Efectividad de la entrevista motivacional en la atención fisioterápica de los trastornos musculoesqueléticos de la espalda / Effectiveness of the motivational interview in the physiotherapy care of musculoskeletal disorders of the back: A quasi-experimental study

Objetivo: Evaluar la efectividad de la entrevista motivacional (EM) junto al tratamiento fisioterapéutico habitual en pacientes con trastornos musculoesqueléticos (TME) de la espalda en atención primaria (AP). Métodos: Estudio cuasiexperimental en pacientes que iniciaron su tratamiento en el año 2020 en una unidad de fisioterapia tras diagnóstico médico de TME en la espalda, con seguimiento prospectivo de 2grupos con actuación terapéutica: grupo experimental (GE) y grupo de control (GC). Se empleó la EM solo en el GE. A ambos grupos se les entrevistó telefónicamente a los 3y 6meses de finalizar el tratamiento fisioterápico, preguntando por el cumplimiento de pautas domiciliarias y por la percepción subjetiva del estado de salud (escala de Barthel). Se ajustaron modelos de regresión lineales (coeficiente de regresión, IC del 95%) y logísticos (OR, IC del 95%). Resultados: La población de estudio fue de 154 personas (76,6% mujeres). La salud percibida fue significativamente mejor (p<0,001) en el GE que en el GC, tanto a los 3meses de seguimiento (7,4 versus 5,0, respectivamente) como a los 6(7,1 versus 4,6, respectivamente). Hubo una fuerte asociación entre percepción de salud y cumplimiento (coeficiente de regresión 3,0 [IC del 95%=2,5-3,4]). La asociación entre la EM y el cumplimiento terapéutico se mantuvo tras ajustes multivariados (OR a 6meses=383,6 [IC del 95% = 31,0-4.742,4]). Conclusiones: la incorporación de la EM como complemento de los tratamientos de fisioterapia es una herramienta factible y efectiva para mejorar el cumplimiento de las pautas domiciliarias y la percepción subjetiva de salud. (AU)

Objective: To evaluate the effectiveness of motivational interviewing (MI) combined with the usual physiotherapy treatment in patients with back musculoskeletal disorders (MSD) in primary care (PC). Methods: Quasi-experimental study with 2groups with therapeutic action (control group and experimental group) and prospective follow-up, in a physiotherapy unit in PC, in patients who began their treatment in 2020, with a medical diagnosis of MSD in the back. MI was used only in the face-to-face visits of the experimental group. Both groups were interviewed by telephone about 3and 6months after finishing the physiotherapy treatment. For this purpose, the Barthel scale was used for the subjective perception of the state of health, and the scale of compliance with home guidelines. Linear (regression coefficient, 95% CI) and logistic (OR, 95% CI) regression models were fitted. Results: The study population was 154 people (76.6% women). Perceived health was significantly better (P<.001) in the experimental group than in the control group, both at 3(7.4 versus 5.0, respectively) and at 6months of follow-up (7.1 versus 4.6, respectively). There was a strong association between perceived health and compliance (regression coefficient 3.0 [95% CI=2.5–3.4]). The strong association between MI and treatment adherence was maintained after multivariate adjustments (6-month OR=383.6 [95% CI 31.0–4742.4]). Conclusions: MI is a feasible and effective complement to physiotherapy treatments to improve compliance with home recommendations and subjective perception of health. (AU)

Afectación ocular secundaria a la infección por Monkeypox virus / Ocular involvement secondary to Monkeypox virus infection

Presentamos el caso de un paciente varón de 37años con cuadro compatible con conjuntivitis adenovírica de 5días de evolución. Se pautaron corticoides tópicos, lubricantes y retirada de pseudomembranas. El análisis mediante PCR del exudado conjuntival resultó positivo para Monkeypox virus. Durante el seguimiento presentó úlceras corneales de evolución tórpida, por lo que precisó ingreso para instaurar tratamiento con tecovirimat. La afectación ocular por Monkeypox virus suele ser leve y autolimitada. Se han descrito casos con afectación visual severa cuando hay daño corneal, tal y como se ejemplifica en este caso. Tras el ingreso hospitalario para tratamiento sistémico, presentó una evolución favorable. (AU)

We present the case of a 37-year-old male patient with symptoms compatible with adenoviral conjunctivitis of 5days’ evolution. Topical corticosteroids, lubricants and removal of pseudomembranes were prescribed. PCR analysis of conjunctival exudate was positive for Monkeypox virus. During follow-up, the patient developed corneal ulcers with a torpid course, requiring admission for treatment with tecovirimat. Ocular involvement by Monkeypox virus is usually mild and self-limiting. Cases with severe visual involvement have been described when there is corneal damage, as exemplified in this case. After admission to hospital for systemic treatment, the patient progressed favourably. (AU)

Ocular involvement secondary to Monkeypox virus infection.

We present the case of a 37-year-old male patient with symptoms compatible with adenoviral conjunctivitis of 5 days' evolution. Topical corticosteroids, lubricants and removal of pseudomembranes were prescribed. PCR analysis of conjunctival exudate was positive for Monkeypox virus. During follow-up, the patient developed corneal ulcers with a torpid course, requiring admission for treatment with Tecovirimat. Ocular involvement by Monkeypox virus is usually mild and self-limiting. Cases with severe visual involvement have been described when there is corneal damage, as exemplified in this case. After admission to hospital for systemic treatment, the patient progressed favourably.

Biomechanical Gait Effects of a Single Intervention with Wearable Closed Loop Control FES System in Chronic Stroke Patients. A Proof-of-Concept Pilot Study.

Foot drop is a gait disturbance characterized by difficulty in performing ankle dorsiflexion during the swing phase of the gait cycle. Current available evidence shows that functional electrical stimulation (FES) on the musculature responsible for dorsal ankle flexion during gait can have positive effects on walking ability. This study aims to present a proof of concept for a novel easy-to-use FES system and evaluates the biomechanical effects during gait in stroke patients, compared to unassisted walking. Gait was quantitatively evaluated in a movement analysis laboratory for five subjects with chronic stroke, in basal condition without assistance and in gait assisted with FES. Improvements were found in all temporospatial parameters during FES-assisted gait, evidenced by statistically significant differences only in gait speed (p=0.02). Joint kinematics showed positive changes in hip abduction and ankle dorsiflexion variables during the swing phase of the gait cycle. No significant differences were found in the Gait Deviation Index. In conclusion, the present pilot study demonstrates that the use of this FES system in the tibialis anterior muscle can cause gait functional improvements in subjects with foot drop due to chronic stroke.

Prolonged voluntary wheel running reveals unique adaptations in mdx mice treated with microdystrophin constructs ± the nNOS-binding site.

We tested the effects of prolonged voluntary wheel running on the muscle function of mdx mice treated with one of two different microdystrophin constructs. At 7 weeks of age mdx mice were injected with a single dose of AAV9-CK8-microdystrophin with (gene therapy 1, GT1) or without (gene therapy 2, GT2) the nNOS-binding domain and were assigned to one of four gene therapy treated groups: mdxRGT1 (run, GT1), mdxGT1 (no run, GT1), or mdxRGT2 (run,GT2), mdxGT2 (no run, GT2). There were two mdx untreated groups injected with excipient: mdxR (run, no gene therapy) and mdx (no run, no gene therapy). A third no treatment group, Wildtype (WT) received no injection and did not run. mdxRGT1, mdxRGT2 and mdxR performed voluntary wheel running for 52 weeks; WT and remaining mdx groups were cage active. Robust expression of microdystrophin occurred in diaphragm, quadriceps, and heart muscles of all treated mice. Dystrophic muscle pathology was high in diaphragms of non-treated mdx and mdxR mice and improved in all treated groups. Endurance capacity was rescued by both voluntary wheel running and gene therapy alone, but their combination was most beneficial. All treated groups increased in vivo plantarflexor torque over both mdx and mdxR mice. mdx and mdxR mice displayed ∼3-fold lower diaphragm force and power compared to WT values. Treated groups demonstrated partial improvements in diaphragm force and power, with mdxRGT2 mice experiencing the greatest improvement at ∼60% of WT values. Evaluation of oxidative red quadriceps fibers revealed the greatest improvements in mitochondrial respiration in mdxRGT1 mice, reaching WT levels. Interestingly, mdxGT2 mice displayed diaphragm mitochondrial respiration values similar to WT but mdxRGT2 animals showed relative decreases compared to the no run group. Collectively, these data demonstrate that either microdystrophin construct combined with voluntary wheel running increased in vivo maximal muscle strength, power, and endurance. However, these data also highlighted important differences between the two microdystrophin constructs. GT1, with the nNOS-binding site, improved more markers of exercise-driven adaptations in metabolic enzyme activity of limb muscles, while GT2, without the nNOS-binding site, demonstrated greater protection of diaphragm strength after chronic voluntary endurance exercise but decreased mitochondrial respiration in the context of running.

Efecto de semaglutida sobre los biomarcadores de la enfermedad del hígado graso en pacientes con diabetes y obesidad / Effect of semaglutide on fatty liver disease biomarkers in patients with diabetes and obesity

Objetivo El objetivo de este trabajo es evaluar el efecto de la semaglutida subcutánea sobre los biomarcadores de la enfermedad metabólica hepática (MAFLD), a saber, el índice de esteatosis hepática (HSI) y el índice de fibrosis-4 (FIB-4), a las 24semanas en pacientes ambulatorios atendidos en los servicios de Medicina Interna. Métodos En este estudio se analizaron pacientes de un registro de cohortes en curso, multicéntrico, prospectivo, pre-post y no controlado que inscribe a pacientes únicos y consecutivos con diabetes tipo2 tratados con semaglutida subcutánea. La esteatosis/fibrosis se determinó mediante HSI (<30 descartada, >36 esteatosis) y FIB-4 (<1,3 descartada, >2,67 fibrosis), respectivamente. Resultados La muestra incluyó 213 pacientes (46,9% mujeres) con una mediana de edad de 64 (±19) años. El índice de masa corporal y el peso basales medios fueron de 36,1 (±8,4) kg/m2 y 98 (±26,9) kg, respectivamente. El 99,9% presentaba valores de HSI indicativos de esteatosis, con un HSI medio de 47,9 (±8,2). Además, el 10,8% presentaba fibrosis (FIB-4 >2,67) y el 42,72% tenía valores en rangos intermedios (FIB-4 1,3-2,67). A las 24 semanas se produjo una reducción significativa del HSI (−2,36 [IC95%: 1,83-2,9], p<0,00001) y del FIB-4 (−0,075 [IC95%: 0,015-0,14], p<0,016), relacionada principalmente con descensos del peso corporal, de los niveles de triglicéridos, de la resistencia a la insulina (estimada mediante el índice triglicéridos-glucosa) y de las enzimas hepáticas. Conclusiones Estos resultados muestran que la semaglutida subcutánea tuvo un efecto beneficioso sobre la esteatosis hepática que fue más allá del control de la glucosa. Sus efectos estaban relacionados principalmente con la pérdida de peso, la disminución de los biomarcadores y la mejora de la sensibilidad a la insulina. Para muchos pacientes, la detección precoz es esencial para mejorar los resultados de la MAFLD y puede permitir seleccionar las opciones terapéuticas más eficaces (AU)

Aim This work aims to assess the effect of weekly subcutaneous semaglutide on biomarkers of metabolic-associated fatty liver disease (MAFLD), namely the hepatic steatosis index (HSI) and the fibrosis-4 (FIB-4) index, at 24weeks in outpatients attended to in internal medicine departments. Methods This study analyzed patients in an ongoing, multicenter, prospective, pre-post, uncontrolled cohort registry that enrolls unique, consecutive patients with type2 diabetes treated with weekly subcutaneous semaglutide. Steatosis/fibrosis were determined by HSI (<30 ruled out, >36 steatosis) and FIB-4 (<1.3 ruled out, >2.67 fibrosis), respectively. Results The sample included 213 patients (46.9% women) with a median age of 64 (±19) years. The median baseline body mass index and weight were 36.1 (±8.4) kg/m2 and 98 (±26.9) kg, respectively. A total of 99.9% had HSI values indicating steatosis, with a mean HSI of 47.9 (±8.2). Additionally, 10.8% had fibrosis (FIB-4 >2.67) and 42.72% had values in intermediate ranges (FIB-4 1.3-2.67). At 24weeks, there was a significant reduction in HSI (−2.36 (95%CI: 1.83-2.9), p<0.00001) and FIB-4 (−0.075 (95%CI: 0.015-0.14), p<0.016), mainly related to declines in body weight, triglyceride levels, insulin resistance (estimated by the triglyceride-glucose index), and liver enzymes. Conclusion These results show that weekly subcutaneous semaglutide had a beneficial effect on liver steatosis that went beyond glucose control. Its effects were mainly related to weight loss, a decline in biomarkers, and improvements in insulin sensitivity. For many patients, early detection is essential for improving MAFLD outcomes and may allow for selecting the most efficient treatment options (AU)

Subduction zone fluids and arc magmas conducted by lithospheric deformed regions beneath the central Andes.

Dehydration of the oceanic subducting slab promotes the formation of magmatic arcs, intra-slab intermediate-depth seismicity, and hydration of the overlying mantle wedge. However, the complex permeability structure of the overriding plate controls the magma and fluid migration and their accumulation at shallower depths. In this regard, mapping the inner structure of the overriding crust and mantle is crucial to understand the magmatic and hydrological processes in subduction zones. We integrate 3-D P-wave, [Formula: see text], and electrical resistivity tomographic models of the northern Chilean subduction zone to map the magmatic and fluids derived from the subducting oceanic Nazca plate. Results show a continental crust relatively thick (50-65 km) characterized by a lower zone of high [Formula: see text] values (7.2-7.6 km/s), which is interpreted as the presence of plutonic rocks. The mantle lithospheric wedge is weakly hydrated ([Formula: see text] = 1.75-1.8) while the forearc continental crust is traversed by regions of reduced electrical resistivity values ([Formula: see text] [Formula: see text]) interpreted as zones of relatively high permeability/fracturing and fluid content. These regions spatially correlate with upper plate trans-lithospheric deformation zones. Ascending melts accumulate preferentially in the back-arc, whereas hydrothermal systems form trenchward of the volcanic arc. The results highlight the complex permeability structure of the upper South American plate.

Cinemática de tronco durante la marcha en pacientes con ictus: revisión sistemática / Trunk kinematics during walking in stroke patients: A systematic review

El tronco y la pelvis se afectan como consecuencia de un ictus, lo que predispone a caídas y dependencia. El objetivo de esta revisión fue describir la cinemática lineal y angular de tronco y pelvis durante la marcha en pacientes con secuela de accidente cerebrovascular. Se incluyeron estudios publicados hasta junio de 2018 que hubieran utilizado un sistema de captura de movimiento 2-3D durante la marcha. La búsqueda fue en Cochrane, Medline, PEDRo, Lilacs, Scielo, EBSCO, ClinicalKey y Elsevier. Se seleccionaron 12 artículos. La cinemática lineal muestra mayores desplazamientos laterales y aceleración en todos los ejes. La cinemática angular en fase de balanceo del segmento parético presenta la pelvis en rotación posterior, elevada y con menor velocidad, y tronco en flexión anterior, inclinación lateral y rotación ipsilaterales. Los estudios tienen alta variabilidad, lo que imposibilita establecer una medida de efecto común. Sin embargo, los resultados permiten describir el comportamiento del tronco y de la pelvis (AU)

The trunk and pelvis are affected after stroke, predisposing individuals to falls and dependency. The aim of this review was to describe the lineal and angular kinematics of the trunk and pelvis in patients with post-stroke sequels during walking. We included studies published up to June 2018 using a 2-3 D motion capture system during walking. We searched the Cochrane, Medline, PEDRo, Lilacs, Scielo, EBSCO, ClinicalKey and Elsevier databases. Twelve articles were selected. Linear kinematics showed greater lateral displacement and acceleration in all axes. Angular kinematics in the swing phase of the paretic segment showed the pelvis in posterior rotation, with elevation and lower velocity and the trunk in anterior flexion, with lateral inclination and ipsilateral rotation. The studies showed wide variability, making it impossible to establish of a common effect. However, the results allow description of the movement of the trunk and pelvis (AU)

[Realities for a Sickle Cell Disease Control Strategy in the World Health Organization African Region]. / Réalités pour une stratégie de lutte contre la drépanocytose dans la région africaine de l'Organisation Mondiale de la Santé: Compte rendu du 7e Symposium International du Réseau d'Étude de la Drépanocytose en Afrique Centrale (REDAC https://www.redacnetwork.org/) Antananarivo, Madagascar. 13 - 15 juin 2018.

The Network for the Study of Sickle Cell Disease in Central Africa or REDAC, is a network of African, European and American researchers whose aim is to combat sickle cell disease. Its congresses take place every year in the partner countries with international symposia alternating with workshops. REDAC enables host countries to obtain from local authorities a real involvement in the fight through resolutions in line with national strategies of fight. The Seventh International Symposium of REDAC was held in 2018 in Antananarivo, Madagascar under the auspices of the Malagasy Minister of Health and the Malagasy Senate Authorities. The theme chosen was that of strategies to combat sickle cell disease recommended by the WHO. The presentations focused on neonatal screening, early diagnosis, management of sickle cell disease and new therapies (marrow transplant, gene therapy and treatment with hydroxyurea).

[Trunk kinematics during walking in stroke patients: A systematic review]. / Cinemática de tronco durante la marcha en pacientes con ictus: revisión sistemática.

The trunk and pelvis are affected after stroke, predisposing individuals to falls and dependency. The aim of this review was to describe the lineal and angular kinematics of the trunk and pelvis in patients with post-stroke sequels during walking. We included studies published up to June 2018 using a 2-3 D motion capture system during walking. We searched the Cochrane, Medline, PEDRo, Lilacs, Scielo, EBSCO, ClinicalKey and Elsevier databases. Twelve articles were selected. Linear kinematics showed greater lateral displacement and acceleration in all axes. Angular kinematics in the swing phase of the paretic segment showed the pelvis in posterior rotation, with elevation and lower velocity and the trunk in anterior flexion, with lateral inclination and ipsilateral rotation. The studies showed wide variability, making it impossible to establish of a common effect. However, the results allow description of the movement of the trunk and pelvis.

[Inflammation, malnutrition, and SARS-CoV-2 infection: a disastrous combination]. / La inflamación, la desnutrición y la infección por SARS-CoV-2: una combinación nefasta.

SARS-CoV-2 infection is associated with a high risk of malnutrition, mainly due to increased nutritional requirements and the presence of a severe and universal inflammatory state. Associated symptoms contribute to hyporexia, which perpetuates the negative nutritional balance. Furthermore, dysphagia, especially post-intubation, worsens and makes intake unsafe. This risk is greater in elderly and multimorbid patients. Inflammation to varying degrees is the common link between COVID-19 and the onset of malnutrition, and it is more correct to refer to disease-related malnutrition (DRM). DRM worsens the poor prognosis of SARS-CoV-2 infection, especially in the most severe cases. Therefore, it is necessary to identify and treat people at risk early, avoiding overexposure and direct contact with the patient. We cannot forget the role that a healthy diet plays in both prevention and recovery after discharge.

Immunogenicity of a new allergoid from Felis domesticus.

BACKGROUND: The chemical modification of allergens with glutaraldehyde improves safety while maintaining clinical efficacy, which permits the administration of higher doses of immunotherapy, reducing the risk of adverse reactions. The aim of this study is to evaluate the immunogenic capacity of a new cat dander polymer by immunizing mice and quantifying immunoglobulins in serum, in comparison with the non-modified allergen. METHODS: The study consists of the immunization of three mice groups with the polymerized and the native extract, together with a negative control group. The immunoglobulin levels in serum have been measured by indirect ELISA. By means of the non-parametric Mann-Whitney U test, it was determined if there were significant differences in the values of specific antibodies between groups. RESULTS: The group immunized with the allergoid showed significantly higher specific IgG and IgG1 values to dander allergens and specific IgG to the major allergen Fel d 1, while there were no significant changes in IgG2a and IgE values. These results could be due to a higher immunization dose. The vaccine formulation was based on the optimal defined dose for clinical efficacy of allergen immunotherapy. CONCLUSIONS: This preclinical study carried out with the present assay has established that the allergoid of cat dander extract, as designed for its optimal use in allergen immunotherapy, produces a higher specific IgG than the native extract, in addition to showing significantly higher specific IgG1 levels, evidencing a greater effectiveness in immunization.