The influence of the perceived requirements of the next match and motivation on the mental fatigue of soccer players.

The high cognitive and/or emotional demands of competition can lead to a state of mental fatigue which has shown to be detrimental to soccer performance. However, there is a need to further understand the true mental demands of soccer players. The aim of the present study was to analyze the influence of motivation and the perceived requirements of the next match on mental fatigue perceived by soccer players over the passing of a season. The combined effect of both variables on the perception of mental fatigue, as well as the influence of the time of the season on perceived mental fatigue, were also analyzed. Twenty-six semi-professional Spanish male players (M = 26.31 ± 5.18 years) participated in the present study, conducted during the 2020-2021 season. Perceived mental fatigue and motivation were measured at each training session. The perceived requirements of the next match were also measured in each of the competitive weeks. Linear mixed models were run with R Studio to examine the influence of motivation and the perceived difficulty of the next match on perceived mental fatigue, the combined effect of both variables on perceived mental fatigue, and the influence of the passing of the season on perceived mental fatigue. The results showed a negative and significant influence of motivation on perceived mental fatigue (p < 0.001) and a positive and significant influence of the perceived requirements of the next match on perceived mental fatigue (p < 0.001). Regarding the combined effect, there was a positive and significant effect (p < 0.01) of the perceived difficulty of the next match on the relation between motivation and perceived mental fatigue. A negative influence of season passage on perceived mental fatigue levels was found (p < 0.001). We recommended coaches to consider using the most motivating training tasks when higher next-match requirements are perceived and to be careful with avoidance strategies for mental fatigue, especially at the beginning of the season.

Adaptation to spanish and validation of the sport team socialization tactics questionnaire / Adaptación y validación al español del cuestionario de tácticas de socialización para equipos deportivos

The aim of the study was to adapt and validate the Sport Team Socialization Tactics Questionnaire (STSTQ) with amateur and semi-professional Spanish players. The participants were 437 male and female players aged 15 to 39 (M = 21.90; SD = 5.67). Confirmatory factor analysis was applied to test the three-factor structure: coach-initiated role communication tactics, serial socialization tactics and social inclusionary tactics. According to the results, the Spanish version of the STSTQ presented adequate index values in its original factor structure and acceptable internal consistency values. Moreover, the instrument presented adequate discriminating and concurrent validity and proved to be invariant regardless of the competitive level. These results suggest that the Spanish version of the STSTQ is a valid and reliable tool to assess socialization tactics in amateur and semi-professional team sports. (AU)

El objetivo del estudio era adaptar y validar el Cuestionario de Tácticas de Socialización para Equipos Deportivos (en inglés Sport Team Socialization Tactics Questionnarie, STSTQ) con jugadores españoles amateurs y semi-profesionales. Participaron 437 jugadores de fútbol de género masculino y femenino con edades comprendidas entre los 15-39 años (M = 21,90; DT = 5,67). Se realizó un análisis factorial confirmatorio para testar la estructura factorial compuesta por tres factores: tácticas de comunicación del rol del entrenador, tácticas de socialización en serie y tácticas sociales de inclusión. Los resultados mostraron que la versión española del STSTQ demuestra índices adecuados en su estructura factorial original y valores aceptables de consistencia interna. Además, el instrumento presentó una adecuada validez discriminante y concurrente y se mostró invariante en función del nivel competitivo. Estos resultados sugieren que la versión española del STSTQ es una herramienta válida y fiable para medir las tácticas de socialización en deportes colectivos amateurs y semi-profesionales. (AU)

How Does Ball Possession Affect the Physical Demands in Spanish LaLiga? A Multilevel Approach.

Purpose: Using a multilevel approach, this study analyzed the relationship between ball possession and distance covered at different speed sections: total distance (TD), distance covered between 14.1-21 km·h-1 (MIRD), 21.1-24 km·h-1 (HIRD), and > 24.1 km·h-1 (VHIRD). Methods: The sample included 1,520 matches played by 80 Spanish professional soccer teams across four consecutive LaLiga seasons (from 2015/2016 to 2018/2019). Two observations were collected per match, one from each team, resulting in a total of 2,950 records (760 per season). Data were collected using Mediacoach®. Results: At match level (i.e., grand-mean centered), ball possession negatively predicted all distances covered. At team level (i.e., group-mean centered), ball possession negatively predicted total distance covered and distance covered between 14.1-21 km·h-1. Furthermore, cross-level interactions (Match X Team) in ball possession negatively predicted all distances covered at speeds above 14.1 km·h-1. Specifically, in high-possession teams, the negative relationship between match ball possession and distances traveled at all speed ranges above 14.1 km·h-1 was stronger than in teams with medium or low possession. Conversely, match ball possession was positively related todistance covered at low intensities, and negatively related at high intensities in low-possession teams. Conclusion: These findings show practitioners and researchers that the distances covered at different speed ranges depend on technical-tactical parameters such as ball possession.

The relationship between running distance and coaches' perception of team performance in professional soccer player during multiple seasons.

This study analyzed how the physical movement profile of soccer matches evolved throughout a season by assessing the variability of different metrics depending on the season phase. In addition, the evolution of running distances was investigated in the relation to the team performance based on the coaches' perception. Games from four consecutives Spanish LaLiga seasons (n = 1520) were recorded using an optical tracking system (i.e., ChyronHego). Total distance (TD), distance covered between 14 and 21 km h-1 (MIRD), 21-24 km h-1 (HIRD), and > 24 km h-1 (VHIRD) were analyzed, as well as the number of efforts between 21 and 24 km h-1 (Sp21) and > 24 km h-1 (Sp24). Seasons were divided into four phases (P): P1 (matches 1-10), P2 (11-19), P3 (20-29), and P4 (30-38). Linear mixed models revealed that soccer players covered significantly greater distances and completed a higher number of sprints in P2 and P3. Also, team performance evaluated by soccer coaches was positively related to TD, HIRD, VHIRD and Sp21 in P1. A negative relationship was observed between team performance and distance covered at speeds below 21 km h-1 in P2 and P3. Team performance was negatively related to TD, MIRD, and HIRD, and Sp21 in P4. As conclusion, the team performance perceived by coaches is related to the movement profile throughout a season, and it significantly influences the evolution of soccer players' movement profiles. Specifically, it seems that the players of the best teams have the best physical performance at the beginning of the season with respect to the rest of the phases.

Análisis de las acciones técnico-tácticas del portero de fútbol en competición / Analysis of the technical-tactical actions by goalkeeper on football in competition

El objetivo del presente estudio fue analizar las diferencias en el número y tipo de acciones técnico-tácticas de los porteros en competición en función de la división y de si juegan como local o visitante. Para ello, se han analizado 80 partidos con un total de 160 porteros de 1ª, 2ª, 2ªB y 3ª división española. Los resultados mostraron que no existen diferencias significativas entre el número de acciones medias realizadas por partido en cada división, pero sí se encontraron diferencias significativas en 9 de los 48 gestos técnico-tácticos específicos estudiados. Además, se encontraron pequeñas diferencias en cuanto al número de acciones en función de si los porteros juegan como local o visitante. Por tanto, la principal conclusión de este estudio es la importancia de analizar los tipos de acciones técnico-tácticas de los porteros ya que nos pueden ofrecer información relevante para el entrenamiento y la competición

The present study tries to respond about three different objectives: a) to quantify the number of technical-tactical actions carried out by goalkeepers during matches and to analyze if there are differences between divisions, b) to examine the possible differences in the number and type of technical-tactical actions between divisions under investigation, and c) to analyze the differences between this number and the type of technical-tactical actions when goalkeepers play at home team or away teams . To this end, a viewing was made of the 80 matches of the four most important divisions of Spanish football and a total of 160 goalkeepers were analyzed using the observational methodology. After the application of the tests the H-test of Krustal-Wallis and U of Mann-Whitney, showed no significant differences between the number of average actions performed per game in each division. Only significant differences were found in 9 of the 48 specific technical-tactical gestures studied. So, the first conclusion in this study is the importance of analyzing the types of technical-tactical actions of goalkeepers, due to they can offer relevant information for training and competition

Enterovirus infection and type 1 diabetes: unraveling the crime scene.

Enteroviruses (EV) have been historically associated to type 1 diabetes. Definitive proof for their implication in disease development is lacking, but growing evidence suggests that they could be involved in beta cell destruction either directly by killing beta cells or indirectly by creating an exacerbated inflammatory response in the islets, capable of attracting autoreactive T cells to the 'scene of the crime'. Epidemiological and serological studies have been associated with the appearance of islet autoimmunity and EV RNA has been detected in prospective studies. In addition, the EV capsid protein has been detected in the islets of recent-onset type 1 diabetic donors, suggesting the existence of a low-grade EV infection that could become persistent. Increasing evidence in the field shows that a 'viral signature' exists in type 1 diabetes and involves interferon responses that could be sustained during prolonged periods. These include the up-regulation of markers such as protein kinase R (PKR), melanoma differentiation-associated protein 5 (MDA5), retinoic acid inducible gene I (RIG-I), myxovirus resistance protein (MxA) and human leukocyte antigen-I (HLA-I) and the release of chemokines able to attract immune cells to the islets leading to insulitis. In this scenario, the hyperexpression of HLA-I molecules would promote antigen presentation to autoreactive T cells, favoring beta cell recognition and, ultimately, destruction. In this review, an overview is provided of the standing evidence that implicates EVs in beta cell 'murder', the time-line of events is investigated from EV entry in the cell to beta cell death and possible accomplices are highlighted that might be involved in beta cell demise.

Athletes' perceptions of coaching competency and team conflict in sport teams: A multilevel analysis.

The purpose of this study was to examine the relationship between coaching competency and team conflict, at individual and team levels, over the season. The participants were professional female and male soccer players, who participated in the First and Second Division. A longitudinal study was performed. At Time 1, the sample of participants consisted of 581 soccer players aged between 15 and 39 years. At Time 2, 549 players were recruited from the original sample aged between 15 and 37 years. Finally, at Time 3, the sample comprised 576 players aged between 15 and 37 years. All participants completed a multi-section questionnaire assessing coaching competency (motivation, game strategy, technique competency, and character-building competency) and team conflict (task conflict and relationship conflict). Results showed that both task and relationship conflict increased significantly over time. Multilevel modelling analysis showed that game strategy and character-building competencies negatively predicted both task and relationship conflicts at the individual level, whereas motivation competency was also added as a significant predictor of task conflict at the team level. Moreover, technique competency positively predicted task conflict at the team level. The current study suggests the importance of coaching competency in group dynamics in sport.

Influencia de la formación de los entrenadores sobre la motivación de los deportistas / Influence of coaches training on athletes motivation

El objetivo del estudio era conocer la influencia de las formaciones académica y federativa de los entrenadores sobre los niveles de motivación, diversión, aburrimiento e intención de persistencia en jóvenes deportistas. Para ello, participaron 432 jóvenes con edades entre 10 y 16 años (M = 13,44; DT = 2,92), pertenecientes a disciplinas deportivas individuales (n = 162) y colectivas (n = 270), de género masculino (n = 245) y femenino (n = 187), seleccionados mediante un muestreo por conglomerados. También, participaron 88 entrenadores deportivos, con edades entre los 20 y 56 años (M = 35,79; DT = 9,58). Se llevó a cabo un análisis de diferencias en función de la cualificación académica y federativa de los entrenadores. Los resultados señalaron que los deportistas dirigidos por entrenadores sin formación federativa presentaban mayores niveles de desmotivación. Asimismo, los deportistas entrenados por técnicos sin titulación académica obtuvieron mayores puntuaciones en las regulaciones extrínsecas (identificada y externa). Por tanto, los hallazgos respaldan parcialmente la relevancia de la formación de los entrenadores, obteniéndose diferencias en regulaciones alejadas del máximo nivel de autodeterminación (externa), desmotivación y aburrimiento (AU)

The aim of the study was to examine the influence of the coaches´ academic and federative training on motivation, enjoyment, boredom and intention to persist levels in youth athletes. Participants were 432 youth athletes (male = 245, female = 187) ranged from 10 to 16 years old (M = 13.44; SD = 2.92) who participated in individual (n = 163) and collectives sports (n = 270) selected by cluster sampling. Moreover, 88 sport coaches, ranged from 20 to 56 years old (M = 35,79; SD = 9,58), participated in the study. An analysis of differences with regard to academic and federative coaches´ qualification was conducted. Results revealed that athletes trained by coaches without federative training showed greater amotivation levels. Moreover, individuals trained by coaches without academic qualification had higher scores in extrinsic regulation (identified and external). Therefore, findings partially supported the relevance of coaches’ qualification levels, due to the differences found in some extrinsic regulations (external), amotivation and boredom (AU)

Asthma control and exacerbations in patients with severe asthma treated with omalizumab in Portugal.

The analysis of outcomes from patients with severe asthma treated with omalizumab, using real-life prospective data, should contribute to future informed decisions about this treatment in Portugal. The aim of this study was to assess the clinical effect of omalizumab in Portuguese patients with severe persistent allergic asthma, considering specifically asthma control and exacerbations. This was an observational, prospective, multicentre study. Data were collected at routine care over a 12-month period. Disease control was defined by Control of Allergic Rhinitis and Asthma Test (CARAT) global score >24. All asthma patients already under treatment with omalizumab in 7 departments from 6 Portuguese hospitals were included (n=48). Most (77%) patients were female and the mean (SD) age was 51.9 (10.2) years old. During the study period, asthma was controlled in 34% of the visits and the 12-month exacerbation rate was 1.7 per patient (0.6 with unscheduled medical care). One-third of the patients needed unscheduled medical care because of asthma and 29% had to start or increase oral corticosteroid. There was still a 41% reduction in the total sum of oral corticosteroids usage from the first to the last trimester of the study. During routine treatment with omalizumab, Portuguese patients with severe asthma achieved asthma control in 1/3 of the visits and only 1/3 needed unscheduled or Emergency Room care because of asthma exacerbations. These outcomes support the maintenance of the clinical effect during treatment with omalizumab in routine care in Portugal.

PfGBP: una proteína de unión al telómero de Plasmodium falciparum / PfGBP: A Plasmodium falciparum telomere binding protein / PfGBP: uma proteína de ligação o telômero em Plasmodium falciparum

Los telómeros son estructuras complejas de ADN y proteína localizadas en el extremo de los cromosomas eucariotes. Su principal función es proteger el extremo cromosomal de ser reconocido y procesado como ADNs fracturado, evitando así eventos de recombinación y fusión que conducen a inestabilidad cromosomal. El ADN telomérico consta de secuencias cortas, repetidas una tras otra, ricas en guanina; la cadena rica en guanina se extiende formando una región de cadena sencilla denominada extremo 3' protuberante. Las proteínas por su parte, se pueden clasificar en: dsBPs, o proteínas de unión a la cadena doble, GBPs aquellas que reconocen específicamente el extremo protuberante y, proteínas que las interconectan mediante interacciones proteína-proteína. El gen PF3D7_1006800 de Plasmodium falciparum codifica para una proteína putativa similar a una GBP de Criptosporidium parvum, con el fin de establecer si esta proteína de P. falciparum presenta la capacidad de unión al ADN telomérico del parásito, se produjo una proteína recombinante a partir de la región codificante del gen, se purificó y se utilizó en ensayos de unión a ADN, y en la generación de anticuerpos policlonales específicos contra PfGBP. Nuestros resultados indican que la proteína de P. falciparum es una proteína nuclear con capacidad de unión al ADN telomérico in vitro, por lo que podría ser parte del complejo proteico encargado de proteger y/o mantener el telómero in vivo.

Telomeres are specialized structures at the end of chromosomes that consist of repetitive DNA sequences and associated proteins. The primary role of telomeres is to protect the end of linear chromosomes from recombination, fusion, and recognition as broken DNA ends. This protective function can be achieved through association with specific telomere binding proteins. Telomeric DNA consists of G-rich double-stranded arrays followed by a single-stranded G-rich overhang. The telomeric proteins can be classified in dsBPs, which bind double-stranded DNA, GBPs those that bind specifically to G-rich overhang, and proteins that interact with telomeric factors. Plasmodium falciparum gene PF3D7_1006800 codifies for a protein highly similar to Cryptosporidium parvum GBP. In order to investigate whether the P. falciparum protein binds telomeric DNA, a recombinant protein was produced, purified and DNA binding assays were performed. Polyclonal antibodies against rPfGBP were produced and tested in western blot. Our results indicate that PfGBP is a nuclear protein that binds telomeric DNA in vitro, which could be part of the protein complex responsible for protecting and/or maintaining the telomere in vivo.

Os telómeros são estruturas complexas de DNA e proteína localizadas no extremo dos cromossomas dos eucariotas. Sua principal função é proteger o extremo dos cromossomas para que não sejam reconhecidos e processados como DNAs fraturados. O anterior evita eventos de recombinação e fusão que conduzem à instabilidade nos cromossomas. O DNA telomérico tem sequencias curtas e repetidas, ricas em guanina. A cadeia rica em guanina estende-se para formar uma região de cadeia simples chamada extremo 3' protuberante. As proteínas podem-se classificar em: dsBPs ou proteínas de união à cadeia dupla, GBPs que são as que reconhecem especificamente o extremo protuberante e, as proteínas que interligam mediante interações proteína-proteína. O gene PF3D7_1006800 de Plasmodium falciparum codifica para uma proteína similar a uma GBP de Criptosporidium parvum. Com o objetivo de estabelecer se a proteína de P. falciparum presenta a capacidade de união ao DNA telomérico, foi produzida uma proteína recombinante partindo da região codificante do gene, purificou-se e utilizou-se nos ensaios de união ao DNA e na geração de anticorpos policlonais específicos contra PfGBP. Os nossos resultados indicam que a proteína de P. falciparum é uma proteína nuclear com capacidade de união ao DNA telomérico in vitro, pelo que poderia fazer parte do complexo proteico encarregado de proteger e/ou manter o telómero in vivo.

The phenomenon of physical aggression against health service personnel: different perspectives.

The doctor-patient relationship has undergone important changes in recent years. Increasing levels of distrust, on the part of patients towards professionals and institutions, have led to an increase of conflicts resulting in violent actions against health service personnel. The aim of this study is to analyse this phenomenon in the public welfare services of the Region of Murcia (Spain), based on an analysis of accusations, as were presented by doctors in courts in the period between 2006 and April 2008. The conclusion reached can presumably be extrapolated to the rest of Spain. The violent reactions in question resulted from patients demanding drug prescriptions; the prolongation of sick leave and the demand for diagnostic tests. The Public Health Services provide directives to anticipate and avoid such situations, emphasize the training of professionals in communication skills, the promotion of skills of negotiation and emotional self-control. Other measures include the installation of alarms, intercoms and video cameras, contracting security companies, collaboration with the police and posters in health facilities warning that legal action will be taken. Nevertheless, given the obvious inadequacy of the above-mentioned measures, Plans of Prevention have been put in place. In addition legal defence has been granted to all such professionals. From the judicial point of view, these aggressions are judged as minor crimes of injury, insult and threat. The most recent view taken on such conduct is to consider it as a crime of attempt or offence against the authority, which has been confirmed in law by the recent judgment passed down by the Spanish High Court on 4th December, 2007.

Brazilian medicinal plant acts on prostaglandin level and Helicobacter pylori.

Among the current treatment strategies for the peptic ulcer patient with Helicobacter pylori infection, the method of choice is triple therapy based on the concurrent use of proton inhibitors and two antibiotics. Alchornea triplinervia is a medicinal plant commonly used by people living in the Cerrado region of Brazil to treat gastrointestinal ulcers. In the present work we proposed therapy based on this medicinal plant that presents effective gastroprotective action with antibiotic effects. Oral pretreatment with methanolic extract (ME) of A. triplinervia in rats and mice decreased the gastric injuries induced by ethanol and HCl/ethanol. Increasing the dose reduced the gastroprotective effects of ME on the gastric lesions induced by nonsteroidal anti-inflammatory drug. After pylorus ligature of mice, oral administration of ME induced a decrease not only in total acid but also in the ulcer index. We also observed that ME displayed antibacterial activity against H. pylori. Liquid-liquid separation of ME indicated that active constituents responsible for the gastroprotective action are concentrated in the ethyl acetate fraction (EAF) (50% protection) rather than in the aqueous fraction, which did not induce significant gastroprotection at the same dose (100 mg/kg). EAF induced an increase of gastric mucosa prostaglandin (PG) E(2) levels, which remained high even after previous administration of indomethacin. The phytochemical profile of ME revealed that EAF contains mainly flavonoids. In conclusion, all these results suggest that ME did not show acute toxicity, but exhibited an antisecretory property, anti-H. pylori effect, and gastroprotective action. The observed effect did not involve the participation of nitric oxide or endogenous sulfhydryl groups. However, EAF showed a more efficient gastroprotective effect than ME at a lower dose and protected the gastric mucosa by increasing PGE(2).

Efectos de duloxetina y amitriptilina en el dolor neuropático: estudio en 180 casos / Effects of duloxetin and amitriptilin in neurophatic pain: study in 180 patients

Objetivo. Valoración de la eficacia analgésica y la tolerancia de duloxetinafrente a amitriptilina en el tratamiento del dolor neuropático. Material y Método. Estudio prospectivo en 180 pacientes durante un periodo de 3 meses. Se excluyeron del estudio los pacientes con depresión y ansiedad. Se dividieron, aleatoriamente, en 3 grupos: Grupo A (recibieron 30 mg de duloxetina con la cena, con incremento a los 3 días a 60 mg, y posteriores incrementos semanales de 30 mg hasta alivio del dolor); Grupo B (recibieron 60 mg de duloxetina con la cena, con incrementos semanales de 30 mg hasta alivio del dolor); Grupo C (recibieron10 mg de amitriptilina los >60 años y 25 mg los menores, con la cena, con incrementos semanales de 25 mg hasta alivio del dolor). Se valoraron: 1. Edad; 2. Diagnóstico; 3. Duración e intensidad del dolor (EVA); 4. Eficacia analgésica (EVA); 5. Tiempo de alivio del dolor; 6. Dosis media analgésica; 7. Efectos indeseable: incidencia, duración e intensidad; 8. Satisfacción del paciente. Los pacientes fueron evaluados a la semana, 15 días, mes y 3 meses de comenzarel tratamiento. Se utilizaron la t de Student para la comparación de medias y una prueba binomial simple para la comparación de proporciones. Resultados. La edad de los pacientes se encontraba, en un intervalo, entre 42-86 años. Los cuadros dolorosos estudiados fueron: Radiculopatía lumbar (45%), radiculopatía cervical (23%), neuralgia postherpética (11.5%), neuralgia del trigémino (10%), síndrome de dolor regional complejo tipo I (5 %), y dolor neuropático postcirugía (5.5%). El tiempo de alivio del dolor fue: A 5±2 días, B 6±1 días, C 14±6 días; las dosis medias analgésicas fueron: A 65±24 mg, B 67±22 mg, C 35±32 mg. La incidencia de efectos indeseables fue significativamente superioren el grupo amitriptilina (sequedad de boca, estreñimientoe hipotensión ortostática) frente a duloxetina (náuseas,somnolencia). En los pacientes del Grupo A, los efectos indeseables fueron de intensidad leve. La satisfacción personal fue excelente/buena en el 95.6% de las pacientes de los grupos A y B y en el 78,7% de las pacientes del grupo C. Conclusiones. Ambos fármacos son eficaces en el tratamiento del dolor neuropático. Duloxetina tiene como ventajas, un menor tiempo de inicio del efecto analgésico y una menor incidencia de efectos indeseables. Los efectos indeseables de duloxetina se minimizan significativamente comenzando con la dosis de 30mg

Objective. Evaluation of analgesia efficacy and tolerability of duloxetine versus amitriptyline in neuropathic pain. Methods. Prospective study in 180 patients during three months. We excluded patients with anxiety or depression. The patients were distributed in three groups: A (30 mg duloxetine at dinner, in the third day 60 mg, increasing 30 mg a week until relief pain); B (60 mg duloxetine at dinner, increasing 30 mg a week until relief pain); C (>60 years: 10 mg amitriptyline and <60 years 25 mg amitriptyline at dinner, increasing 25 mg a week until relief pain). We study: Age,diagnose, duration and severity pain (VAS), analgesia efficacy, time until relief pain, analgesic dose, adverse events (frequency, duration and severity), satisfaction of patient. The patients were evaluated a week, fifteen days, a month and three months. The student t test and binomial model was used for statistical comparison. Results. We studied: lumbar radiculopathy (45%), cervical radiculopathy (23%), postherpetic neuralgia (11.5%), trigeminal neuralgia (10%), Complex Regional Pain syndrome I (5%), postsurgical neuropathic pain (5.5%). In A and B groups the pain relief in a week of treatment, in C group after 15 days of treatment. The time until relief pain were: A 5±2, B 6±1,C 14±6 days; the analgesic doses were: A 65±24 mg, B67±22 mg, C 35±32 mg. The frequency of adverse events was more significant in the group amitriptyline (dry mouth,constipation, orthostatic hypotension) versus duloxetine(nausea, somnolence). Adverse events in the patients of the group A were weight. The personal satisfaction was excellent/good in 95.6% patients included in groups A and B,and 78.7% in groups C. Conclusions: Duloxetine andamitriptyline are effective in neuropathic pain. Less time until relief pain and less adverse events with duloxetine. The beginning of treatment with 30 mg duloxetine decrease events adverse

Eficacia analgésica de citrato de fentalino transmucosa oral (CFOT) en histeroscopias / Analgesic efficacy of transmucosal fentanyl for hysteroscopies

ObjetivoEl objetivo de este estudio fue valorar la eficacia del fentanilotransmucosa oral como analgésico, sedante y ansiolítico en pacientes sometidas a histeroscopia diagnóstica y terapéutica.MétodosSe estudiaron 40 pacientes programadas para histeroscopiadiagnóstica y/o terapéutica. Los criterios de inclusión fueron:pacientes ASA I y II, con 8 h. de ayuno. Los criterios deexclusión fueron: embarazo y ASA >=3. Ninguna de las pacientesestaba en tratamiento con antidepresivos y/o ansiolíticos.Se dividieron en 2 grupos: Grupo A (n=20), pacientesprogramas para histeroscopia diagnóstica, que recibieron 200 mg de CFOT 20 min. antes del procedimiento. A aquellas pacientesen las que el procedimiento diagnóstico se convertíaen terapéutico, o la dosis era insuficiente, se les administrabaotra dosis de 200 mg. Grupo B (n=20), pacientes programadaspara histeroscopia terapéutica, que recibieron 400 mg.A aquellas pacientes en las que se consideraba que la dosisinicial era insuficiente, se les administraba otra dosis de 200 mg. Se estudiaron: 1. Presión arterial (PA), Frecuencia Cardiaca(FC) y Saturación de O2 (Sat O2), cada 10 min. 2. Nivelde analgesia, sedación y grado de ansiedad, durante todoel proceso. Tiempo transcurrido desde la premedicación hastael alta. Efectos indeseables. Satisfacción del paciente. Parala valoración del dolor se utilizó una escala de 1 a 5. Parael nivel de sedación, se utilizó la escala de Ramsay de 1 a 6.Para el grado de ansiedad se utilizó Spielberger State-TraitAnxiety Inventory Short Form. Resultados: La PA, FC y SatO2, se mantuvo estable en todas las pacientes desde la premedicaciónhasta el alta. El nivel medio de analgesia, el gradode sedación y de ansiedad fue satisfactorio durante todo elestudio. La dosis de CFOT consumido A: 210 mg y B 434.78mg y los tiempos premedicación - alta fueron: A 1.8 ± 0.7 h.y B 2.6 ± 1 1 h.La satisfacción fue buena/excelente en el 99.3% de loscasos. Conclusiones: este estudio demostró que el CFOT esun buen analgésico, ansiolítico y sedante en histeroscopias (AU)

Background: The aim of this study was to evaluate the effectiveness of the OTFC as analgesic, sedative and anxiolytic in patients who undergo diagnostic and therapeutic hysteroscopy. Methods: We carried out a prospective study in 40 patients who were programmed for diagnostic and therapeutic hysteroscopy. The inclusion’s criteria were: Patients with ASA I y II and who were nil by mouth for 8 hours. The exclusion’s criteria were: pregnancy and ASA > 3. None of the patients consumed antidepressants and/or anxiolytics. The patients were divided en 2 groups. Group A (n =20), patients planned for undergo diagnostic hysteroscopy received OTFC 20 minutes before surgery. The doses administrated were 200 μg. In those patients in which the diagnostic procedure was converted to the therapeutic, and the doses were insufficient an other dose of 200 μg was given 30 minutes after the first one. Group B (n = 20), patients planned for therapeutic hysteroscopy received 400 μg, 20 minutes before the procedure. In those patients in which we consider that the initial dose was insufficient, we given them a second dose of 200 μg 30 minutes after the first one. It was studied: 1. Blood pressure, heart rate and oxygen saturation, every 10 minutes from the premedication up to the discharge. 2. Level of analgesia, sedation and anxiety from the premedication up to the discharge. 3. Times between premedication up to the discharge. 4. Side effects. 5. Satisfaction of the patients: bad, regular, good and excellent. To evaluate the pain, we used a scale from 1 to 5. To evaluate the level of sedation, we used the scale of Ramsay from 1 to 6. To evaluate the grade of anxiety we used the Spilberger State-Trait Inventory sort form. Results: The blood pressure, heart rate and pulse oxymetry were constant in both groups from from the premedication up to the discharge. The level of analgesia, the grade of sedation and anxiety in both groups were satisfactory. The average of OTFC used was 210 μg and 434.78 μg in the group A and B respectively. Times between the premedication up to the discharge were: A 1.8 ± 0.7 h. y B 2.6 ± 1 1 h. 99.3% of the patients found OTFC excellent. Conclusions: This study demonstrates that the OTFC is an effective anxiolytic in patients who undergo diagnostic and therapeutic hysteroscopy

Réplica a “Accidental dural puncture in an obstetric patient, continuous spinal analgesia for labor and postdural puncture headache” / Reply. Accidental dural puncture in an obstetric patient, continuous spinal analgesia for labor and postdural puncture headache

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[Treatment of accidental dural puncture during obstetric epidural analgesia]. / Tratamiento de la punción dural accidental en la analgesia epidural del trabajo de parto.

OBJECTIVE: To assess the effectiveness of continuous intrathecal analgesia as prophylaxis for postdural puncture headache (PDPH) and for analgesia during labor in 12 patients who suffered accidental dural puncture. PATIENTS AND METHODS: A total of 920 patients who received spinal analgesia during labor were enrolled. Group A (no accidental dural puncture) received a single dose of 10 mL of 0.2% ropivacaine, and 5 minutes later continuous epidural infusion of 0.125% ropivacaine and 3 micromg mL(-1) was started at a rate of a 5 mL h(-1); a 5 mL bolus dose was allowed every 20 minutes if needed. In patients who suffered accidental dural puncture (Group B) we inserted an intrathecal catheter to administer an initial dose of 3 mL of 0.2% ropivacaine and the same analgesic mixture at the same dose as was administered in Group A. Patient characteristics, analgesic efficacy, duration of labor and delivery, motor blockade, analgesic volume, and incidence of PDPH were recorded. The Student t test was used for statistical comparisons. RESULTS: No significant differences in duration of labor and delivery, analgesic efficacy, or motor blockade were observed. The incidence of PDPH was 16.6% in Group B and 0.33% in Group A. The patients in Group B required more additional bolus doses: 10 (SD, 2) in Group B and 3 (1.25) in Group A (P<0.01). CONCLUSIONS: Continuous intrathecal analgesia after accidental dural puncture was a safe way to provide analgesia during labor and to reduce the expected incidence of PDPH.

Tratamiento de la punción dural accidental en la analgesia epidural del trabajo de parto / Treatment of accidental dural puncture during obstetric epidural analgesia

OBJETIVO: Valorar la analgesia intratecal continua durante el trabajo de parto, en doce pacientes que sufrieron una punción dural accidental, como opción de tratamiento preventivo de la cefalea postpunción dural (CPPD)y medida analgésica eficaz en el parto. PACIENTES Y MÉTODOS: Se estudiaron 920 pacientes que recibieron analgesia espinal para el parto. En el Grupo A se colocó un catéter epidural, se administró un bolo de 10 mL de ropivacaína al 0,2%y a los 5 minutos, se inició una perfusión continua de ropivacaína al 0,125%+fentanilo 3 μg mL-1, a 5mL h-1, con la posibilidad de bolos de 5mL/20 minutos. En aquellas pacientes en las que se realizó una punción dural accidental (Gru- po B)se colocó el catéter intratecal, se administró un bolo inicial de 3mL de ropivacaína 0,2%y la misma mezcla analgésica que en el grupo A a 0,5mL h-1 con bolos de 0,5mL/20 minutos. Se valoraron: variables demográficas, eficacia analgésica, duración del parto, bloqueo motor, volumen analgésico e incidencia de CPPD. El estudio estadístico se realizó utilizando la t de Student. RESULTADOS: No se encontraron diferencias signifi- cativas en la duración del parto, eficacia analgésica y bloqueo motor. La incidencia de CPPD en el grupo B fue del 16,6% y en el grupo A del 0,33%.Las pacientes del grupo B requirieron un mayor número de bolos adicionales respecto al A (10 ±2 frente a 3 ±1,25; p<0,01). CONCLUSIONES: La analgesia intratecal continua, tras punción dural accidental, fue un método de analgesia seguro durante el trabajo de parto y redujo la incidencia esperada de CPPD

OBJECTIVE: To assess the effectiveness of continuous intrathecal analgesia as prophylaxis for postdural punc- ture headache (PDPH)and for analgesia during labor in 12 patients who suffered accidental dural puncture. PATIENTS AND METHODS: A total of 920 patients who received spinal analgesia during labor were enrolled. Group A (no accidental dural puncture) received a single dose of 10 mL of 0.2% ropivacaine, and 5 minutes later continuous epidural infusion of 0.125% ropivacaine and 3 μmg mL-1 was started at a rate of a 5 mL h-1; a 5 mL bolus dose was allowed every 20 minutes if needed. In patients who suffered accidental dural puncture (Group B) we inserted an intrathecal catheter to administer an initial dose of 3 mL of 0.2%ropivacaine and the same analgesic mixture at the same dose as was administered in Group A. Patient characteristics, analgesic efficacy, duration of labor and delivery, motor blockade, analgesic volume, and incidence of PDPH were recorded. The Student t test was used for statistical comparisons. RESULTS: No significant differences in duration of labor and delivery, analgesic efficacy, or motor blockade were observed. The incidence of PDPH was 16.6%in Group B and 0.33% in Group A. The patients in Group B required more additional bolus doses: 10 (SD,2) in Group B and 3 (1.25) in Group A (P<0.01). CONCLUSIONS: Continuous intrathecal analgesia after accidental dural puncture was a safe way to provide analgesia during labor and to reduce the expected incidence of PDPH

Ação do extrato metanólico e etanólico de Davilla elliptica St. Hill. (Malpighiaceae) na resposta imune / Action of Davilla elliptica St. Hill. (Malpighiaceae) methanolic and ethanolic extracts in the immune response

Plantas têm contribuído no tratamento da maioria das doenças. Considerando a importância terapêutica das plantas medicinais, foi avaliada a atividade imunológica dos extratos metanólico e etanólico de Davilla elliptica. Macrófagos estão envolvidos em todos estágios da resposta imune, podendo liberar componentes como: peróxido de hidrogênio (H2O2), óxido nítrico (NO) e fator de necrose tumoral-alfa (TNF-alfa). A estimulação dos macrófagos foi avaliada pela determinação de H2O2, NO e TNF-alfa em culturas de macrófagos peritoneais de camundongos na presença dos extratos da D. elliptica. IC50 foi determinado através de ensaio utilizando MTT. Os estudos fitoquímicos realizados mostraram a presença de flavonóides derivados da quercetina e miricetina entre outros compostos. A produção de H2O2 não foi muito expressiva em ambos extratos, contudo a de NO foi significativa. Os dois extratos induziram a produção de TNF-alfa, sendo que a liberação dessa citocina pelo extrato metanólico foi quase cinco vezes maior do que pelo extrato etanólico. Uma relação entre as sínteses de NO e TNF-alfa foi observada. O aumento na produção de NO está relacionado com a indução de citocinas pró-inflamatórias como TNF-alfa. Analisando os resultados, sugere-se que os extratos metanólico e etanólico de D. elliptica podem modular a ativação de macrófagos.

Plants have contributed in a significant way to the treatment of most of the diseases. Considering the therapeutic importance of the medicinal plants, the immunological activity of the methanolic and ethanolic extract of Davilla elliptica was evaluated. In every stage of the immune response macrophages are involved and they can release many compounds such as hydrogen peroxide (H2O2), nitric oxide (NO) and tumor necrosis factor-alpha (TNF-alpha). Macrophages stimulation was evaluated by the determination of H2O2, NO and TNF-alpha in peritoneal macrophages cultures of mice in the presence of the D. elliptica extracts. IC50 was determined by MTT assay. The phytochemical study showed flavonoids derived from quercetin and myricetin and other compounds. The production of H2O2 was not very expressive in both extracts, but they presented a significant effect on NO production. The two extracts induced TNF-alpha production, although the methanolic liberated almost five times more TNF-alpha than the ethanolic one. A relationship among the synthesis of NO and TNF-alpha was observed. The increase of NO production is related with the induction of proinflammatory cytokines like TNF-alpha. Analyzing the results, it is suggested that methanolic and ethanolic extract of D. elliptica can modulate macrophage activation.