Clinical relevance of combined treatment with exercise in patients with chronic low back pain: a randomized controlled trial.

Low back pain is a widespread public health concern owing to its high prevalence rates according to the Global Burden of Diseases. This study aimed to investigate the effect of exercise alone or in combination with manual therapy and kinesiotherapy on pain sensitivity, disability, kinesiophobia, self-efficacy, and catastrophizing in patients with chronic low back pain (CLBP). A total of 55 participants were enrolled and randomly allocated to one of three groups: (1) exercise alone group (ET; n = 19), (2) exercise + manual therapy group (ETManual therapy; n = 18), and (3) exercise + kinesio tape group (ETkinesiotape; n = 18). The interventions consisted of core stabilization exercises (ET group), prior spinal manipulation with core exercises (ETManual therapy group), and combined application of kinesiotape plus core stabilization exercises (ETkinesiotape group). The primary outcome was disability. The secondary outcomes were pain sensitization, kinesiophobia, catastrophizing, and self-efficacy. Assessments were performed at baseline and at weeks 3, 6, and 12. All therapies applied achieved significant improvements over time after 12 weeks in all parameters analyzed. ETmanualtherapy showed the greatest changes in all variables, with significant differences from the rest of the interventions in Oswestry (ODI) (3 and 6 weeks, respectively). A clinically significant cutoff point was achieved for the ETmanualtherapy group in the ODI parameter (-54.71%, -63.16% and -87.70% at 3, 6, and 12 weeks, respectively). Manual therapy prior to the core exercise technique was the most effective approach to improve health-related functionality compared with exercise alone or exercise combined with kinesiotape in patients with CLBP.Clinical Trial Registration Number: NCT05544890.

Excited-state quantum phase transitions in the anharmonic Lipkin-Meshkov-Glick model: Dynamical aspects.

The standard Lipkin-Meshkov-Glick (LMG) model undergoes a second-order ground-state quantum phase transition (QPT) and an excited-state quantum phase transition (ESQPT). The inclusion of an anharmonic term in the LMG Hamiltonian gives rise to a second ESQPT that alters the static properties of the model [Gamito et al., Phys. Rev. E 106, 044125 (2022)2470-004510.1103/PhysRevE.106.044125]. In the present work, the dynamical implications associated to this new ESQPT are analyzed. For that purpose, a quantum quench protocol is defined on the system Hamiltonian that takes an initial state, usually the ground state, into a complex excited state that evolves on time. The impact of the new ESQPT on the time evolution of the survival probability and the local density of states after the quantum quench, as well as on the Loschmidt echoes and the microcanonical out-of-time-order correlator (OTOC) are discussed. The anharmonity-induced ESQPT, despite having a different physical origin, has dynamical consequences similar to those observed in the ESQPT already present in the standard LMG model.

Excited-state quantum phase transitions in the anharmonic Lipkin-Meshkov-Glick model: Static aspects.

The basic Lipkin-Meshkov-Glick model displays a second-order ground-state quantum phase transition and an excited-state quantum phase transition (ESQPT). The inclusion of an anharmonic term in the Hamiltonian implies a second ESQPT of a different nature. We characterize this ESQPT using the mean field limit of the model. The alternative ESQPT, associated with the changes in the boundary of the finite Hilbert space of the system, can be properly described using the order parameter of the ground-state quantum phase transition, the energy gap between adjacent states, the participation ratio, and the quantum fidelity susceptibility.

Clinical guide to perioperative management for videothoracoscopy lung resection (Section of Cardiac, Vascular and Thoracic Anesthesia, SEDAR; Spanish Society of Thoracic Surgery, SECT; Spanish Society of Physiotherapy).

The introduction of video-assisted thoracoscopic (VATS) techniques has led to a new approach in thoracic surgery. VATS is performed by inserting a thoracoscope through a small incisions in the chest wall, thus maximizing the preservation of muscle and tissue. Because of its low rate of morbidity and mortality, VATS is currently the technique of choice in most thoracic procedures. Lung resection by VATS reduces prolonged air leaks, arrhythmia, pneumonia, postoperative pain and inflammatory markers. This reduction in postoperative complications shortens hospital length of stay, and is particularly beneficial in high-risk patients with low tolerance to thoracotomy. Compared with conventional thoracotomy, the oncological results of VATS surgery are similar or even superior to those of open surgery. This aim of this multidisciplinary position statement produced by the thoracic surgery working group of the Spanish Society of Anesthesiology and Reanimation (SEDAR), the Spanish Society of Thoracic Surgery (SECT), and the Spanish Association of Physiotherapy (AEF) is to standardize and disseminate a series of perioperative anaesthesia management guidelines for patients undergoing VATS lung resection surgery. Each recommendation is based on an in-depth review of the available literature by the authors. In this document, the care of patients undergoing VATS surgery is organized in sections, starting with the surgical approach, and followed by the three pillars of anaesthesia management: preoperative, intraoperative, and postoperative anaesthesia.

Guía clínica en el manejo perioperatorio para la cirugía de resección pulmonar por videotoracoscopia (Sección de Anestesia Cardiaca, Vascular y Torácica, SEDAR; Sociedad Española de Cirugía Torácica, SECT; Asociación Española de Fisioterapia, AEF) / Clinical guide to perioperative management for videothoracoscopy lung resection (Section of Cardiac, Vascular and Thoracic Anesthesia, SEDAR; Spanish Society of Thoracic Surgery, SECT; Spanish Society of Physiotherapy)

La introducción de técnicas toracoscópicas asistidas por video en cirugía torácica (VATS) ha permitido realizar un nuevo enfoque en la cirugía torácica. El acceso videotoracoscópico se realiza con pequeñas incisiones, preservando al máximo los músculos y los tejidos. En la actualidad, la VATS se considera de elección en la mayoría de los procedimientos torácicos, principalmente debido a la menor morbimortalidad asociada. La resección pulmonar por VATS presenta reducción de las fugas de aire prolongadas, arritmias, neumonía, dolor postoperatorio y una disminución de los marcadores inflamatorios. Esta reducción de las complicaciones postoperatorias está vinculada a una reducción de la estancia hospitalaria, siendo los pacientes de alto riesgo y con poca tolerancia a la toracotomía los principales beneficiarios de esta técnica.En comparación con la toracotomía convencional, los?resultados?oncológicos de la cirugía VATS son similares o incluso superiores a los de la cirugía abierta.Este documento, de redacción multidisciplinar, consensuado por el grupo de trabajo de cirugía torácica de la Sociedad Española de Anestesiología y Reanimación (SEDAR), de la Sociedad Española de Cirugía Torácica (SECT) y la Asociación Española de Fisioterapia (AEF), pretende estandarizar y difundir, con base en la bibliografía más actual, las mejores pautas de manejo clínico perioperatorio de los pacientes que se someten a una cirugía de resección pulmonar por VATS. Cada recomendación parte de una revisión de la literatura disponible y analizada en profundidad por los autores.Con el objetivo de dirigir el curso asistencial que seguirá el paciente que se somete a una cirugía pulmonar por VATS, esta guía se organiza inicialmente en el enfoque quirúrgico, seguido de los tres puntos clásicos del proceso anestésico. Estos puntos son preoperatorio, intraoperatorio y postoperatorio.(AU)

The introduction of video-assisted thoracoscopic (VATS) techniques has led to a new approach in thoracic surgery. VATS is performed by inserting a thoracoscope through a small incisions in the chest wall, thus maximizing the preservation of muscle and tissue. Because of its low rate of morbidity and mortality, VATS is currently the technique of choice in most thoracic procedures. Lung resection by VATS reduces prolonged air leaks, arrhythmia, pneumonia, postoperative pain and inflammatory markers. This reduction in postoperative complications shortens hospital length of stay, and is particularly beneficial in high-risk patients with low tolerance to thoracotomy.Compared with conventional thoracotomy, the oncological results of VATS surgery are similar or even superior to those of open surgery.This aim of this multidisciplinary position statement produced by the thoracic surgery working group of the Spanish Society of Anesthesiology and Reanimation (SEDAR), the Spanish Society of Thoracic Surgery (SECT), and the Spanish Association of Physiotherapy (AEF) is to standardize and disseminate a series of perioperative anaesthesia management guidelines for patients undergoing VATS lung resection surgery. Each recommendation is based on an in-depth review of the available literature by the authors.In this document, the care of patients undergoing VATS surgery is organized in sections, starting with the surgical approach, and followed by the three pillars of anaesthesia management: preoperative, intraoperative, and postoperative anaesthesia.(AU)

Usefulness of thoracic ultrasound for diagnosis and follow-up of pneumonia.

Classically the diagnosis of both bacterial and viral pneumonias was made with chest radiology, later the use of chest CT was implemented, however in recent years lung ultrasound has become very important in the diagnosis of pulmonary pathology and increased in pandemic by SARS-CoV-2, due to the practicality of being done at the patient's bedside, the ability to be reproducible, and the decrease in radiation exposure to patients.

High serum nitrates levels in non-survivor COVID-19 patients / Altas concentraciones séricas de nitratos en pacientes fallecidos por COVID-19

Objective: Higher blood nitrate and nitrite levels have been found in coronavirus disease 2019 (COVID-19) patients than in healthy subjects. The present study explores the potential association between serum nitrate levels and mortality in COVID-19 patients. Design: A prospective observation study was carried out. Setting: Eight Intensive Care Units (ICUs) from 6 hospitals in the Canary Islands (Spain). Patients: COVID-19 patients admitted to the ICU. Interventions: Determination of serum nitrate levels at ICU admission. Main variable of interest: Mortality at 30 days. Results: Non-surviving (n=11) compared to surviving patients (n=42) showed higher APACHE-II (p<0.001) and SOFA scores (p=0.004), and higher serum nitrate levels (p=0.001). Logistic regression analyses showed serum nitrate levels to be associated to 30-day mortality after controlling for SOFA (OR=1.021; 95%CI=1.006–1.036; p=0.01) or APACHE-II (OR=1.023; 95%CI=1.006–1.041; p=0.01). There were no differences in the area under the curve (AUC) for mortality prediction by serum nitrate levels (AUC=83%; 95%CI=73–92%; p<0.001), APACHE II (AUC=85%; 95%CI=75–96%; p<0.001) and SOFA (AUC=78%; 95%CI=63–92%; p=0.005) based on the DeLong method. The Kaplan–Meier analysis found patients with serum nitrates levels>68.4μmol/l to have a higher mortality rate (hazard ratio=138.8; 95%CI=22.3–863.9; p<0.001). Conclusions: The main novel finding was the association between serum nitrate levels and mortality in COVID-19 patients controlling for the SOFA or APACHE-II scores, though larger studies are needed to confirm this observation (AU)

Objetivo: Se han encontrado niveles más elevados de nitratos en la sangre de pacientes con enfermedad del coronavirus 2019 (COVID-19) que en sujetos sanos. Por lo tanto, el objetivo de estudio consistió en explorar la posible asociación entre los niveles séricos de nitratos y la mortalidad de pacientes por COVID-19. Diseño: Estudio observacional y prospectivo. Ámbito: Ocho unidades de cuidados intensivos (UCI) de 6 hospitales de las Islas Canarias (España). Pacientes: Pacientes COVID-19 ingresados en la UCI. Intervenciones: Se midieron los niveles séricos de nitratos al ingreso en la UCI. Variable de interés principal: Mortalidad a los 30 días. Resultados: Los pacientes fallecidos (n=11) comparados con los supervivientes (n=42) presentaron mayores APACHE-II (p<0,001), SOFA (p=0,004) y niveles séricos de nitratos (p=0,001). Los análisis de regresión logística mostraron una asociación entre los niveles séricos de nitratos al ingreso en la UCI y la mortalidad a los 30 días controlando por SOFA (OR:1.021; IC 95%:1.006-1.036; p=0,01) o APACHE-II (OR:1.023; IC 95%:1.006-1.041; p=0,01). No encontramos diferencias en el área bajo la curva (ABC) para la predicción de mortalidad entre los niveles séricos de nitratos (ABC:83%; IC 95%:73-92%; p<0,001), APACHE-II (ABC:85%; IC 95%:75-96%; p<0,001) y SOFA (ABC:78%; IC 95%:63-92%; p=0,005) con el método de DeLong. El análisis de Kaplan-Meier mostró que los pacientes que tenían niveles séricos de nitratos al ingreso en la UCI>68,4μmol/l presentaban mayor riesgo de fallecer (hazard ratio:138,8; IC 95%:22,3-863,9; p<0,001). Conclusiones: El principal nuevo hallazgo fue la asociación entre los niveles séricos de nitratos y la mortalidad de pacientes COVID-19 controlando por SOFA o APACHE-II; pero estudios de mayor tamaño muestral son necesarios para confirmar este resultado (AU)

High serum nitrates levels in non-survivor COVID-19 patients.

OBJECTIVE: Higher blood nitrate and nitrite levels have been found in coronavirus disease 2019 (COVID-19) patients than in healthy subjects. The present study explores the potential association between serum nitrate levels and mortality in COVID-19 patients. DESIGN: A prospective observation study was carried out. SETTING: Eight Intensive Care Units (ICUs) from 6 hospitals in the Canary Islands (Spain). PATIENTS: COVID-19 patients admitted to the ICU. INTERVENTIONS: Determination of serum nitrate levels at ICU admission. MAIN VARIABLE OF INTEREST: Mortality at 30 days. RESULTS: Non-surviving (n=11) compared to surviving patients (n=42) showed higher APACHE-II (p<0.001) and SOFA scores (p=0.004), and higher serum nitrate levels (p=0.001). Logistic regression analyses showed serum nitrate levels to be associated to 30-day mortality after controlling for SOFA (OR=1.021; 95%CI=1.006-1.036; p=0.01) or APACHE-II (OR=1.023; 95%CI=1.006-1.041; p=0.01). There were no differences in the area under the curve (AUC) for mortality prediction by serum nitrate levels (AUC=83%; 95%CI=73-92%; p<0.001), APACHE II (AUC=85%; 95%CI=75-96%; p<0.001) and SOFA (AUC=78%; 95%CI=63-92%; p=0.005) based on the DeLong method. The Kaplan-Meier analysis found patients with serum nitrates levels>68.4µmol/l to have a higher mortality rate (hazard ratio=138.8; 95%CI=22.3-863.9; p<0.001). CONCLUSIONS: The main novel finding was the association between serum nitrate levels and mortality in COVID-19 patients controlling for the SOFA or APACHE-II scores, though larger studies are needed to confirm this observation.

Effects of conditioning on the welfare of jaguars (Panthera onca) in captivity / Efeitos do condicionamento sobre o bem-estar de onças-pintadas (Panthera onca) em cativeiro

The jaguar is the largest feline in the Americas and in the face of the threat of extinction and the reduction of natural areas, keeping the species in captivity may be important for its conservation. This condition can lead to a reduction in well-being, especially due to spatial limitation and lack of environmental stimulus. In recent decades, techniques have been sought to minimize the negative impacts of captivity, with an increase in the use of environmental enrichment and operational conditioning in order to facilitate routine procedures for the animal management. In this scenario, this study aimed to evaluate the effects of conditioning on the welfare of jaguars in captivity, analyzing behavioral and physiological effects through salivary cortisol. Seven jaguars were studied in a Scientific Breeder. There was an increase in behaviors associated with welfare and cortisol during conditioning, possibly related to learning. The increase in behaviors associated with welfare suggests that the technique can contribute to improve the quality of life of these animals in captivity.(AU)

A onça-pintada é o maior felino das Américas e, diante da ameaça de extinção e da redução de áreas naturais, manter a espécie em cativeiro pode ser importante para sua conservação. Essa condição pode levar à redução no bem-estar, especialmente devido à limitação espacial e à carência de estímulos ambientais. Nas últimas décadas, têm sido buscadas técnicas para minimizar os impactos negativos do cativeiro, com crescimento da utilização de enriquecimento ambiental e do condicionamento operante, com o intuito de facilitar procedimentos de rotina do manejo dos animais. Nesse cenário, o presente estudo teve por finalidade avaliar os efeitos do condicionamento sobre o bem-estar de onças-pintadas em cativeiro, analisando-se efeitos comportamentais e fisiológicos por meio do cortisol salivar. Foram estudadas sete onças-pintadas em um criadouro científico. Houve aumento dos comportamentos associados ao bem-estar e do cortisol durante o condicionamento, possivelmente relacionados à aprendizagem. O aumento nos comportamentos de bem-estar sugere que a técnica pode contribuir para melhorar a qualidade de vida desses animais em cativeiro.(AU)

Efficiency of ultraviolet light for disinfection of fertile broiler eggs / Eficiência da luz ultravioleta para desinfecção de ovos férteis de matrizes de frangos de corte

This study aimed to evaluate the effectiveness of ultraviolet light in reducing bacterial load of eggshells and the impact of experimental disinfection on hatching, embryo mortality, and time-borne distribution using broiler breeder hens of different ages (38, 42, and 48 weeks old). Fertile eggs were subjected to different exposure periods (5, 7, and 9 minutes) of UV light (UV-C) with a 254 nm wavelength. For controls, eggs disinfected with paraformaldehyde (5.3 g/m3) and eggs not disinfected (NC). After subjection to disinfection protocols, the eggs were placed into sterile plastic bags containing 20 mL of peptone saline solution (0.1% m:v) and massaged for 1 minute to release the bacterial load. Aliquots of this solution were incubated in specific medium for bacterial growth for 48 hours at 37ºC for subsequent CFU counts. To evaluate the effects of disinfection on production, eggs previously disinfected by UV-C (9 min) and paraformaldehyde and NC eggs were candled between incubation days 10 and 13 and at the end of the incubation period to assess embryonic mortality. Hatchability distribution was performed every 8 hours. The 9 minutes 254nm UV-C light exposure was able to disinfect viable eggs and matched the effectiveness of the paraformaldehyde technique.(AU)

Objetivou-se avaliar a eficácia da luz ultravioleta na redução da carga bacteriana de cascas de ovos e o impacto na eclosão e na mortalidade embrionária observando-se a idade das matrizes (38, 42 e 48 semanas). Os ovos foram submetidos a diferentes períodos de exposição (cinco, sete e nove minutos) à luz UV (UV-C) com comprimento de onda de 254nm. Os controles foram ovos desinfetados com paraformaldeído (5,3g/m³) e ovos não desinfetados (NC). Após a desinfecção, os ovos foram colocados em sacos plásticos estéreis contendo 20mL de solução salina peptonada (0,1% m:v) e massageados por um (1) minuto para descolamento das bactérias. Alíquotas dessa solução foram incubadas em meio para crescimento bacteriano por 48 horas a 37ºC e contagem de UFC. Para avaliar os efeitos da desinfecção, ovos previamente desinfetados por UV-C (nove minutos) e ovos com paraformaldeído e NC foram submetidos à ovoscopia entre os dias 10 e 13 de incubação e ao final do período de incubação, para avaliação da mortalidade embrionária. A distribuição da eclodibilidade foi realizada a cada oito horas. A exposição à luz UV-C de 25nm de nove minutos desinfetou os ovos férteis e coincidiu com a eficácia do paraformaldeído.(AU)

Traducción, validación y adaptación cultural de la evaluación SANE (Single Assessment Numeric Evaluation) en pacientes con patología de hombro / Translation, validation and cultural adaptation of the SANE (Single Assessment Numeric Evaluation) in patients with shoulder pathology

Resumen: Introducción: La evaluación SANE (Single Assessment Numeric Evaluation) es un tipo de desenlace reportado por el paciente, corto y fácil de administrar que se correlaciona con otras evaluaciones funcionales del hombro más extensas. Hasta la fecha no se encuentra validada en nuestra lengua. Objetivo: Traducir, validar y adaptar la evaluación SANE al idioma español. Material y métodos: Se realizó la traducción y contra-traducción por dos evaluadores expertos bilingües y un traductor oficial. Se determinó la validez de constructo con un grupo de expertos en cirugía de hombro, la validez de criterio con la escala de American Shoulder and Elbow Surgeons (ASES) previamente validada en español y la reproducibilidad de la prueba. Resultados: Se evaluaron 113 pacientes con un promedio de edad de 53.6 años, siendo 56% mujeres. El diagnóstico más frecuente fue síndrome de manguito rotador en un 78.6% seguido por artrosis glenohumeral y acromioclavicular, hombro congelado e inestabilidad del hombro. El índice de correlación de Pearson entre el SANE y el ASES fue de 0.699. La reproducibilidad de la prueba fue alta con un coeficiente de correlación intraclase de 0.86. Conclusiones: La evaluación SANE es una medida de desenlace centrada en el paciente fiable y válida, que tiene una buena correlación con puntajes funcionales previamente validados al español más extensos. Se presenta la versión traducida y adaptada al español, que puede ser utilizada como medida de desenlace para intervenciones quirúrgicas o no quirúrgicas en patologías de hombro.

Abstract: Introduction: The Single Assessment Numeric Evaluation (SANE) score is a brief method of evaluating patients' perception of the shoulder joint and has proven high correlation with other outcome measures that are more lengthy and time-consuming in daily practice. The SANE score to date has not been validated in Spanish. Objective: To translate, adapt, and validate the SANE score in Spanish. Material and methods: An initial translation and counter-translation was conducted by two bilingual evaluators and an official translator. Content validity was evaluated by a group of experts in shoulder surgery. The criteria validity was determined by determining correlation with the previously translated and validated ASES score. Reliability of the test was determined. Results: 113 patients were evaluated, with an average age of 53.6 being 56% female. The most frequent diagnosis was rotator cuff syndrome in 78.6% followed by frozen shoulder, glenohumeral and acromioclavicular osteoarthritis and shoulder instability and acromioclavicular dislocation. Correlation between the SANE and ASES results was 0.699. The test was highly reliable with an intraclass correlation coefficient of 0.86. Conclusion: The SANE score is a valid and reliable patient centered outcome measure that has a good correlation with other previously validated scores in Spanish that are less practical. We present a translated valid version of the SANE score in Spanish that can be used as a patient reported outcome measure for shoulder pathologies.

Clinical guide to perioperative management for videothoracoscopy lung resection (Section of Cardiac, Vascular and Thoracic Anesthesia, SEDAR; Spanish Society of Thoracic Surgery, SECT; Spanish Society of Physiotherapy). / Guía clínica en el manejo perioperatorio para la cirugía de resección pulmonar por videotoracoscopia (Sección de Anestesia Cardiaca, Vascular y Torácica, SEDAR; Sociedad Española de Cirugía Torácica, SECT; Asociación Española de Fisioterapia, AEF).

The introduction of video-assisted thoracoscopic (VATS) techniques has led to a new approach in thoracic surgery. VATS is performed by inserting a thoracoscope through a small incisions in the chest wall, thus maximizing the preservation of muscle and tissue. Because of its low rate of morbidity and mortality, VATS is currently the technique of choice in most thoracic procedures. Lung resection by VATS reduces prolonged air leaks, arrhythmia, pneumonia, postoperative pain and inflammatory markers. This reduction in postoperative complications shortens hospital length of stay, and is particularly beneficial in high-risk patients with low tolerance to thoracotomy. Compared with conventional thoracotomy, the oncological results of VATS surgery are similar or even superior to those of open surgery. This aim of this multidisciplinary position statement produced by the thoracic surgery working group of the Spanish Society of Anesthesiology and Reanimation (SEDAR), the Spanish Society of Thoracic Surgery (SECT), and the Spanish Association of Physiotherapy (AEF) is to standardize and disseminate a series of perioperative anaesthesia management guidelines for patients undergoing VATS lung resection surgery. Each recommendation is based on an in-depth review of the available literature by the authors. In this document, the care of patients undergoing VATS surgery is organized in sections, starting with the surgical approach, and followed by the three pillars of anaesthesia management: preoperative, intraoperative, and postoperative anaesthesia.

[Translation, validation and cultural adaptation of the SANE (Single Assessment Numeric Evaluation) in patients with shoulder pathology]. / Traducción, validación y adaptación cultural de la evaluación SANE (Single Assessment Numeric Evaluation) en pacientes con patología de hombro.

INTRODUCTION: The Single Assessment Numeric Evaluation (SANE) score is a brief method of evaluating patients' perception of the shoulder joint and has proven high correlation with other outcome measures that are more lengthy and time-consuming in daily practice. The SANE score to date has not been validated in Spanish. OBJECTIVE: To translate, adapt, and validate the SANE score in Spanish. MATERIAL AND METHODS: An initial translation and counter-translation was conducted by two bilingual evaluators and an official translator. Content validity was evaluated by a group of experts in shoulder surgery. The criteria validity was determined by determining correlation with the previously translated and validated ASES score. Reliability of the test was determined. RESULTS: 113 patients were evaluated, with an average age of 53.6 being 56% female. The most frequent diagnosis was rotator cuff syndrome in 78.6% followed by frozen shoulder, glenohumeral and acromioclavicular osteoarthritis and shoulder instability and acromioclavicular dislocation. Correlation between the SANE and ASES results was 0.699. The test was highly reliable with an intraclass correlation coefficient of 0.86. CONCLUSION: The SANE score is a valid and reliable patient centered outcome measure that has a good correlation with other previously validated scores in Spanish that are less practical. We present a translated valid version of the SANE score in Spanish that can be used as a patient reported outcome measure for shoulder pathologies.

INTRODUCCIÓN: La evaluación SANE (Single Assessment Numeric Evaluation) es un tipo de desenlace reportado por el paciente, corto y fácil de administrar que se correlaciona con otras evaluaciones funcionales del hombro más extensas. Hasta la fecha no se encuentra validada en nuestra lengua. OBJETIVO: Traducir, validar y adaptar la evaluación SANE al idioma español. MATERIAL Y MÉTODOS: Se realizó la traducción y contra-traducción por dos evaluadores expertos bilingües y un traductor oficial. Se determinó la validez de constructo con un grupo de expertos en cirugía de hombro, la validez de criterio con la escala de American Shoulder and Elbow Surgeons (ASES) previamente validada en español y la reproducibilidad de la prueba. RESULTADOS: Se evaluaron 113 pacientes con un promedio de edad de 53.6 años, siendo 56% mujeres. El diagnóstico más frecuente fue síndrome de manguito rotador en un 78.6% seguido por artrosis glenohumeral y acromioclavicular, hombro congelado e inestabilidad del hombro. El índice de correlación de Pearson entre el SANE y el ASES fue de 0.699. La reproducibilidad de la prueba fue alta con un coeficiente de correlación intraclase de 0.86. CONCLUSIONES: La evaluación SANE es una medida de desenlace centrada en el paciente fiable y válida, que tiene una buena correlación con puntajes funcionales previamente validados al español más extensos. Se presenta la versión traducida y adaptada al español, que puede ser utilizada como medida de desenlace para intervenciones quirúrgicas o no quirúrgicas en patologías de hombro.

Nociceptive pain and anxiety in equines: Physiological and behavioral alterations.

Pain and anxiety are two of the most important concerns in clinical veterinary medicine because they arise as consequences of multiple factors that can severely affect animal welfare. The aim of the present review was to provide a description and interpretation of the physiological and behavioral alterations associated with pain and anxiety in equines. To this end, we conducted an extensive review of diverse sources on the topic. The article begins by describing the neurophysiological pathway of pain, followed by a discussion of the importance of the limbic system in responses to pain and anxiety, since prolonged exposure to situations that cause stress and pain generates such physiological changes as tachycardia, tachypnea, hypertension, hyperthermia, and heart rate variability (HRV), often accompanied by altered emotional states, deficient rest, and even aggressiveness. In the long term, animals may show deficiencies in their ability to deal with changes in the environment due to alterations in the functioning of their immune, nervous, and endocrinologic systems. In conclusion, pain and anxiety directly impact the homeostasis of organisms, so it is necessary to conduct objective evaluations of both sensations using behavioral scales, like the horse grimace scale, complemented by assessments of blood biomarkers to analyze their correlation with physiological parameters: Heart rate, respiratory rate, HRV, theparasympathetic tone activity index, lactate and glucose levels, and temperature. Additional tools - infrared thermography, for example - can also be used in these efforts to improve the quality of life and welfare of horses.

High serum nitrates levels in non-survivor COVID-19 patients.

OBJECTIVE: Higher blood nitrate and nitrite levels have been found in coronavirus disease 2019 (COVID-19) patients than in healthy subjects. The present study explores the potential association between serum nitrate levels and mortality in COVID-19 patients. DESIGN: A prospective observation study was carried out. SETTING: Eight Intensive Care Units (ICUs) from 6 hospitals in the Canary Islands (Spain). PATIENTS: COVID-19 patients admitted to the ICU. INTERVENTIONS: Determination of serum nitrate levels at ICU admission. MAIN VARIABLE OF INTEREST: Mortality at 30 days. RESULTS: Non-surviving (n=11) compared to surviving patients (n=42) showed higher APACHE-II (p<0.001) and SOFA scores (p=0.004), and higher serum nitrate levels (p=0.001). Logistic regression analyses showed serum nitrate levels to be associated to 30-day mortality after controlling for SOFA (OR=1.021; 95%CI=1.006-1.036; p=0.01) or APACHE-II (OR=1.023; 95%CI=1.006-1.041; p=0.01). There were no differences in the area under the curve (AUC) for mortality prediction by serum nitrate levels (AUC=83%; 95%CI=73-92%; p<0.001), APACHE II (AUC=85%; 95%CI=75-96%; p<0.001) and SOFA (AUC=78%; 95%CI=63-92%; p=0.005) based on the DeLong method. The Kaplan-Meier analysis found patients with serum nitrates levels>68.4µmol/l to have a higher mortality rate (hazard ratio=138.8; 95%CI=22.3-863.9; p<0.001). CONCLUSIONS: The main novel finding was the association between serum nitrate levels and mortality in COVID-19 patients controlling for the SOFA or APACHE-II scores, though larger studies are needed to confirm this observation.

Milk production and fatty acid profile of dairy cows grazing four grass species pastures during the rainy season in small-scale dairy systems in the highlands of Mexico.

The study evaluated small-scale dairy systems with continuous grazing of pastures based on three temperate grasses festulolium (FL), tall fescue (TF), and perennial ryegrass (RG), compared with subtropical kikuyu grass (KG). All pastures were associated with white clover (Trifolium repens L.). Twelve multiparous Holstein cows were assigned to a 4 × 4 Latin square replicated three times with 14-day experimental periods. Sampling and analyses of pastures, concentrates, and animal variables followed standard procedures. FL showed a significantly (p < 0.05) higher mean sward height, but there were no differences (p > 0.05) in net herbage accumulation. There were significant differences (p < 0.05) among pastures for CP, NDF, ADF, in vitro digestibility of OM (IVOMD), and estimated metabolizable energy (eME). There were no differences (p > 0.05) between treatments for milk yield and composition, live weight, or body condition score. There were significant differences (p < 0.05) in fatty acid values for pastures in C14:0, C16:1, and C18:3n3. There were significant differences between treatments (p < 0.05) in milk contents for C18:0, C18:1t11, and C18:2c9t11. Grazing FL, TF, RG, or KY pastures showed no differences in milk yields. Higher values for C18:0, C18:1t11, and C18:2c9t11 were detected in KY, RG, and TF. RG had significantly higher MUFA than FL and higher PUFA than TF. A value under 65% of SFA, a ratio of n-6/n-3 lower than 4, and an atherogenic index of 1.7 are indicators of milk with beneficial effects for human health.

Sistemas de clasificación y predicción de riesgo de malignidad de las lesiones anexiales / Classification systems and prediction of risk of malignancy of the adnexal masses

El diagnóstico de una masa anexial es un problema frecuente en la consulta ginecológica. El principal objetivo de la evaluación de una masa anexial es el diagnóstico o exclusión de malignidad, dado que el cáncer de ovario es la neoplasia ginecológica más letal y que una cirugía inicial adecuada es uno de sus principales factores pronósticos. La evaluación ecográfica continúa siendo el mejor método para clasificar las masas anexiales. Si existe la sospecha de malignidad de la lesión, la paciente debe ser remitida a un centro especializado en ginecología oncológica. Sin embargo, si la sospecha es de benignidad, se puede optar por una actitud expectante o por un tratamiento quirúrgico conservador. El objetivo de este artículo es revisar los sistemas de clasificación de las lesiones anexiales más importantes y más ampliamente empleados, analizando su metodología y los resultados de su aplicación en los principales estudios de validación publicados hasta el momento

The diagnosis of an adnexal mass is a common problem in gynaecological consultation. The main objective of an adnexal mass evaluation is the diagnosis or exclusion of malignancy. This is the case because ovarian cancer is the most lethal gynaecological neoplasia and appropriate initial surgery is one of the main prognostic factors. Ultrasound scans continue to be the best method of classifying an adnexal mass. If there is any suspicion of a malignant tumour, the patient must be referred to a specialist gynaecological oncology centre. However, if there is any suspicion of a benign tumour, watchful waiting or minimally invasive surgery may be indicated. The objective of this article is to carry out a review of the most important and widely used classification systems of adnexal masses, analysing their methodology and the results of their application in the main validation studies published to date

Effects of season and distance during transport on broiler chicken meat.

This research aims to evaluate the microclimate of commercial loads of broiler chickens at different distances in the summer (rainy) and winter (dry) seasons and their effects on meat quality. Twelve broiler loads were monitored with a total of 24 crates per load. Data loggers were used to record temperature and relative humidity. The experiment followed a completely randomized design with 48 treatments in a factorial scheme (2 seasons: rainy and dry) x 2 (distances: short and long) x 12 (positions), with 3 replicates per experimental group. In the rainy season, meat quality was influenced by transport distance. For longer distances, it recorded the highest enthalpy comfort index (ECI), suggesting a tendency of dark, firm, and dry meat (DFD-like) and lower cooking losses (CL). The lowest ECI was recorded during the transport in dry season. Broiler chickens transported and slaughtered in the winter presented meat pH and L* (lightness) classified as "normal," but with higher cooking losses. For the shear force (SF), the seasons and distances had no significant influence on tenderness of the meat. Regarding the crate positioning in the load, no effect was observed during transport on this variable, given the meat quality characteristics of pH, L*, CL, and SF. These results suggest that the distance and the seasons present more influence on broiler meat quality than crate position in the truck.