La web 2.0 como un nuevo apoyo a la lactancia materna: percepción de madres y profesionales mediante un enfoque cualitativo / Web 2.0 as a new support for breastfeeding: Perception of mothers and professionals through a qualitative approach

Objetivo: El objetivo del presente trabajo es explorar la influencia de la web 2.0 como una red de apoyo complementaria a las redes tradicionales para el fomento de la lactancia materna (LM). Método: Estudio cualitativo explorativo, desarrollado del 8 de septiembre al 31 diciembre de 2022, en el Centro Sanitario «Las Vegas» (Corvera), Servicio de Salud del Principado de Asturias (SESPA). Las participantes fueron 5 profesionales expertas en LM y 7 madres lactantes, que constituyeron 2 grupos focales, seleccionadas por muestreo por conveniencia. El análisis consistió en transcripción de datos, lectura en profundidad, análisis mediante agrupación de conceptos y clasificación de la información en categorías. Resultados: Tras el análisis final se identificaron 7 categorías, organizadas según la proximidad del tema y el objetivo propuesto, a partir de los discursos más significativos del estudio: dificultades durante la LM, importancia de recibir ayuda, primeras redes de apoyo, otras redes de apoyo, un sistema sanitario con deficiencias, pandemia y LM 2.0, Salud 2.0 y app en LM: nueva forma de apoyo y características de una app sobre LM «ideal». Conclusiones: La web 2.0 ha revolucionado la forma en que las madres acceden a la información y al apoyo sobre LM, creando una red de ayuda en línea conectando a madres y profesionales de todo el mundo, proporciona información actualizada y posibilita una fuente de apoyo emocional mediante la creación de grupos de iguales. Esta influencia positiva de la web 2.0 ha tenido un impacto significativo en el fomento de la LM y el empoderamiento materno para tomar decisiones informadas sobre su proceso de amamantamiento.(AU)

Objective: The objective of this paper is to explore the influence of web 2.0 as a complementary support network to traditional networks for the promotion of breastfeeding (BF). Method: Qualitative and exploratory study carried out from September 8 to December 31, 2022, at the Las Vegas Health Centre (Corvera), Health Service of the Principality of Asturias (SESPA). The participants were 5 professional experts in BF and 7 breastfeeding mothers, who made up two focus groups, selected by convenience sampling. The analysis consisted of transcription of data, in-depth reading, analysis by grouping concepts and classification of the information into categories. Results: After the final analysis, seven categories were identified, organised according to the proximity of the topic and the proposed objective, based on the most significant discourses of the study: Difficulties during BF, Importance of receiving help: First support networks, Other support networks, A health system with deficiencies, Pandemic and BF 2.0, Health 2.0 and apps in BF: new form of support and Characteristics of an “ideal” app on BF. Conclusions: Web 2.0 has revolutionised the way mothers access information and support on BF, creating an online support network connecting mothers and professionals around the world, providing up-to-date information and enabling a source of emotional support through the creation of peer groups. This positive influence of web 2.0 has had a significant impact on promoting BF and empowering mothers to make informed decisions about their breastfeeding process.(AU)

Web 2.0 as a new support for breastfeeding: Perception of mothers and professionals through a qualitative approach.

OBJECTIVE: The objective of this paper is to explore the influence of Web 2.0 as a complementary support network to traditional networks for the promotion of breastfeeding (BF). METHOD: Qualitative and exploratory study carried out from September 8 to December 31, 2022, at the Las Vegas Health Centre (Corvera), Health Service of the Principality of Asturias (SESPA). The participants were 5 professional experts in BF and 7 breastfeeding mothers, who made up two focus groups, selected by convenience sampling. The analysis consisted of transcription of data, in-depth reading, analysis by grouping concepts and classification of the information into categories. RESULTS: After the final analysis, seven categories were identified, organised according to the proximity of the topic and the proposed objective, based on the most significant discourses of the study: difficulties during BF, importance of receiving help: first support networks, other support networks, A health system with deficiencies, pandemic and BF 2.0, Health 2.0 and apps in BF: new form of support and characteristics of an "ideal" app on BF. CONCLUSIONS: Web 2.0 has revolutionised the way mothers access information and support on BF, creating an online support network connecting mothers and professionals around the world, providing up-to-date information and enabling a source of emotional support through the creation of peer groups. This positive influence of Web 2.0 has had a significant impact on promoting BF and empowering mothers to make informed decisions about their breastfeeding process.

Systemic epigallocatechin gallate protects against retinal degeneration and hepatic oxidative stress in the P23H-1 rat.

Retinitis pigmentosa (RP) is a group of inherited retinal disorders that lead to photoreceptor loss. RP has been reported to be related to oxidative stress, autophagy, and inflammation. (-)-Epigallocatechin gallate (EGCG), the most abundant catechin-based flavonoid in green tea leaves, has significant antioxidant, anti-carcinogenic, antimicrobial, and neuroprotective properties. EGCG, given its low molecular weight and hydrophilic properties, can cross the blood-retinal barrier and is able to reach different ocular tissues such as the lens, cornea, and retina. EGCG has been shown to provide retinal protection against ischemia; sodium nitroprusside-, N-methyl-D-aspartate-, lipopolysaccharide-, light-, sodium iodate-, or H2O2-induced damage and diabetic retinopathy. This suggests that systemic EGCG administration has the potential to protect against retinal degenerative or neurodegenerative diseases such as RP. The aim of this work was to investigate whether EGCG can protect against RP progression in the animal P23H line 1, the model of RP. Albino P23H rats were crossed with pigmented Long Evans rats to produce offspring exhibiting the clinical features of RP. Pigmented P23H rats were treated via intraperitoneal injection with saline or EGCG at a dose of 25 mg/kg every week from P100 to P160 and then compared to wild-type Long Evans rats. Rats treated with EGCG showed better visual and retinal electrical function with increased contrast sensitivity and b-wave values compared with those observed in P23H rats treated with vehicle. EGCG reduced lipid peroxidation and increased total antioxidant capacity and catalase and superoxide dismutase activities. No differences were observed in visual acuity, nitrate levels, nitrite levels or glutathione S-transferase activity. In conclusion, EGCG not only reduced the loss of visual function in P23H rats but also improved the levels of antioxidant enzymes and reduced oxidative damage. This study was approved by the Institutional Animal Care and Use Committee (CEICA) from the University of Zaragoza under project license PI12/14 on July 11, 2014.

Photometric and Colorimetric Evaluation of Phototherapy Instruments for Syntonic Treatment of Visual Anomalies.

SIGNIFICANCE: Ocular light exposure therapy has been used in optometric therapies to improve binocular anomalies such as accommodative or vergence dysfunctions, amblyopia therapy or to increase the visual field. Currently, syntonic phototherapy is used worldwide by behavioral optometrists, vision trainers, or occupational therapists, among others, although these treatments are supported by only a few research studies that lack consensus on the efficacy of this approach. PURPOSE: In this article, we highlight the optical characteristics of lamps without evaluating the efficacy of their use in optometric procedures. METHODS: Our work analyzes four devices often used in clinical practice in terms of spectral power distribution, illuminance levels at the corneal plane, and both theoretical photopic and melanopic contributions to the visual system. RESULTS: First, illuminance levels reaching the corneal plane depend on the characteristics of each lamp and their distance from where the eye should be positioned; for example, delta-theta filter photopic illuminance is 13.1, 93.7, 22.7, or 41.6 lux with the four evaluated devices. Second, filters or modes named the same differ in terms of their spectral power distribution. Third, substantial difference in color appearance has been found among the same configurations. CONCLUSIONS: The spectral and iluminance characteristics of syntonic systems used for vision therapy vary widely, including variations among filters with the same identifying characteristics. This provides significant sources of variability, which limit the ability to conduct evidence-based medicine clinical trials to assess the true efficacy of syntonic therapy. This study furthers our knowledge of syntonic phototherapy from a technical perspective; however, longitudinal research examining patients' evolution pre-lighting and post-lighting treatments is required to justify and understand the effects of light exposure and its impact on optometric and ocular parameters more clearly.

Aneurisma de arteria braquial inducido por el uso de muleta / Crutch-induced brachial artery aneurysm

Introducción: el uso de muletas de forma prolongada como desencadenante de aneurisma de arteria braquial es raro pero potencialmente vital. Caso clínico: presentamos a una paciente de 84 años, con historia de poliomielitis y uso prolongado de muleta en brazo derecho. Se diagnostica de isquemia crítica secundaria a oclusión de aneurisma de arteria braquial y lesiones por embolización distal. A pesar de realizarse injerto venoso, la paciente presenta mala evolución con amputación de antebrazo. Discusión: es de vital importancia el reconocimiento y tratamiento de esta patología.(AU)

Introduction: the prolonged use of crutches resulting in a brachial aneurysm is rare but potentially vital. Case report: we present an 84-year-old patient with a history of poliomyelitis and prolonged use of a crutch in her right arm. She was diagnosed with critical ischemia secondary to occlusion of brachial artery aneurysm and distal embolization lesions. Despite having performed a venous graft, the patient presented a poor evolution which resulted in a forearm amputation. Discussion: it's of vital importance to recognize and treat this pathology.(AU)

Análisis descriptivo de aplicaciones móviles sobre lactancia materna / Descriptive analysis of mobile phone applications on breastfeeding

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Injerto venoso permeable por colaterales en miembro inferior / Patent venous graft by collaterals in lower limb

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Ultrastructural and immunohistochemical study of phenotypic switch in gastrointestinal smooth muscle cells.

Dedifferentiation is a loss of phenotypic specialization that converts differentiated cells into adult stem cells in order to proliferate and differentiate into replacement tissue. This occurs in several tissues from various organs, such as smooth muscle cells (SMCs) of the mammalian gastrointestinal tract. The aim of this study was to describe ultrastructural and immunohistochemical changes in SMCs which could be compatible with a dedifferentiation process in human and rabbit intestinal muscles. Ultrastructural study and immunohistochemical staining (SMemb and MyoD) on human and rabbit duodenum tissue sections were performed. In both species, this dedifferentiation process is characterized by a loss of intercellular junctions, increased intercellular spaces, cytoskeletal disorganization, perinuclear accumulation of large vacuoles that tend to fuse, rupture of the vacuole membrane and release of cytoplasmic fragments. Dedifferentiated cells show the characteristic phenotype of a mesenchymal cell with scarce perinuclear cytoplasm, long cytoplasmic prolongations and finely distributed granular chromatin in the nucleus. These morphological changes are accompanied by a modulation to a less mature phenotype showing immunoreactivity for the embryonic form of the myosin heavy chain and for the myogenic regulatory factor MyoD. We suggest that SMC dedifferentiation includes the elimination of the contractile apparatus, the activation of the nucleus and the re-expression of embryonic markers. We described an ultrastructural dedifferentiation process possible in intestinal SMCs. This dedifferentiation process seems to play a key role in the homeostasis of the intestinal muscle.

Hepatic oxidative stress in pigmented P23H rhodopsin transgenic rats with progressive retinal degeneration.

Retinitis pigmentosa (RP) comprises a group of inherited retinal degenerative conditions characterized by primary degeneration of the rod photoreceptors. Increased oxidative damage is observed in the retina, aqueous humor, and plasma of RP animal models and patients. The hepatic oxidative status may also be affected in RP due to oxidative damage influencing soluble macromolecules exiting the retina or to alterations in the melanopsin system resulting in chronic circadian desynchronization that negatively alters the oxidative stress defense system. P23H rats were crossed with pigmented Long Evans rats to produce offspring exhibiting the clinical conditions of RP. We measured hepatic malondialdehyde and 4-hydroxyalkenal concentrations as oxidative stress markers; nitrite level as a total nitrosative damage marker; total antioxidant capacity; and the activities of catalase, superoxide dismutase (SOD), and glutathione S-transferase. Retinal visual function was assessed based on optomotor and electroretinogram responses. P23H transgenic rats exhibited diminished visual acuity, contrast sensitivity, and electroretinographic responses according to the level of retinal degeneration. P23H rats at 30 days of age already demonstrated only 47% of the hepatic total antioxidant capacity of wild-type animals. Hepatic catalase and SOD activities were also reduced in P23H rats after 120 days, but we detected no difference in glutathione S-transferase activity. P23H rats had increased hepatic oxidative and nitrosative damage markers. GSH/GSSG ratio showed a significant diminution in P23H rats at P120 compared to WT. We conclude that the liver is under increased oxidative stress in P23H rats. Further studies are required, however, to clarify the contribution of systemic oxidative damage to the pathogenesis of RP.

Relationship between the use of benzodiazepines and falls in older adults: A systematic review.

Falls in the elderly represent a major health problem. The etiology of falls is usually multifactorial. Special attention should be paid on benzodiazepines (BZDs) since they are widely used by older adults. A literature search of the PUBMED and EMBASE databases from January 2007 to February 2017 was conducted using the MeSH terms "benzodiazepines", "elderly" and "falls" or "accidental falls". The systematic review was performed according to PRISMA criteria. Of the 27 references selected for full reading from 235 found, 15 were eliminated and 12 papers were selected for systematic review. Exposure to BZDs was associated with a higher risk of falls in older adults, which is consistent with the results reported in the literature and previous reviews and meta-analyses. BZDs increase the risk of falling when used either as monotherapy or in combined therapies. It is preferable to use short-acting BZDs, to avoid cumulative effects over time predisposing to falls. A high proportion of falls in older adults are related to the use of BZDs. They should be prescribed to older patients in accordance with current clinical guidelines and reviewed over time. BZDs should be prescribed as a short-term therapy and progressively withdrawn. Short-acting BZDs should be the treatment of choice.

Long time remodeling during retinal degeneration evaluated by optical coherence tomography, immunocytochemistry and fundus autofluorescence.

PURPOSE: To characterize the relationship between fundus autofluorescence (FAF), Optical Coherence Tomography (OCT) and immunohistochemistry (IHC) over the course of chronic retinal degeneration in the P23H rat. METHODS: Homozygous albino P23H rats, Sprague-Dawley (SD) rats as controls and pigmented Long Evans (LE) rats were used. A Spectralis HRA OCT system was used for scanning laser ophthalmoscopy (SLO) imaging OCT and angiography. To determine FAF, fluorescence was excited using diode laser at 488 nm. A fast retina map OCT was performed using the optic nerve as a landmark. IHC was performed to correlate with the findings of OCT and FAF changes. RESULTS: During the course of retinal degeneration, the FAF pattern evolved from some spotting at 2 months old to a mosaic of hyperfluorescent dots in rats 6 months and older. Retinal thicknesses progressively diminished over the course of the disease. At later stages of degeneration, OCT documented changes in the retinal layers, however, IHC better identified the cell loss and remodeling changes. Angiography revealed attenuation of the retinal vascular plexus with time. CONCLUSION: We provide for the first time a detailed long-term analysis of the course of retinal degeneration in P23H rats using a combination of SLO and OCT imaging, angiography, FAF and IHC. Although, the application of noninvasive methods enables longitudinal studies and will decrease the number of animals needed for a study, IHC is still an essential tool to identify retinal changes at the cellular level.

Efectos adversos de antipsicóticos atípicos, diferencias según sexo / Gender differences in the adverse effects of atypical antipsychotic drugs

Los efectos adversos de los antipsicóticos atípicos varían en función del sexo de los pacientes. Las mujeres tienen un peso medio inferior al de los hombres, y además, a nivel farmacocinético tienen un menor aclaramiento de algunos antipsicóticos como la clozapina y olanzapina. Entre los efectos secundarios más frecuentes en mujeres, cabe destacar el incremento del intervalo QT corregido. También el riesgo metabólico es mayor en mujeres: estas tienen más probabilidades de aumentar el peso tras tratamientos prolongados, sobre todo con clozapina y olanzapina. La prolactina se incrementa más en las mujeres que en los varones tras tratamiento antipsicótico. Este efecto secundario es más frecuente con amisulpride, risperidona y paliperidona. Entre los efectos secundarios extrapiramidales, la acatisia es también más frecuente en mujeres. En el futuro es necesario tener en cuenta la variable género al hacer el cálculo de la dosis y valoración de efectos secundarios tras el tratamiento antipsicótico (AU)

The adverse effects of atypical antipsychotic drugs vary depending on the sex of the patients. Females have a lower mean body weight than males, thus, at pharmacokinetic level, they have a lower clearance of some antipsychotics such as, clozapine and olanzapine. Among the most common adverse effects is highlighted the increase in corrected QT interval. Metabolic risks are also greater in females, with these being more likely to increase the weight after prolonged treatments, particularly with clozapine and olanzapine. Prolactin is increased more in females than in males after antipsychotic treatment. This adverse effect is more common with amisulpride, risperidone and paliperidone. Among the extrapyramidal secondary effects, akathisia is also more common in females. Gender variability should be taken into account in the future when calculating the dose, as well as when evaluating the adverse effects after antipsychotic treatment (AU)