Sex-related differences in young binge drinkers on the neurophysiological response to stress in virtual reality.

Background: Stress is one of the main environmental factors involved in the onset of different psychopathologies. In youth, stressful life events can trigger inappropriate and health-damaging behaviors, such as binge drinking. This behavior, in turn, can lead to long-lasting changes in the neurophysiological response to stress and the development of psychological disorders late in life, e.g., alcohol use disorder. Our aim was to analyze the pattern of neurophysiological responses triggered with the exposition to a stressful virtual environment in young binge drinkers. Methods: AUDIT-3 (third question from the full AUDIT) was used to detect binge drinking (BD) in our young sample (age 18-25 years). According to the score, participants were divided into control (CO) and BD group. Next, a standardized virtual reality (VR) scenario (Richie's Plank) was used for triggering the stress response while measuring the following neurophysiological variables: brain electrical activity by electroencephalogram (EEG) and cortisol levels through saliva samples both measurements registered before and after the stressful situation. Besides, heart rate (HR) with a pulsometer and electrodermal response (EDA) through electrodes placed on fingers were analyzed before, during and after the VR task. Results: Regarding the behavior assessed during the VR task, BD group spent significantly less amount of time walking forward the table and a tendency toward more time walking backwards. There was no statistically significant difference between the BD and the CO group regarding time looking down, but when we controlled the variable sex, the BD women group displayed higher amount of time looking down than the rest of the groups. Neurophysiological measurements revealed that there was not any statistically significant difference between groups in any of the EEG registered measures, EDA response and cortisol levels. Sex-related differences were found in HR response to VR scenario, in which BD women displayed the highest peak of response to the stressor. Also, the change in heartbeat was higher in BD women than men. Conclusion: Unveiling the neurophysiological alterations associated with BD can help us to prevent and detect early onset of alcohol use disorder. Also, from our data we conclude that participants' sex can modulate some stress responses, especially when unhealthy behaviors such as BD are present. Nevertheless, the moment of registration of the neurophysiological variables respect to the stressor seems to be a crucial variable.

Glycolytic lactate in diabetic kidney disease.

Lactate elevation is a well-characterized biomarker of mitochondrial dysfunction, but its role in diabetic kidney disease (DKD) is not well defined. Urine lactate was measured in patients with type 2 diabetes (T2D) in 3 cohorts (HUNT3, SMART2D, CRIC). Urine and plasma lactate were measured during euglycemic and hyperglycemic clamps in participants with type 1 diabetes (T1D). Patients in the HUNT3 cohort with DKD had elevated urine lactate levels compared with age- and sex-matched controls. In patients in the SMART2D and CRIC cohorts, the third tertile of urine lactate/creatinine was associated with more rapid estimated glomerular filtration rate decline, relative to first tertile. Patients with T1D demonstrated a strong association between glucose and lactate in both plasma and urine. Glucose-stimulated lactate likely derives in part from proximal tubular cells, since lactate production was attenuated with sodium-glucose cotransporter-2 (SGLT2) inhibition in kidney sections and in SGLT2-deficient mice. Several glycolytic genes were elevated in human diabetic proximal tubules. Lactate levels above 2.5 mM potently inhibited mitochondrial oxidative phosphorylation in human proximal tubule (HK2) cells. We conclude that increased lactate production under diabetic conditions can contribute to mitochondrial dysfunction and become a feed-forward component to DKD pathogenesis.

A new approach to urinalysis: effectiveness of a contingency management program among adolescent offenders in Spain.

Background: When addressing antisocial behaviour among adolescents, programs based on the paradigm of positive psychology through enhancing self-efficacy have demonstrated their effectiveness in furthering the positive development of young people with a history of antisocial behaviour. Nevertheless, there has been little research into the effectiveness of these type of programs in mitigating substance abuse among juvenile offenders. The aim of this paper is to analyse the effectiveness of a contingency management program in reducing the prevalence of relapses into drug consumption among adolescents who have committed serious crimes. Methods: The study consisted of a sample of 91 male adolescents, between 15 and 19 years, in juvenile detention, who were divided into two treatment groups. For both groups, biological testing was used to detect drug consumption upon their re-turn from leave permits from the Centre. Results: The quasi-experimental group had significantly lower rates of relapse than the quasi-control group. Furthermore, being part of the quasi-experimental group was a significant predictor of reduced rates of relapses. Conclusion: The results suggest that the incorporation of treatment strategies which reinforce feelings of self-efficacy and adequate orientation towards the future, as a complement to disciplinary sanctions, are effective in reducing relapses in drug use among adolescent offenders.

Mitochondrial antiviral signaling protein enhances MASLD progression through the ERK/TNFα/NFκß pathway.

BACKGROUND AND AIMS: Mitochondrial antiviral signaling protein (MAVS) is a critical regulator that activates the host's innate immunity against RNA viruses, and its signaling pathway has been linked to the secretion of proinflammatory cytokines. However, the actions of MAVS on inflammatory pathways during the development of metabolic dysfunction-associated steatotic liver disease (MASLD) have been little studied. APPROACH AND RESULTS: Liver proteomic analysis of mice with genetically manipulated hepatic p63, a transcription factor that induces liver steatosis, revealed MAVS as a target downstream of p63. MAVS was thus further evaluated in liver samples from patients and in animal models with MASLD. Genetic inhibition of MAVS was performed in hepatocyte cell lines, primary hepatocytes, spheroids, and mice. MAVS expression is induced in the liver of both animal models and people with MASLD as compared with those without liver disease. Using genetic knockdown of MAVS in adult mice ameliorates diet-induced MASLD. In vitro, silencing MAVS blunts oleic and palmitic acid-induced lipid content, while its overexpression increases the lipid load in hepatocytes. Inhibiting hepatic MAVS reduces circulating levels of the proinflammatory cytokine TNFα and the hepatic expression of both TNFα and NFκß. Moreover, the inhibition of ERK abolished the activation of TNFα induced by MAVS. The posttranslational modification O -GlcNAcylation of MAVS is required to activate inflammation and to promote the high lipid content in hepatocytes. CONCLUSIONS: MAVS is involved in the development of steatosis, and its inhibition in previously damaged hepatocytes can ameliorate MASLD.

Facilitators of and barriers to gastric cancer and precursor diagnosis among South Texas residents: Social determinants of health.

BACKGROUND: Latinos/Hispanics are at higher risk for developing gastric cancer (GC) compared with non-Hispanic whites, and social determinants of health (SDoH) are thought to contribute. AIMS/MATERIALS AND METHODS: This study addressed SDoH and their interactions contributing to disparities in the testing and treatment of Helicobacter pylori (HP) infection and diagnosis of GC and its known precursors, among Latinos/Hispanics relative to non-Latinos at two affiliated but independent health systems in San Antonio, Texas, using a mixed methods approach. RESULTS: Secondary data abstraction and analysis showed that GCs represented 2.6% (n = 600) of our population. Men and older individuals were at higher GC risk. Individuals with military insurance were 2.7 times as likely to be diagnosed as private insurance. Latinos/Hispanics had significantly (24%) higher GC risk than Whites. Poverty and lack of insurance contributed to GC risk among the minorities classified as other (Asians, Native Americans, Multiracial; all p < 0.01). All SDoH were associated with H. pylori infection (p < 0.001). Qualitative analysis of patient and provider interviews showed providers reporting insurance as a major care barrier; patients reported appointment delays, and lack of clinic staff. Providers universally agreed treatment of H. pylori was necessary, but disagreed on its prevalence. Patients did not report discussing H. pylori or its cancer risk with providers. DISCUSSION/CONCLUSION: These data indicate the importance of considering SDoH in diagnosis and treatment of GC and its precursors, and educating providers and patients on H. pylori risks for GC.

A pilot study to investigate the safety and feasibility of antiretroviral therapy for Alzheimer's disease (ART-AD).

Retrotransposons are viral-like DNA sequences that constitute approximately 41% of the human genome. Studies in Drosophila, mice, cultured cells, and human brain indicate that retrotransposons are activated in settings of tauopathy, including Alzheimer's disease, and causally drive neurodegeneration. The anti-retroviral medication 3TC (lamivudine), a nucleoside analog reverse transcriptase inhibitor, limits retrotransposon activation and suppresses neurodegeneration in tau transgenic Drosophila, two mouse models of tauopathy, and in brain assembloids derived from patients with sporadic Alzheimer's disease. We performed a 24-week phase 2a open-label clinical trial of 300 mg daily oral 3TC (NCT04552795) in 12 participants aged 52-83 years with a diagnosis of mild cognitive impairment due to suspected Alzheimer's disease. Primary outcomes included feasibility, blood brain barrier penetration, effects of 3TC on reverse transcriptase activity in the periphery, and safety. Secondary outcomes included changes in cognition and fluid-based biomarkers of neurodegeneration and neuroinflammation. All participants completed the six-month trial; one event of gastrointestinal bleeding due to a peptic ulcer was reported. 3TC was detected in blood and cerebrospinal fluid (CSF) of all participants, suggestive of adherence to study drug and effective brain penetration. Cognitive measures remained stable throughout the study. Glial fibrillary acidic protein (GFAP) (P=0.03) and Flt1 (P=0.05) were significantly reduced in CSF over the treatment period; Aß42/40 (P=0.009) and IL-15 (P=0.006) were significantly elevated in plasma. While this is an open label study of small sample size, the significant decrease of some neurodegeneration- and neuroinflammation-related biomarkers in CSF, significantly elevated levels of plasma Aß42/40, and a trending decrease of CSF NfL after six months of 3TC exposure suggest a beneficial effect on subjects with mild cognitive impairment due to suspected Alzheimer's disease. Feasibility, safety, tolerability, and central nervous system (CNS) penetration assessments further support clinical evaluation of 3TC in a larger placebo-controlled, multi-dose clinical trial.

p63 controls metabolic activation of hepatic stellate cells and fibrosis via an HER2-ACC1 pathway.

The p63 protein has pleiotropic functions and, in the liver, participates in the progression of nonalcoholic fatty liver disease (NAFLD). However, its functions in hepatic stellate cells (HSCs) have not yet been explored. TAp63 is induced in HSCs from animal models and patients with liver fibrosis and its levels positively correlate with NAFLD activity score and fibrosis stage. In mice, genetic depletion of TAp63 in HSCs reduces the diet-induced liver fibrosis. In vitro silencing of p63 blunts TGF-ß1-induced HSCs activation by reducing mitochondrial respiration and glycolysis, as well as decreasing acetyl CoA carboxylase 1 (ACC1). Ectopic expression of TAp63 induces the activation of HSCs and increases the expression and activity of ACC1 by promoting the transcriptional activity of HER2. Genetic inhibition of both HER2 and ACC1 blunt TAp63-induced activation of HSCs. Thus, TAp63 induces HSC activation by stimulating the HER2-ACC1 axis and participates in the development of liver fibrosis.

Implantación de una metodología para evaluarpatient-reported outcomes en pacientes con cáncer de pulmón: Protocolo del estudio PeOpLe(Patient-reported Outcomes in Lung cancer) / Implementation of a methodology to assess patient reported outcomes in lung cancer patients: The PeOpLe (Patient-reported Outcomes in Lung cancer) study protocol

Objetivo: El objetivo es describir el protocolo del estudio PeOpLe, cuyofin es evaluar los resultados en salud centrados en el paciente con cáncerde pulmón no microcítico avanzado o metastásico en la práctica clínicahabitual mediante una metodología adaptada de la herramienta del International Consortium for Health Outcomes Measurement.Método: Estudio observacional, ambispectivo, longitudinal y multicéntrico. Se compararán dos grupos: grupo control (seguimiento según práctica clínica habitual) frente a un grupo intervención (seguimiento mediantela metodología del International Consortium for Health Outcomes Measurement adaptada al entorno español) durante un período de 6 meses. Lasvariables recogidas incluirán aspectos demográficos (edad, sexo, apoyofamiliar), clínicos (hábito tabáquico, comorbilidades, capacidad pulmonar), del tumor (histología, estadiaje, mutaciones), farmacoterapéutico(esquema de tratamiento, modificaciones y complicaciones), grado desalud (estado funcional, calidad de vida, satisfacción y supervivencia global) y consumo de recursos (visitas a urgencias, ingresos hospitalariosy tiempo dedicado por los profesionales sanitarios). El protocolo del estudio PeOpLe ha sido aprobado por el Comité de Ética de la Investigacióncon medicamentos y se realizará respetando los principios y las normaséticas básicas. (AU)

Objective: The purpose of this article is to describe the PeOpLe studyprotocol, developed to assess patient-reported health outcomes in advanced or metastatic non-small-cell lung cancer in routine clinical practiceusing the methodology provided by the International Consortium forHealth Outcomes Measurement tool.Method: The study envisaged will be multicenter, longitudinal, ambispective and observational. Two groups will be compared: a control group(followed up according to standard clinical practice) and an experimentalgroup (followed up using the International Consortium for Health OutcomesMeasurement methodology adapted to the Spanish setting for 6 months).The variables collected will be related to demography (age, sex, degreeof family support), clinical factors (smoking, comorbidities, lung capacity),the neoplasm (histology, staging, mutations), pharmacotherapy (treatmentschedule, modifications, and complications), health status (functionalstatus, quality of life, satisfaction and overall survival) and resource consumption (emergency visits, hospital admissions and time spent by healthproviders). The PeOpLe study protocol has been approved by the EthicsCommittee for Research into Medicinal Products of the Gregorio MarañónGeneral University Hospital and will be conducted in compliance withprevailing ethical principles and standards. (AU)

Influencia del sueño y el ambiente familiar en el rendimiento académico de adolescentes

RESUMEN Introducción: El cambio de hábitos de vida y sueño está impactando el desempeño escolar de los adolescentes. Objetivo: Relacionar hábitos de sueño y ambiente familiar en adolescentes con el rendimiento académico y conductual. Métodos: Estudio observacional, descriptivo transversal realizado en 178 adolescente estudiantes de la secundaria "Conrado Duany Pulido" (7mo. 8vo. y 9no. grado), entre septiembre 2016-mayo 2018. Se aplicaron encuestas, se identificaron trastornos de conducta o aprendizaje y los resultados académicos. Resultados: Los varones (67,2%) obtuvieron calificaciones entre 41 y 84 puntos; las hembras, (60,7%) entre 85 y 100 puntos (p= 0,0005). Estudiar fue la actividad vespertina habitual en hembras (p= 0,0006); 82,6 % de los encuestados refirieron despertarse en la madrugada con frecuencia por la necesidad de ir al baño (predominio femenino); despiertan, en segundo lugar, para comer (predominio masculino) y, en tercer lugar, para jugar con medios electrónicos o mirar la televisión (49,3 % varones). Refirieron tener trastornos del sueño 71,9 %, somniloquia y sonambulismo 47,6 %, sueño intranquilo 42,9 %, pesadillas 40,6 % Los trastornos más abundantes fueron: hiperactividad, frecuente en el sexo masculino y aprendizaje lento 12,9 %. Conclusiones: Las adolescentes tienen tres veces más probabilidades de mejor rendimiento académico, con mayor estudio y entretenimiento con la televisión como actividad vespertina. Los varones juegan más en grupo y despiertan en la noche para jugar con equipos electrónicos. Son muy frecuentes los despertares. Existe alta frecuencia de trastornos del sueño en ambos sexos, mayor hiperactividad en varones y aprendizaje lento en hembras.

Inestabilidad cronica lateral del tobillo: comparacion entre la reparacion de brostrom-gould y una tecnica artroscopica / Chronic Lateral Ankle Instability: Comparison Between Brostrom-Gould Repair And An Arthroscopic Technique

Introducción La inestabilidad crónica lateral del tobillo es una patología frecuente en las personas que sufren esguinces. El tratamiento inicial es conservador y de no funcionar se recomienda el tratamiento quirúrgico; la técnica descrita por Broström y modificada por Gould es la más utilizada, efectiva y reportada en la actualidad. Con el advenimiento de la cirugía artroscópica, uno de los autores (JBGG) ha desarrollado una técnica mínimamente invasiva que se ha utilizado en la unidad de pie desde hace 8 años. Este trabajo evalúa los resultados funcionales, de dolor y cicatrización de los pacientes tratados con la técnica Artroscópica y la técnica de Broström-Gould abierta. Materiales & Métodos Se evaluaron un total de 111 pacientes, 50 con la técnica abierta y 61 con técnica artroscópica, operados por inestabilidad lateral crónica del tobillo entre enero de 2004 y diciembre de 2011. Se utilizo la escala AOFAS de tobillo y retropié para la medición del dolor, función y alineación, y la escala EVA para la medición del dolor. Resultados El promedio de puntuación final de la escala AOFAS fue de 90 puntos y la inestabilidad se revirtió en el 96% de los casos, para ambos grupo de pacientes. El dolor fue aliviado eficientemente por ambas técnicas. No se observaron diferencias estadísticamente significativas entre los grupos del estudio. Discusión La reparación artroscópica de la inestabilidad crónica lateral del tobillo fue tan efectiva para restablecer la función, estabilidad y eliminar el dolor del tobillo como la técnica abierta y puede tener una menor posibilidad de complicaciones relacionadas con las heridas.

Background Chronic lateral ankle instability is a common condition in people with inversion sprains. Initial treatment is conservative, and if that does not work a surgical approach is recommended, such as that described by Broström and later modified by Gould, and is the most used and effective. With the advent of arthroscopic surgery, one of the authors (JBGG) has recently developed a minimally invasive technique that has been used in the Surgical Foot and Ankle Unit of Imbanaco Medical Centre for 8 years. Therefore, this work aims to determine functional outcomes of patients treated with the arthroscopic technique compared with the open technique of Broström-Gould. Methods A total of 111 patients were evaluated, including 50 with the open method, and 61 with arthroscopic surgery technique for chronic lateral ankle instability between January 2004 and December 2011. The American orthopaedic foot and ankle score (AOFAS) scale for ankle and hindfoot was used for measuring pain, function, and alignment, and a visual analogue scale (VAS) was used to assess the pain. Results The final AOFAS score was 90 points, and instability was reversed in 96% of cases, for both groups of patients. The pain was relieved efficiently by both techniques. There were no statistically significant differences between the study groups. Discussion Arthroscopic repair of chronic lateral ankle instability is an effective tool to restore the function and stability, as well as eliminate ankle pain, and is comparable in effectiveness with the conventional technique. Additionally, there is a lower chance of complications related to wounds.

Hábitos saludables y prevención de la osteoporosis en mujeres perimenopáusicas de un ámbito rural / Healthy habits and osteoporosis prevention in perimenopausal women from rural areas

Objetivos La posibilidad de padecer osteoporosis disminuye, entre otros factores, con un aporte adecuado de vitamina D, dieta equilibrada y aumentando la actividad física. En este estudio evaluamos si una intervención educativa mejora comportamientos relacionados con la prevención de la osteoporosis en mujeres perimenopáusicas de un ámbito rural. Métodos Ensayo clínico aleatorizado con intervención educativa. Variables: actividad física, ingesta de calcio y exposición solar en mujeres rurales de 45-54 años (n=216) en el momento 0 y 12 meses después de la intervención. Grupo control (n=106): se envió información por correo (mes 0). Grupo intervención (n=110): se impartieron dos talleres interactivos (mes 0) sobre factores de prevención. Resultados El grupo de intervención, pero no el control, a los 12 meses de la intervención había aumentado la actividad física (p=0,006), la exposición al sol (p=0,029) y la ingesta de calcio (53% a 64%). Conclusiones Una sencilla intervención educativa en mujeres perimenopáusicas mejora hábitos saludables para la prevención de la osteoporosis (AU)

Objective The probability of developing osteoporosis decreases with an adequate supply of vitamin D, a balanced diet, and increased physical activity. In this study, we evaluated whether an educational intervention improves osteoporosis-related behavior in perimenopausal women from rural areas. Methods A randomized experimental evaluation was performed of an educational intervention. The variables were physical activity, calcium intake and sun exposure in women from rural areas aged 45-54 years (n=216) at time 0 and 12 months after the educational intervention. In the control group (n=106), the information was sent by surface mail (month 0). In the intervention group (n=110), two interactive workshops were given (month 0). The topic of the workshops and the information sent by surface mail was healthy habits for osteoporosis prevention. Results After 12 months, the intervention group, but not the control group, had increased their physical activity (p=0.006), sun exposure (p=0.029), and calcium intake (53% to 64%).Conclusion A simple educational intervention in perimenopausal women from rural areas improved healthy habits for osteoporosis prevention (AU)

Intervención educativa para la prevención de osteoporosis en un servicio de Atención Primaria rural / Educational intervention for the prevention of osteoporosis in a rural Primary Healthcare service

Fundamento y objetivo: Determinar si una intervención educativa en mujeres perimenopáusicas rurales consigue cambios cuantificables en comportamientos de riesgo relacionados con la osteoporosis. Material y métodos: Ensayo clínico aleatorizado de grupos paralelos: 216 mujeres (45-54 años) de un servicio de Atención Primaria rural. Se recogieron preintervención y postintervención: índice de masa corporal (IMC), densitometría y analítica (calcio [Ca], parathormona [PTH]). Grupo intervención (n1 = 110): 2 talleres interactivos sobre prevención de osteoporosis. Grupo control (n2 = 106): información por correo.Resultados: Tras la intervención educativa, el grupo intervención mantuvo su IMC, aumentó su densidad mineral ósea (DMO) (p < 0,001) y disminuyó los niveles de Ca (p ≤ 0,048) y PTH (p < 0,001). El grupo control aumentó su IMC (p < 0,001) y su DMO (p ≤0,048), mantuvo sus niveles de Ca y disminuyó los de PTH (p = 0,01). Conclusiones: La mejoría de parámetros objetivos relacionados con la osteoporosis indica la validez de la educación sanitaria como medida preventiva en este grupo de mujeres. Sería interesante analizar la repercusión de esta mejoría a largo plazo en términos de reducir la incidencia de osteoporosis y de fracturas (AU)

Background and objective: The aim of this study is to determine whether an educational intervention in perimenopausal women in rural environments achieves significant changes in risk behaviors related to osteoporosis. Material and methods: Randomized clinical trials of parallel groups: 216 women (45-54 years old) of a rural Primary Healthcare service. Pre- and post- intervention were covered: body mass index (BMI), densitometry and blood test (calcium [Ca], parathormone [PTH]). Intervention group (n1 = 110): 2 interactive workshops on the prevention of osteoporosis. Control group (n2 = 106): information by post. Results: After the educational intervention, the intervention group maintained its BMI, increased its bone mineral density (BMD) (P < .001) and decreased the Ca (P ≤ .048) and PTH (P < .001) levels. The control group increased its BMI (P < .001) and its BMD (P ≤ .048), maintained its Ca levels and decreased the PTH values (P = .01).Conclusions: The improvement in the objective parameters related to osteoporosis indicates the importance of health education as a preventive measure in this group of women. It would be interesting to analyze the repercussions of this improvement on a long-term basis in terms of reducing the incidence of osteoporosis and fractures (AU)

Holoprosencefalia: a proposito de un caso / Holoprosencephaly: report a case

Se reporta el caso de una mujer de 22 años de edad, sin antecedentes de importancia. Fue admitida en el hospital, enpródromos de trabajo de parto, gestación de 40 semanas y malformación cerebral: holoprosencefalia semilobar, hipotelorismo, hidronefrosis derecha leve (diagnóstico ecográfico). Es intervenida mediante la operación cesáreaobteniéndose un recién nacido con características de holoprosencefalia siendo lo resaltante el hipotelorismo y laarrinencefalia. No presenta llanto al nacimiento, por lo que se le realiza maniobras de reanimación cardio pulmonar, continùaen mal estado general con periodos de apnea, baja saturación, expansibilidad torácica disminuida, se procede a colocaciónde tubo endotraqueal, administración de adrenalina, es llevada al servicio de unidad de cuidados intensivos pediátricos,presentando en el trayecto dos episodios de paro cardiaco, el menor luego es colocado en ventilador mecánico, no teniendouna buena evolución ,fallece el día siguiente de nacido.

It is reported the case of a woman, 22 years of age, without important background information. She was admitted to the hospital, in premonitory signs of 40 weeks and cerebral malformation: semilbar holoprosencephaly, hipotelorismo, mild right hydronephrosis (sonographic diagnosis). She is operated by the cesarean section obtaining a newborn with characteristics of holoprosencephaly remains what the striking hipotelorismo and arrinencefalia. There is no crying at birth, by what is realized maneuvers cardio pulmonary resuscitation, continues un poor condition general, with periods of apnea, low saturation, chest diminished expansibility, so proceeded to endotracheal tube placement, placement of adrenaline, is taken to the pediatric intensive care units, presenting in the journey two episodes of cardiac arrest, the minor then is placed on mechanical ventilator, not taking a good evolution, dies the net day of birth.

Relationship between glycated hemoglobin and glucose concentrations in the adult Galician population: selection of optimal glycated hemoglobin cut-off points as a diagnostic tool of diabetes mellitus

Aims/hypothesis To analyze the relationship between glucose and glycated hemoglobin (HbA1c) in the adult Galician population, evaluate the use of HbA1c for the screening and diagnosis of diabetes, and calculate the diagnostic threshold required for this purpose. Methods We analyzed data on 2848 subjects (aged 18-85 years) drawn from a study undertaken in 2004 to assess the prevalence of diabetes in Galicia. For study purposes, diabetes was defined using the criteria recommended in 2002. Participants were classified into four glucose-based groups. The relationship between glucose and HbA1c was described using linear regression models, generalized additive models and Spearman's correlation. Diagnostic capacity was assessed, and optimal HbA1c cut-off points were calculated as a diabetes marker using the receiver operating characteristic curve. Results Prevalence of pre-diabetes, unknown diabetes and known diabetes was 20.86, 3.37 and 4.39%, respectively. The correlations between HbA1c and fasting glucose were higher than those obtained for HbA1c and glycemia at 2h of the oral glucose overload (0.344 and 0.270, respectively). Taking glucose levels as the gold standard, a greater discriminatory capacity was obtained for HbA1c (area under de cruve: 0.839, 95% confidence intervals: 0.788-0.890). Based on the study criteria, the optimal minimum and maximum HbA1c values were 5.9% and 6.7%, respectively. Conclusions/interpretationHbA1c did not prove superior to glycemia for diagnosis of diabetes in the adult Galician population, and cannot therefore be used to replace the oral glucose tolerance test for screening and diagnosis purposes. Indeed, determination of glucose is essential to verify the diagnosis in the majority of cases (AU)

Objetivos/hipótesis: Analizar la relación entre la glucosa y la hemoglobina glucosilada (HbA1c)en la población gallega adulta, evaluar el uso de la HbA1c para cribado y diagnóstico de la diabetes y calcular el umbral diagnóstico necesario para este fin. Métodos: Se analizaron datos de 2.848 sujetos (de 18---85 años de edad) procedentes de un estudio emprendido en 2004 para valorar la prevalencia de diabetes en Galicia. A efectos del estudio, se definió la diabetes de acuerdo con los criterios recomendados en 2002. Se clasificó a los participantes en cuatro grupos en función de los valores de glucosa. Se describió la relación entre glucosa y HbA1c mediante modelos de regresión lineal, modelos aditivos generalizados yl a correlación de Spearman. Se valoró la capacidad diagnóstica y se calcularon los puntos de corte óptimos de la HbA1c como marcador de la diabetes empleando la curva de características operativas del receptor. Resultados: Las tasas de prevalencia de prediabetes, diabetes desconocida y diabetes conocidas eran del 10,86, 3,37 y 4,39%, respectivamente. Las correlaciones entre la HbA1c y la glucemia en ayunas eran mayores que las obtenidas entre la HbA1c y la glucemia en ayunas dos horas después de la sobrecarga oral de glucosa (0,344 y 0,270, respectivamente). Tomando los valores de glucosa como referencia, se obtuvo una mayor capacidad discriminatoria para la HbA1c (área bajo la curva: 0,839, intervalos de confianza del 95%: 0,788---0,890). Basándose en los criterios del estudio, los valores óptimos mínimos de la HbA1c eran del 5,9 y el 6,7%, respectivamente. Conclusiones/interpretación: La HbA1c no fue superior a la glucemia para el diagnóstico de la diabetes en la población gallega adulta, por lo que no puede utilizarse en lugar de la prueba de tolerancia oral a la glucosa con fines de cribado y diagnóstico. De hecho, la determinación de la glucosa es esencial para confirmar el diagnóstico en la mayoría de los casos (AU)

Efectos del tratamiento con Kinesio tape en el pie plano / Effects of treatment with Kinesio tape for flat feet

El objetivo principal de este estudio era evaluar los cambios producidos en el dolor posterior de la pierna y en el valgo del retropié mediante la aplicación del Kinesio tape (KT) sobre el musculo tibial posterior en sujetos con pies planos pronados. Para ello, se realizaron mediciones pre/post-intervencion (a las 24 h) del dolor percibido mediante la escala visual analogica (EVA) y de los grados de pronacion del retropie con la regla de Perthes, en 15 sujetos (13 mujeres, 2 hombres). Los resultados mostraron que los sujetos experimentales percibieron una disminucion estadisticamente significativa de su dolor tras la intervencion (p < 0,05). Sin embargo, no reflejaron un cambio estadisticamente significativo en la pronacion del retropie (p ≥ 0,05). Asi mismo, no se observaron diferencias estadisticamente significativas entre sexos o grados de obesidad en los valores preintervencion y post-intervencion del dolor percibido ni en los grados de pronacion del retropie. En conclusion, los resultados obtenidos de este trabajo parecen indicar que un KT aplicado 24 h sobre el musculo tibial posterior en sujetos con pies pronados puede producir una disminucion de la sintomatologia dolorosa de la zona, pero no del grado de pronacion del retropie (AU)

Abstract The main purpose of this study was to investigate changes in pain in the back of leg and hindfoot valgus with Kinesio tape application over tibialis posterior muscle in subjects with flat feet. We made pre-post-intervention measurements (24hours) of perceived pain with visual analogue scale (VAS) and degrees of pronation rear foot with Perthes Ruler in 15 subjects (13 women, 2 men). The results showed that the subjects perceived a statistically significant decrease in their pain after treatment (P<0.05). However, a statistically significant change was not observed in rearfoot pronation (P≥0.05). Similarly, no statistically significant differences were observed between gender or degrees of obesity in pre-post intervention measures of perceived pain and the degree of pronation rearfoot. In conclusion, the results obtained in this study suggest that Kinesio tape application for 24hours over tibialis posterior muscle in subjects with flat feet can decrease pain in the area but not the degrees of rearfoot pronation

Índice de errores de dispensación en una farmacia / No disponible

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Incapacitados con ACV / Patients disabled due to a V.C.A

Objetivo: Conocer las características de nuestros pacientes incapacitados con A.C.V., en función de sus variables socio-demográficas, capacidad funcional y diagnósticos enfermeros más frecuentes. Material y método: Estudio descriptivo transversal. La población objeto de estudio: pacientes con accidente cerebro-vascular incluidos en el programa de incapacitados de dos Zonas Básicas de Salud de Marbella. Resultados: El número de pacientes con A.C.V. fue de 86, lo que supone un 23 por ciento de los pacientes incapacitados del programa, de los que obtuvimos sus características demográficas, convivencia, capacidad funcional para las actividades de la vida diaria así como los diagnósticos enfermeros que presentaban. Discusión: Determinar aquellos problemas y áreas de necesidad que con mayor frecuencia afectan a nuestros pacientes con A.C.V. nos permitirá detectar y planificar mejor nuestras intervenciones mediante la realización de planes de cuidados estandarizados que nos garanticen la continuidad y calidad de nuestros cuidados. Estudio presentado como comunicación oral que obtuvo el I Premio del XI Congreso y XIV Jornadas Nacionales de Enfermería Vascular (AU)

Cambios en la estructura histológica del útero de chinchillas (Eryomis laniger) jóvenes y adultas implantadas con zeranol / Histomorphological changes in the uterus of young and adult chinchillas (eryomis laniger) implanted with zearalenol

El propósito del presente estudio fue evaluar el efecto del zeranol sobre la estructura histológica del útero de chinchillas implantadas con este compuesto por vía subcutánea a dosis de 12 mg/animal. Se utilizaron 30 chinchillas con las que se formaron dos grupos, uno de hembras vírgenes de 12 a 15 meses de edad y otro de hembras adultas de 24 a 30 meses de edad, con partos previos. Cada uno de estos grupos tuvo su respectivo testigo. Los animales fueron sacrificados y se obtuvieron fragmentos de útero para efectuar su evaluación histológica. En los animales implantados, de ambas edades, los hallazgos más relevantes fueron aumento de dos a tres veces las dimensiones del útero (determinado en campos microscópicos), congestión vascular en la lámina propia y en el miometrio. Asimismo, se observaron células epiteliales en mitosis o apoptosis en los animales implantados de 12 a 15 meses de edad, mientras que en las hembras con edad de 24 a 30 meses se identificaron de cuatro a cinco veces más células mitóticas o apoptóticas, respectivamente, en las hembras implantadas en relación con las no implantadas; se cuantificó un mayor número de glándulas endometriales en la mayoría de los animales implantados de ambas edades. En el endometrio de los animales no implantados no se observó congestión vascular y sólo en 20 por ciento de los animales de 24 a 30 meses de edad se observó mitosis o apoptosis. Estos resultados demuestran que el zeranol a dosis de 12 mg/ animal induce en el útero de las chinchillas jóvenes y adultas, cambios en los ámbitos vascular y tisular, característicos de un estado estrogénico predominante.

Efecto del zeranol sobre la maduración de piel en chinchilla lanígera (Eryomis laniger) / Zeranol effect over chinchilla's (Eryomis laniger) fur maturation

Con el objeto de evaluar el efecto de la lactona del ácido resorcílico (zeranol) sobre la maduración de la piel de chinchilla, se realizó un experimento en un diseño completamente al azar por grupo de edad y sexo. El estudio duró 4 meses en la época de verano-otoño (junio-septiembre). Se incluyeron 33 hembras vírgenes de 12 a 24 meses de edad, 60 machos de 12 a 18 meses; y 29 hembras en producción de 24 a 48 meses de edad; a la mitad de los animales se les implantó subcutáneamente 12 mg de zeranol. La evaluación visual se hizo cada 2 semanas y se obtuvieron las pieles cuando las 3 franjas del color del pelo presentaban el mismo nivel en toda la superficie del cuerpo, momento en el cual se considera como piel madura. Se realizó un análisis de sobrevida mediante el método de Log Rank ajustado por grupos, en el cual se encontró un efecto anagénico significativo (P< 0.01) del zeranol. El porcentaje de maduración en los animales implantados fue 84 por ciento, 94 por ciento y 50 por ciento en los machos, hembras jóvenes y hembras adultas, respectivamente; mientras que para los no tratados la maduración fue de 20 por ciento, 38 por ciento y 13.3 por ciento, para los mismos grupos. Se hicieron dos análisis de Log Rank ajustado por grupos de tratamiento, los cuales mostraron un efecto de edad y sexo; en ambos casos las hembras jóvenes presentaron un mayor porcentaje de maduración que las hembras adultas y que los machos (P< 0.01)