lower prevalence of ischemic etiology (22.2% vs. 42.2%; p<0.05), with less basal dilatation of the left ventricle. At the end of follow-up (mean 19(1) months) Group-1 had a lower hospital readmission rate (3.1% vs. 26.7%; p<0.01), as well as lower mortality (0% vs. 24.4%; p<0.01). CONCLUSION: Patients with HFimpEF seem to have a better mid-term prognosis in terms of reduced mortality and hospital admissions. This improvement could be conditioned by the clinical profile of patients HFimpEF.

Extension of the equilibration period up to 24 h maintains the post-thawing quality of Holstein bull semen frozen with OPTIXcell®.

Semen cryopreservation in bovine livestock is well established, but logistics often require deviations from standard protocols. Extending the equilibration time to the following day is convenient in many situations. To improve our knowledge of the effects of this modification, we studied the post-thawing and post-incubation (4 h, 38 °C) sperm quality after freezing with 4 or 24-h extension in the OPTIXcell extender by using an ample panel of analyses: CASA for motility; flow cytometry for viability, physiology, oxidative stress, and chromatin parameters (DNA fragmentation, chromatin compaction, and thiol groups status); and spectrometry for malondialdehyde production. Semen was obtained from 12 Holstein bulls. The 24-h equilibration time showed few significant effects, with only a tiny decrease in progressive motility and a positive impact on chromatin structure. The incubation removed some of these effects, with the pattern for chromatin compaction remaining the same. No detrimental oxidative stress or increase in apoptotic or capacitation markers was detected. Additionally, the individual bull interacted with the effects of the incubation and the equilibration, especially regarding the chromatin status. Whereas this interaction did not critically affect sperm quality, it could be relevant in practice. Bull fertility as non-return rates (NRR56) was associated with some sperm parameters (especially with an improved chromatin structure) but not in the 4-h post-thawing analysis. Our study supports that extending the equilibration time by at least 24-h is feasible for bull semen freezing with the OPTIXcell extender.

Single layer centrifugation (SLC) for bacterial removal with Porcicoll positively modifies chromatin structure in boar spermatozoa.

The storage of boar semen samples at 17 °C for artificial insemination (AI) doses enables the proliferation of the bacteria, making antibiotics necessary. This can contribute to the development of antimicrobial resistance (AMR). This study tested bacterial presence and sperm chromatin structure after using a low-density colloid (Porcicoll) as an antibiotic alternative to eliminate bacteria. Ejaculates (8 boars, 3 ejaculates each) were split as control and low-density colloid centrifugation (single layer centrifugation, SLC, 20%, and 30% Porcicoll) into 500 ml tubes. Analyses were carried out at days 0, 3, and 7 (17 °C) for microbial presence and sperm chromatin structure analysis: %DFI (DNA fragmentation) and %HDS (chromatin immaturity), monobromobimane (mBBr; free thiols and disulfide bridges), and chromomycin A3 (CMA3; chromatin compaction). Besides comparing bacterial presence (7 species identified) and chromatin variables between treatments, the associations between these sets of variables were described by canonical correlation analysis (CCA). Results showed a significant decrease of some bacteria or a complete removal after SLC (especially for P30). SLC also caused a decrease of %HDS and an increase of disulfide bridges and low and medium mBBr populations, suggesting the removal of immature sperm (poor chromatin compaction). CCA showed an association pattern compatible with the degradation of sperm chromatin parameters with bacterial contamination, especially Enterobacteria, P. aeuriginosa, and K. variicola. In conclusion, bacterial contamination affects sperm chromatin beyond DNA fragmentation; SLC with low-density colloid not only removes bacteria from boar semen, but also chromatin structure is enhanced after selection.

Risk scores for predicting incident heart failure admission in patients with chronic coronary syndromes: Validation in a prospective, monocentric, long-term, cohort study.

BACKGROUND: Heart failure (HF) admission in chronic coronary syndrome (CCS) patients has a prognostic impact. Stratification schemes have been described for predicting this endpoint, but none of them has been externally validated. OBJECTIVES: Our aim was to develop point scores for predicting incident HF admission with data from previous studies, to perform an external validation in an independent prospective cohort and to compare their discriminative ability for this event. METHODS: Independent predictive variables of HF admission in CCS patients without baseline HF were selected from four previous prospective studies (CARE, PEACE, CORONOR and CLARIFY), generating scores based on the relative magnitude of the coefficients of Cox of each variable. Finally, the scores were validated and compared in a monocentric prospective cohort. RESULTS: The validation cohort included 1212 patients followed for up to 17 years, with 171 patients suffering at least one HF admission in the follow-up. Discriminative ability for predicting HF admission was statistically significant for all, and paired comparisons among them were all nonsignificant except for CORONOR score was superior to CLARIFY score (C-statistic 0.73, 95%CI 0.69-0.76 vs. 0.69, 95% CI 0.65-0.73; p = 0.03). CONCLUSION: All tested scores showed significant discriminative ability for predicting incident HF admission in this independent validation study. Their discriminative ability was similar, with significant differences only between the two scores with higher and lower performance.

Concurrent validity and reliability of a smartphone-based application for the head repositioning and cervical range of motion.

OBJECTIVES: To evaluate the validity and reliability of a smartphone-based application against inertial sensors to measure head repositioning (by using joint position sense -JPS) and cervical range of motion (ROM). METHODS: JPS and cervical ROM were evaluated for neck flexion, extension and both-sides lateral flexion in thirty-one volunteers. Participants were simultaneously evaluated with inertial sensors and the smartphone application. A total of 248 angles were compared for concurrent validity. Inter-tester and intra-tester reliability were evaluated through scoring of images with the smartphone application by two testers, and re-scoring images by the same tester. RESULTS: Very high correlation was observed between both methods for ROM in all neck movements and JPS in left-side lateral flexion (r>0.9), and high for JPS in the rest of movements (r>0.8). Bland-Altman plots always demonstrated absolute agreement. Inter-and intra-tester reliability was perfect for JPS and ROM in all the neck movements (ICC>0.81). CONCLUSIONS: This smartphone-based application is valid and reliable for evaluating head repositioning and cervical ROM compared with inertial sensors in healthy and young adults. Health professionals could use it in an easier and portable way in field conditions.

Factores de riesgo psicosociales que influyen en el comportamiento suicida en las personas privadas de la libertad en Colombia / Psychosocial risk factors that influence suicidal behavior in people deprived of liberty in Colombia

Resumen Objetivo: Identificar los factores de riesgo psicosocial y las características que los componen; que a su vez repercuten en el comportamiento suicida, en los privados de la libertad de Colombia, para mejorar la atención psicológica que se lleva a cabo en los centros penitenciarios. Método: Articulo de revisión documental, de tipo cualitativo, realizado a través de una recolección, revisión y análisis de 55 documentos; de los cuales se seleccionaron 13 artículos que cumplían con los criterios de inclusión y exclusión previamente establecidos. Durante la investigación se tiene en cuenta la elaboración y distinción del documento, de acuerdo a la recolección y organización de la información obtenida a través de bases de datos como Scielo, Scopus, Oxford, Science Direct, Redalyc, Pubmed, entre otros, por lo tanto, se discriminaron las categorías y subcategorías desarrolladas durante la indagación correspondientes al tema a trabajar. Resultados: Se identificaron los factores de riesgo psicosociales fundamentales como: prisionización, vínculo familiar o afectivo, consumo de sustancias psicoactivas, proyecto de vida, problemas psicológicos y tiempo de condena; que presenta la población penitenciaria a nivel mundial, los cuales se tienen en cuenta para reducir las tasas de comportamiento suicida en el ámbito carcelario. Conclusiones: En la revisión documental se logró identificar cuáles son los factores de riesgo que permitan detectar a tiempo el comportamiento suicida en las personas privadas de la libertad, teniendo en cuenta que la población carcelaria a nivel mundial va en aumento y el comportamiento suicida es catalogado como un problema grave de salud pública; se evidenció la falta de existencia de información para la investigación con base a la atención psicosocial que se le brinda a las personas privadas de la libertad alrededor de los factores de riesgos psicosociales que influyen en el comportamiento suicida; por tal razón es importante investigar a profundidad acerca de los factores protectores que pueden prevenir el suicidio en la población.

Abstract Objective: To identify the characteristics that make up the psychosocial risk factors that have an impact on suicidal behavior in Colombian prisoners, in order to improve the psychological care provided in penitentiaries. Method: Documentary review article, of qualitative type, carried out through a collection, review and analysis of 50 documents; of which 13 articles were selected for the elaboration of the results. During the research, the elaboration and distinction of the document is taken into account, according to the collection and organization of information collected through databases such as Scielo, Scopus, Oxford, Science Direct, Redalyc, Pubmed, among others, Therefore, the categories and subcategories developed during the investigation corresponding to the topic to work are discriminated. Results: Key psychosocial risk factors were identified, such as: prison ionization, family or affective bond, use of psychoactive substances, life plan, psychological problems and time of sentence; presented by the prison population worldwide, which are taken into account to reduce suicide rates in prison settings. Conclusions: The documentary review identifies the risk factors and protective factors that allow the timely detection of suicidal behaviour in persons deprived of their liberty, taking into account that some of the risk factors may also be protective factors, such as family ties, the life plan, the process of imprisonment and the time of sentence, and other factors if they are highly relevant because of their risk in suicidal behavior; such as substance use and psychological problems.

Motor Control and Regularity of Menstrual Cycle in Ankle and Knee Injuries of Female Basketball Players: A Cohort Study.

Inadequate motor control facilitates ankle and knee injuries in female basketball. Although biomechanical analysis could help to detect it, aspects such as irregular menstruation make these associations controversial. We aimed to evaluate associations between 2D biomechanics during landing and proprioception with ankle and knee injuries of female basketball players, considering their menstruation regularity. Seventy-one players participated in this study. In the preseason, participants performed a drop-jump to obtain biomechanics during landing and a weight-bearing proprioception test. During the competitive season, all the non-contact ankle and knee injuries were registered. Data showed that 16% of players sustained an ankle or knee injury, being more frequent in players with irregular menstruation compared to regulars (22% vs. 13%, χ2 = 6.009, p = 0.050, d = 0.6). Players who sustained a left-side injury displayed higher left-side dynamic valgus during landing than uninjured players (χ2 = 25.88, p = 0.006, d = 1.5). The rest of the variables did not show any significant difference (p > 0.05). Monitoring 2D dynamic valgus from a drop-jump could help to detect inadequate motor control that may facilitate ankle or knee injuries of female basketball players, mainly for those with irregular menstruation. Proprioception seems not to be related to injuries.

Alteraciones electrocardiográficas y necesidad de marcapasos en amiloidosis cardiaca: análisis de 58 casos / Electrocardiographic features and need for pacemaker in cardiac amyloidosis: Analysis of 58 cases

ObjetivoEn la amiloidosis cardiaca (AC) el material amiloide puede depositarse en diferentes estructuras cardiacas pudiendo producir diferentes alteraciones electrocardiográficas. El objetivo fue describir qué alteraciones electrocardiográficas son más frecuentes en pacientes con AC, analizando su impacto en la necesidad de marcapasos.MetodosEstudio retrospectivo que incluye pacientes diagnosticados de AC por cadenas ligeras (AC-AL) y AC por transtirretina (AC-TTR), entre enero-2013 y marzo-2021. Se analizó el ritmo basal, el porcentaje con patrón de seudoinfarto, bajo voltaje o alteraciones de la conducción; también se analizó el impacto en la necesidad de marcapasos definitivo.ResultadosSe incluyeron 58 pacientes con AC (20 AC-AL, 38 AC-TTR). Varones (69%), 21 (36%) tenían FA al diagnóstico. El 60% tenía patrón de seudoinfarto, el 35% bajo voltaje y un 22% tenían criterios de hipertrofia ventricular. Dos tercios tenían algún trastorno de conducción: bloqueo auriculoventricular de primer grado, 18 pacientes (31%); 12 bloqueo completo de rama derecha (BCRD), 3 bloqueo completo de rama izquierda (BCRI) y 25 con un hemibloqueo de rama. No hubo diferencias entre AC-AL y AC-TTR. Los pacientes con AC-TTR tuvieron mayor necesidad de marcapasos en el seguimiento (39±40 meses). El bloqueo completo de rama (BCR) fue un predictor de necesidad de marcapasos permanente (HR: 23,43; IC 95%: 4,09-134,09; p=0,01).ConclusionesLas alteraciones electrocardiográficas en pacientes diagnosticados de AC son heterogéneas, siendo la más frecuente la presencia de trastornos de conducción, el patrón de seudoinfarto, seguido del de bajo voltaje. Los pacientes con cualquier BCR en el electrocardiograma basal son más propensos a precisar marcapasos en el seguimiento, sobre todo en AC-TTR. (AU)

AimAmyloidosis is a disease in which amyloid fibrils can be deposited in different cardiac structures, and several electrocardiographic abnormalities can be produced by this phenomenon. The objective of this study was to describe the most common basal electrocardiographic alterations in patients diagnosed with cardiac amyloidosis (CA) and to determine if these abnormalities have an impact on the need of pacemaker.MethodsThis retrospective study included patients who had an established diagnosis of CA [light-chain cardiac amyloidosis (LA-CA) or transthyretin cardiac amyloidosis (TTR-CA)] between January 2013 and March 2021. The baseline heart rate, the percentage of patients with a pseudo-infarct pattern, low-voltage pattern or cardiac conductions disturbances, and the impact of these factors on the need of pacemaker were analysed.ResultsFifty-eight patients with CA (20 with LA-CA and 38 with TTR-CA) were included, and the majority were male (69.0%). Twenty-one patients had atrial fibrillation (AF) at diagnosis. Thirty-five patients had a pseudo-infarct pattern, 35% had a low-voltage pattern, and 22% had criteria for ventricular hypertrophy. Two hirds had a conduction disorder: 18 patients with first degree atrioventricular block, 12 right bundle branch block, 3 left bundle branch block and 25 with a branch hemiblock. There were no differences between LA-CA and TTR-CA. Patients with TTR-CA had a greater need for pacemakers in the folow-up (39±40 meses). Bundle branch block was a predictor of the need for a permanent pacemaker (HR: 23.43; CI 95%: 4.09.134.09; P=.01).ConclusionsElectrocardiographic abnormalities in patients diagnosed wich CA are heterogeneus. Most frecuent is the presence of conduction disorders, the pseudoinfarction pattern, followed by the low voltage pattern. Patients with any bundle branch block at the baseline electrocardiogram need more frecuent to require a pacemaker during follow-up, especially in TTR-CA. (AU)

Bos taurus and Cervus elaphus as Non-Seasonal/Seasonal Models for the Role of Melatonin Receptors in the Spermatozoon.

Melatonin is crucial in reproduction due its antioxidant, hormonal, and paracrine action. Melatonin membrane receptors (MT1/MT2) have been confirmed on spermatozoa from several species, but functionality studies are scarce. To clarify their role in ruminants as reproductive models, bull (Bos taurus, non-seasonal) and red deer (Cervus elaphus, highly seasonal) spermatozoa were analyzed after 4 h of incubation (38 °C, capacitating media) in 10 nM melatonin, MT1/MT2 agonists (phenylmelatonin and 8M-PDOT), and antagonists (luzindole and 4P-PDOT). Motility and functionality (flow cytometry: viability, intracellular calcium, capacitation status, reactive oxygen species (ROS) production, and acrosomal and mitochondrial status) were assessed. In bull, MT1 was related to sperm viability preservation, whereas MT2 could modulate cell functionality to prevent excess ROS produced by the mitochondria; this action could have a role in modulating sperm capacitation. Deer spermatozoa showed resistance to melatonin and receptor activation, possibly because the samples were of epididymal origin and collected at the breeding season's peak, with high circulating melatonin. However, receptors could be involved in mitochondrial protection. Therefore, melatonin receptors are functional in the spermatozoa from bull and deer, with different activities. These species offer models differing from traditional laboratory experimental animals on the role of melatonin in sperm biology.

Urinary Incontinence Among Elite Track and Field Athletes According to Their Event Specialization: A Cross-Sectional Study.

BACKGROUND: Physical effort in sports practice is an important trigger for urinary incontinence (UI). Among high-impact sports, all track and field events require continuous ground impacts and/or abdominal contractions that increase intra-abdominal pressure and impact on the pelvic floor musculature. However, studies to date have not taken into account the specific sports tasks that elite track and field athletes perform according to the competitive events for which they are training. METHODS: This cross-sectional study describes the prevalence, type, and severity of UI among elite track and field athletes considering their event specialization and training characteristics. A total of 211 female and 128 male elite track and field athletes answered an online questionnaire including anthropometric measures, medical history, training characteristics, and UI symptoms. To determine self-reported UI, the International Consultation on Incontinence Questionnaire-UI Short-Form (ICIQ-UI-SF) was used. To determine UI type and severity, the incontinence questionnaire and incontinence severity index were used, respectively. RESULTS: The ICIQ-UI-SF showed that 51.7% of female and 18.8% of male athletes had UI, with stress UI (SUI) being the most frequent type (64.4%) for female and urge UI for male athletes (52.9%). Of athletes who were not identified as having UI according to the questionnaires, 24.6% of female and 13.6% of male athletes experienced urine leakage during training, mainly during jumping. Although training characteristics (experience, volume, and resting) were not related to UI, female athletes specializing in vertical jumps showed significantly lower UI prevalence compared to those specializing in horizontal jumps (χ2 [1] = 4.409, p = 0.040), middle-distance running (χ2 [1] = 4.523, p = 0.033), and sprint/hurdles events (χ2 [1] = 4.113, p = 0.043). These female athletes also displayed the lowest training volume. No differences were shown for males (p > 0.05). CONCLUSIONS: Over half of the elite track and field female athletes have self-reported UI, especially SUI, and prevalence is higher when considering urine leakage events during training. Training characteristics and specialization were not related to UI identified by questionnaires, but female athletes specializing in vertical jump events showed the lowest prevalence and training volume. Males showed significantly lower prevalence, without correlation with their specialization. Sport professionals should increase UI detection among elite athletes and design-specific approaches that consider their physical demands to make visible, prevent, or improve pelvic floor dysfunction in this population.

Electrocardiographic features and need for pacemaker in cardiac amyloidosis: Analysis of 58 cases. / Alteraciones electrocardiográficas y necesidad de marcapasos en amiloidosis cardiaca: análisis de 58 casos.

AIM: Amyloidosis is a disease in which amyloid fibrils can be deposited in different cardiac structures, and several electrocardiographic abnormalities can be produced by this phenomenon. The objective of this study was to describe the most common basal electrocardiographic alterations in patients diagnosed with cardiac amyloidosis (CA) and to determine if these abnormalities have an impact on the need of pacemaker. METHODS: This retrospective study included patients who had an established diagnosis of CA [light-chain cardiac amyloidosis (LA-CA) or transthyretin cardiac amyloidosis (TTR-CA)] between January 2013 and March 2021. The baseline heart rate, the percentage of patients with a pseudo-infarct pattern, low-voltage pattern or cardiac conductions disturbances, and the impact of these factors on the need of pacemaker were analysed. RESULTS: Fifty-eight patients with CA (20 with LA-CA and 38 with TTR-CA) were included, and the majority were male (69.0%). Twenty-one patients had atrial fibrillation (AF) at diagnosis. Thirty-five patients had a pseudo-infarct pattern, 35% had a low-voltage pattern, and 22% had criteria for ventricular hypertrophy. Two hirds had a conduction disorder: 18 patients with first degree atrioventricular block, 12 right bundle branch block, 3 left bundle branch block and 25 with a branch hemiblock. There were no differences between LA-CA and TTR-CA. Patients with TTR-CA had a greater need for pacemakers in the folow-up (39±40 meses). Bundle branch block was a predictor of the need for a permanent pacemaker (HR: 23.43; CI 95%: 4.09.134.09; P=.01). CONCLUSIONS: Electrocardiographic abnormalities in patients diagnosed wich CA are heterogeneus. Most frecuent is the presence of conduction disorders, the pseudoinfarction pattern, followed by the low voltage pattern. Patients with any bundle branch block at the baseline electrocardiogram need more frecuent to require a pacemaker during follow-up, especially in TTR-CA.

Organosolv and ionosolv processes for autohydrolyzed poplar fractionation: Lignin recovery and characterization.

Biomass fractionation plays a major role in the search for competitive biorefineries, where the isolation and recovery of the three woody fractions is key. In this sense, we have used autohydrolyzed hemicellulose-free poplar as feedstock to compare two fractionation processes, organosolv and ionosolv, oriented to lignin recovery. The recovered lignins were then characterize by different techniques (NMR, GPC, TGA). Both treatments were tested at different temperatures to analyze temperature influence on lignin recovery and properties. The highest lignin recovery was obtained with the ionosolv process at 135 °C, reaching a solid yield of ~70%. Lignin characterization showed differences between both treatments. Lignins enriched in C-O linkages and G units were recovered with the organosolv process, where increasing temperature led to highly depolymerized lignins. However, lignins with higher C-C linkages and S units contents were obtained with the ionosolv process, producing more thermically stable lignins. In addition, increasing temperature caused lignin repolymerization when employing ionic liquids as solvents. Therefore, this work outlines the most important differences between ionosolv and organosolv processes for biomass fractionation, focusing on lignin recovery and its properties, which is the first step in order to valorize all biomass fractions.

The Suinfort® Semen Supplement Counters Seasonal Infertility in Iberian Sows.

Suinfort®, a commercial semen supplement demonstrated to increase fertility and litter size in commercial sows, was tested to improve reproductive performance in Iberian sows. A total of 1430 Iberian sows were artificially inseminated (AI) with semen from Duroc boars and assigned by parity to receive the seminal additive Suinfort® containing 2 IU oxytocin, 5 µg lecirelin, and 2 mM caffeine (SF; n = 1713 AI), or to serve as non-supplemented controls (CON; n = 2625 AI). CON showed a lower fertility comparing to winter for spring (p = 0.001) and summer (p < 0.001); summer was lower than autumn (p = 0.012). SF removed this seasonal effect (p > 0.05). Fertility was significantly higher for SF sows during summer (p = 0.025) and autumn (p = 0.004). Total born, live-born, stillborn, and mummified piglets did not differ between CON and SF but were impacted by the season, with total and live-born decreasing in summer compared with autumn (p < 0.001) and winter (p = 0.005). In conclusion, seminal supplementation with Suinfort® improved the fertility of Iberian sows during periods of seasonal infertility.

Effect of Season and Parity on Reproduction Performance of Iberian Sows Bred with Duroc Semen.

The Iberian pig is an autochthonous breed from the Iberian Peninsula highly valued for its meat. The sows are often bred as Iberian × Duroc crossings for increased efficiency. Since sow parity and season affect the reproductive performance, we evaluated two-year records from a commercial farrow-to-finish farm (live, stillborn, and mummified piglets after artificial insemination, AI). A total of 1293 Iberian sows were inseminated with semen from 57 boars (3024 AI). The effects of parity (gilts, 1, 2-4, 5-10, and >10 farrowings) and season were analyzed by linear mixed-effects models (LME). The data were fitted to cosinor models to investigate seasonal effects within parity groups. The effects of maximum daily temperature (MDT) and day length change (DLC) during spermatogenesis, pre-AI, and post-AI periods were analyzed with LME. The 2-4 group was the optimal one for parity. A seasonal effect was evident between spring-summer (lower fertility/prolificacy) and autumn-winter (higher). Cosinor showed that the seasonal drop in reproductive performance occurs earlier in Iberian sows than in other breeds, more evident in gilts. MDT negatively affected performance in all periods and DLC in spermatogenesis and pre-AI. These results are relevant for the improvement of Iberian sows' intensive farming.

Cross-cultural Adaptation of the Health Sciences Evidence-based Practice Questionnaire into Japanese and Its Test-Retest Reliability in Undergraduate Students.

OBJECTIVES: The Health Sciences Evidence-Based Practice (HS-EBP) questionnaire was recently developed for measuring five constructs of evidence-based clinical practice among Spanish health professionals by applying content and construct validity investigation. The current study aims to undertake a cross-cultural adaptation of the HS-EBP into Japanese and to investigate the internal consistency and test-retest reliability of the Japanese HS-EBP among undergraduate students of nursing and physical and occupational therapies. METHODS: Cross-cultural adaptation was undertaken by following Beaton's five-step process. Subsequently, the Japanese HS-EBP test-retest reliability was assessed with a 2-week interval. Participants were recruited from among third and fourth grade undergraduate students of nursing and physical and occupational therapies with clinical training experience. RESULTS: Pilot testing included 30 participants (11 nursing students, 11 physical therapy students, 8 occupational therapy students). Consequently, we developed the Japanese HS-EBP to be understandable for undergraduate students of nursing and physical and occupational therapies. Data from 52 participants who completed test-retest reliability questionnaires demonstrated adequate test-retest reliability in the total scores of Domains 1, 3, 4, and 5 [intraclass correlation coefficients were (ICC)=0.74, 0.70, 0.75, and 0.74, respectively]; the exception was Domain 2, which had an ICC of 0.66. Internal consistency (Cronbach's α) was adequate for Domains 1-5, for which α was 0.87, 0.94, 0.86, 0.93, and 0.95, respectively. CONCLUSIONS: This study developed the Japanese version of HS-EBP and provided preliminary evidence of adequate internal consistency and test-retest reliability in most domains for undergraduate students of nursing and physical and occupational therapies.