Spanish translation and validation of the Music-Related Quality of Life Questionnaire (MuRQoL) in postlingually deaf cochlear implant users.

PURPOSE: The aim of this study was to translate and validate the "Music-Related Quality of Life Questionnaire" into Spanish (sMuRQoL) and assess its convergent validity and discriminative capacity by comparing its scores with the outcomes of the musical perception test Meludia. METHODS: The sMuRQoL was completed by 129 patients: 55 cochlear implant (CI) users and 74 normal hearing (NH) individuals. Conducted in this study were an exploratory factor analysis, an evaluation of internal consistency, an assessment of score stability through test-retest reliability, a comparison of sMuRQoL scores between CI users and NH individuals and an examination of potential evidence of convergent validity and discriminative capacity of sMuRQoL in relation to other tools. This involved the comparison of the questionnaire scores with the Meludia outcomes. RESULTS: The sMuRQoL demonstrated a two-dimensional structure. All the dimensions displayed high internal consistency (α = 0.879-0.945) and score stability (ICC = 0.890-0.942). There were significant differences in the Frequency test between NH and CI users (d = 1.19-1.45). There's evidence of convergent validity between the scores of the Frequency test and the results of Meludia (r = 0.242-0.645). Additionally, the Frequency test demonstrate a good discriminative capacity to identify patients with poorer musical perception. CONCLUSIONS: The sMuRQoL is a reliable questionnaire, with adequate evidence of validity based on internal structure. This study provides an accessible, cost-effective, and quick-to-administer instrument in Spanish, optimizing available healthcare resources and bringing us closer to the patient needs.

Solid pseudopapillary neoplasms of the pancreas: Multicenter Vasepa study.

INTRODUCTION: Solid pseudopapillary tumors (SPT) of the pancreas are rare exocrine neoplasms of the pancreas. Correct preoperative diagnosis is not always feasible. The treatment of choice is surgical excision. These tumors have a good prognosis with a high disease-free survival rate. OBJECTIVE: To describe the clinicopathological and radiological characteristics as well as short- and long-term follow-up results of patients who have undergone SPT resection. METHODS: Multicenter retrospective observational study in patients with SPT who had undergone surgery from January 2000-January 2022. We have studied preoperative, intraoperative, and postoperative variables as well as the follow-up results (mean 28 months). RESULTS: 20 patients with histological diagnosis of SPT in the surgical specimen were included. 90% were women; mean age was 33.5 years (13-67); 50% were asymptomatic. CT was the most used diagnostic test (90%). The most frequent location was body-tail (60%). Preoperative biopsy was performed in 13 patients (65%), which was correct in 8 patients. Surgeries performed: 7 distal pancreatectomies, 6 pancreaticoduodenectomies, 4 central pancreatectomies, 2 enucleations, and 1 total pancreatectomy. The R0 rate was 95%. Four patients presented major postoperative complications (Clavien-Dindo > II). Mean tumor size was 81 mm. Only one patient received adjuvant chemotherapy. With a mean follow-up of 28 months, 5-year disease-free survival was 95%. CONCLUSION: SPT are large, usually located in the body-tail of the pancreas, and more frequent in women. The R0 rate obtained in our series is very high (95%). The oncological results are excellent.

Is It Necessary to Adapt Training According to the Menstrual Cycle? Influence of Contraception and Physical Fitness Variables.

(1) Background: The influence of the menstrual cycle on physical fitness in athletes is controversial in the scientific literature. There is a marked fluctuation of sex hormones at three key points of the menstrual cycle, where estrogen and progesterone vary significantly. Hormonal contraception induces hormonal levels different from the natural menstrual cycle, requiring specific study in relation to physical fitness. (2) Method: Women aged 18 to 40 years with regular natural menstrual cycles and women using hormonal contraception were recruited, creating two study groups. All participants needed to be athletes classified as level II-III, based on training volume/physical activity metrics, among other variables. To assess their physical fitness, cardiorespiratory fitness (measured by V˙O2max), high-speed strength, hand grip strength, and flexibility were evaluated. Blood samples were taken to determine the menstrual cycle phase through analysis of sex hormone levels. Additionally, urine tests for ovulation detection were performed for the natural menstrual cycle group. Neurosensory stimulation tests were incorporated to measure sensory thresholds and pain thresholds in each phase. Body composition in each phase and its relationship with the other variables were also taken into account. (3) Results: Athletes in the natural cycling group showed differences in V˙O2max (mL·kg-1·min-1) (phase I = 41.75 vs. phase II = 43.85 and (p = 0.004) and phase I vs. phase III = 43.25 mL·kg-1·min-1 (p = 0.043)), as well as in body weight (phase I = 63.23 vs. phase III = 62.48 kg; p = 0.006), first pain threshold (phase I = 1.34 vs. phase II = 1.69 (p = 0.027) and phase III = 1.59 mA (p = 0.011)), and sensitive threshold (phase I = 0.64 vs. phase II = 0.76 mA (p = 0.017)). The pain threshold was found to be an important covariate in relation to V˙O2max, explaining 31.9% of the variance in phase I (p = 0.006). These findings were not observed between the two phases of contraceptive cycling. (4) Conclusion: The natural menstrual cycle will cause significant changes in the physical fitness of athletes. The use of hormonal contraception is not innocuous. Women with natural cycles show an increase in cardiorespiratory fitness in phases II and III, which is a factor to be considered in relation to training level and workload.

Clinical Features and Outcomes Associated with Bronchial Asthma Among COVID-19 Hospitalized Patients.

Background: The impact of diagnosis treatment and bronchial asthma on coronavirus disease 2019 (COVID-19) associated outcomes remains unclear. Objective: To identify the prevalence and outcomes associated with asthma among hospitalized patients with COVID-19. Methods: Electronic health records of 130 patients with asthma among hospitalized patients with COVID-19 were reviewed. Two subgroups of asthmatic patients were compared according to clinical outcomes during hospitalization. Patients with death results, intubation, and/or need of intensive care unit (ICU) stay were grouped as asthmatic patients with severe COVID-19 outcomes, and the rest were grouped as asthmatic patients with non-severe COVID-19 outcomes. Multivariable analyses were conducted with logistic regression to identify independent risk factors for severe outcomes. Results: The prevalence of asthma in COVID-19 hospitalized patients was 5%. The mean age was 59.4 years and 54% were women. 17% received treatment in GINA step 4-5 asthma at the time of admission. An allergic asthma phenotype was determined in 38%. There was no significant difference in hospital length of stay or need for intubation between asthmatic patients and global COVID-19 admitted patients. 17% of asthmatic patients developed a severe outcome, and 5% had a death result. Elevated Lactate Dehydrogenase (LDH) level, low transcutaneous pulse oximetry (SpO2), the coexistence of atrial fibrillation (AF), and need for moderate or high ICS at admission were independent risk factors for a worse outcome in asthmatics COVID-19 hospitalized patients. Conclusion: The prevalence of asthma in COVID-19 hospitalized patients was 5%, consistent with the asthma prevalence in the general population. The asthmatic patients with the previous prescription of moderate or high doses of ICS and/or coexistence of atrial fibrillation at admission had a higher risk of the severe outcome.

Breast Cancer Patients' Experiences with Online Group-Based Physical Exercise in a COVID-19 Context: A Focus Group Study.

In patients with breast cancer, physical exercise reduces the toxicity of treatment; however, this physical exercise must meet a set of criteria, such as being guided by knowledgeable instructors. Thus, the aim of this study was to explore the perceptions of female breast cancer patients regarding the impact of an online physical exercise programme in the context of the COVID-19 pandemic. Nineteen female breast cancer patients participated in four focus group interviews as part of a qualitative study using a thematic analysis between December 2020 and May 2021. Three major themes emerged: "Experiences and perceptions of online physical exercise with breast cancer"; "Incorporating exercise-based activity for cancer-related side effects"; and "Increasing self-esteem and empowerment". Online, live-streamed, and supervised group activities help breast cancer patients engage and prevent the recurrence of cancer-related side effects, as well as to control COVID-19-related fear and provide an alternative to promote mental health-related quality of life.

Using Y-chromosome capture enrichment to resolve haplogroup H2 shows new evidence for a two-path Neolithic expansion to Western Europe.

Uniparentally-inherited markers on mitochondrial DNA (mtDNA) and the non-recombining regions of the Y chromosome (NRY), have been used for the past 30 years to investigate the history of humans from a maternal and paternal perspective. Researchers have preferred mtDNA due to its abundance in the cells, and comparatively high substitution rate. Conversely, the NRY is less susceptible to back mutations and saturation, and is potentially more informative than mtDNA owing to its longer sequence length. However, due to comparatively poor NRY coverage via shotgun sequencing, and the relatively low and biased representation of Y-chromosome variants on capture assays such as the 1240 k, ancient DNA studies often fail to utilize the unique perspective that the NRY can yield. Here we introduce a new DNA enrichment assay, coined YMCA (Y-mappable capture assay), that targets the "mappable" regions of the NRY. We show that compared to low-coverage shotgun sequencing and 1240 k capture, YMCA significantly improves the mean coverage and number of sites covered on the NRY, increasing the number of Y-haplogroup informative SNPs, and allowing for the identification of previously undiscovered variants. To illustrate the power of YMCA, we show that the analysis of ancient Y-chromosome lineages can help to resolve Y-chromosomal haplogroups. As a case study, we focus on H2, a haplogroup associated with a critical event in European human history: the Neolithic transition. By disentangling the evolutionary history of this haplogroup, we further elucidate the two separate paths by which early farmers expanded from Anatolia and the Near East to western Europe.

2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy.

Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4-1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI.

Recovery of Inflammation, Cardiac, and Muscle Damage Biomarkers After Running a Marathon.

ABSTRACT: Bernat-Adell, MD, Collado-Boira, EJ, Moles-Julio, P, Panizo-González, N, Martínez-Navarro, I, Hernando-Fuster, B, and Hernando-Domingo, C. Recovery of inflammation, cardiac and muscle damage biomarkers after running a marathon. J Strength Cond Res 35(3): 626-632, 2021-Physical endurance sports conditions the increase of blood biomarkers responsible for the acute inflammatory response. The purpose of this study was to observe the impact of intense physical exercise on these biomarkers and detect their recovery pattern. This is an experimental study of repeated measures (pre-post marathon). The biomarkers lactate dehydrogenase (LDH), creatine kinase (CK), high-sensitivity troponin T (hs-TNT), and C-reactive protein (CRP) were analyzed in a total of 86 runners, 24 hours before the marathon, immediately after finishing the race and at 24, 48, 96, and 144 postrace hours. The comparative analyses were performed using the Friedman and Wilcoxon tests. The correlations between dependent and independent variables were analyzed using Spearman correlations. The data were processed through the IBM SPSS package, version 23. Significant value was p ≤ 0.05. The LDH increased and showed significant differences (p ≤ 0.001) for all times, compared with the initial LDH value, normalizing after 192 hours (p = 0.667) (effect size [ES], r = 0.807). The CK increased and showed significant differences (p ≤ 0.001) (ES, r = 0.975) up to 96 hours afterward, normalizing after 144 hours. The hs-TNT presented an increase and showed significant differences (p ≤ 0.001) between the pre-post race times, 24 and 48 hours, normalizing after 96 hours, although it showed a new significant value at 192 hours (p ≤ 0.001) (ES, r = 0.519). The CRP increased and showed significant differences (p ≤ 0.001) between the pre-post race times, at 24, 48, 96, 144, and 192 hours after race. The recovery after alterations produced by the marathon varies according to the biomarker. Blood levels of biomarkers decrease with longer race times. Greater energy expenditure increases the blood levels of LDH, CK, and hs-TNT.

Quick Recovery of Renal Alterations and Inflammatory Activation after a Marathon.

PURPOSE: We evaluated the incidence of acute kidney injury in a cohort of marathon participants. METHODS: We conducted a prospective observational study focused on evaluating the incidence of kidney damage after a marathon, and its evolution in the first 48 h after the marathon in 88 runners who completed the Valencia Marathon. RESULTS: From the 88 participants, 42 (48.28%) presented with acute kidney injury, mainly grade 1 (95.20%). Microscopic haematuria was observed in 29 runners (33%). Levels of interleukin 6, leukocytes, and neutrophils were markedly increased at the marathon's finish line. CONCLUSIONS: Our results confirmed that there are slight transient changes in glomerular filtration rate and inflammatory activation after a marathon.

Effect of elastic bandage on postural control in subjects with chronic ankle instability: a randomised clinical trial.

PURPOSE: To report the immediate and prolonged (one week) effects of elastic bandage (EB) on balance control in subjects with chronic ankle instability. MATERIAL AND METHODS: Twenty-eight individuals successfully completed the study protocol, of whom 14 were randomly assigned to the EB group (7 men, 7 women) and 14 were assigned to the non-standardised tape (NST) group (9 men, 5 women). To objectively measure postural sway we used computerised dynamic posturography (CDP) with sensory organisation test (SOT) and unilateral stance (US) test. We analysed the following SOT parameters: the composite SOT score, the composite SOT strategy and the SOT condition 2 and its strategy. In addition, we studied the centre of gravity (COG) sway velocity with open eyes and close eyes during the US test. RESULTS: Repeated measures ANOVA showed a significant effect for time in composite SOT score (F= 34.98; p= <0.01), composite SOT strategy (F= 12.082; p= 0.02), and COG sway with open eyes (F= 3.382; p= 0.039) in EB group and NST group. Therefore, there were improvements in balance control after bandage applications (defined as better scores in SOT parameters and decreased COG sway in US test). However, no differences between groups were observed in the most relevant parameters. CONCLUSIONS: This study did not observe differences between EB and NST during the follow-up in the majority of measurements. Several outcome measures for SOT and US tests improved in both groups immediately after bandage applications and after one week of use. EB of the ankle joint has no advantage as compared to the non-standardised tape. Implications for rehabilitation Elastic bandage (EB) of the ankle joint has no advantage as compared to the non-standardised tape. The effects of the bandages could be due to a greater subjective sense of security. It is important to be prudent with the use of bandage, since a greater sense of safety could also bring with it a greater risk of injury. The application of the bandage on subjects with chronic ankle instability (CAI) should be prolonged and used alongside other physiotherapy treatments.

Effect of Kinesiology Tape on Measurements of Balance in Subjects With Chronic Ankle Instability: A Randomized Controlled Trial.

OBJECTIVE: To examine the immediate and prolonged effects (7d) of Kinesiology Tape (KT) on balance in subjects with chronic ankle instability using computerized dynamic posturography (CDP). DESIGN: A 7-day follow-up, single-blind randomized controlled trial. SETTING: University community. PARTICIPANTS: Subjects (N=36) were screened for possible eligibility criteria, and 30 successfully completed the study protocol. Of these, 15 were randomly assigned to the experimental group (KT: 5 men, 10 women), and 15 were assigned to the control group (placebo tape: 10 men, 5 women). INTERVENTIONS: The experimental group was taped for a lateral ankle sprain with KT. In the control group, a placebo tape was used. Balance was assessed under the following 3 conditions: without taping, immediately after application, and after 7 days of use. MAIN OUTCOME MEASURES: The CDP device used in this study was the Smart Equitest version 8.2. CDP analysis was conducted using the Sensory Organization Test (SOT). As primaries outcome measures, the composite SOT score and composite SOT strategy were chosen. The partial score for SOT condition 2 and its strategy were considered as the secondary outcomes measures. RESULTS: Repeated-measures analysis of variance (ANOVA) demonstrated that there was not a significant interaction between group and time in the composite SOT score (F=.239; P=.73), SOT condition 2 (F=.333; P=.705), and SOT strategy 2 (F=.899; P=.43). Additionally, repeated-measures ANOVA showed a significant effect for time (composite SOT score: F=40.69; P≤.01; SOT condition 2: F=4.61; P=.014; SOT strategy 2: F=.899; P=.413; composite SOT strategy: F=15.14; P≤.01). Specifically, post hoc analysis showed that both groups obtained improvements in composite SOT scores immediately after tape application and 7 days of use. CONCLUSIONS: According to our results, the SOT scores of both the KT and control groups improved during follow-up. No differences between them were observed during the follow-up in most balance measurements. The observed changes may be related to a subjective increase in confidence after the tape application.

Intestinal failure.

PURPOSE OF REVIEW: The gastrointestinal tract plays a major role in critical illness. We will review four common problem areas pertaining to the gut and abdominal compartment that intensivists managing critically ill patients must deal with on an everyday basis. RECENT FINDINGS: In the area of enteral nutrition, there have been concerns that early feeding in hemodynamically unstable patients might cause bowel infarction by increasing the gut oxygen consumption beyond splanchnic oxygen delivery. The most recent data suggest that early enteral feeding, even when patients are receiving vasopressors, is safe and may actually protect the gut by increasing gut perfusion. Although there are no new treatments for ileus, in most critically ill patients ileus primarily affects the stomach and large intestine, and most patients who are diagnosed with ileus may still be fed enterally as long as they are fed distal to the stomach. Diarrhea is a common occurrence in the intensive care unit, particularly in patients who are being fed enterally. Of most import is the realization that Clostridium difficile infection is ubiquitous and must be considered in virtually every case of diarrhea. Abdominal compartment syndrome is usually a result of shock, and its resuscitation with increased intra-abdominal pressure results in many untoward hemodynamic and respiratory events. Early recognition and treatment seem to be associated with improved outcome. SUMMARY: Continued progress in the areas of optimal nutritional support, understanding the implications of alterations in immune function of the gut, and the avoidance of such morbid complications as abdominal compartment syndrome are expected.

Delivery of radiofrequency energy to the lower esophageal sphincter improves symptoms of gastroesophageal reflux.

BACKGROUND: The Stretta procedure has been proposed as a novel therapeutic alternative to antireflux surgery for gastroesophageal reflux disease (GERD). Early reports indicated improvement in GERD symptoms overall, but improvement in patients who have poor outcome after surgery remains unclear. METHODS: Patients with reflux who did not have a hiatal hernia were offered the procedure. All were administered a GERD Health Related Quality of Life survey at preprocedure and at greater than 3 months postprocedure. Differences in pre- and postprocedure responses were deemed significant with the use of the Wilcoxon rank sum test with P <.05. RESULTS: Fifty patients underwent the Stretta procedure. There were no complications. All were evaluated postprocedure, with 74% completing a postprocedure survey. Overall heartburn score improved from 3.19 (scale, 0-5) preprocedure to 1.74 postprocedure (P=.0012). Overall symptoms satisfaction score improved from 3.92 to 1.63 (P=.0001). Symptoms satisfaction score of patients who failed antireflux surgery improved from 3.5 to 1.75 (P=.0166), and, in those with a body mass index >30, it improved from 4.11 to 1.56 (P=.0024). Four patients went on to have antireflux surgery after having the Stretta procedure. CONCLUSIONS: Stretta improves heartburn symptoms both overall and in patients with poor outcome after antireflux surgery, with a low procedural risk. It may have a role in the treatment of patients with primary reflux and in those who have failed antireflux surgery or who are a high risk for surgery.