Percepciones sobre la rehabilitación durante la pandemia por COVID-19 de las personas con discapacidad motora / People's perceptions with motor disabilities of rehabilitation during the COVID-19 pandemic

Antecedentes y objetivo: La Organización Mundial de la Salud declaró a la infección por COrona VIrus Disease 19 (COVID-19) como pandemia y recomendó, como medida preventiva, el distanciamiento social. Esto afectó a todos los tratamientos médico-clínicos, incluidos los relacionados con el proceso de rehabilitación física. El objetivo fue describir las percepciones sobre el proceso de rehabilitación debido a las modificaciones experimentadas por las personas con discapacidad motora de un hospital de rehabilitación durante la pandemia por COVID-19. Pacientes y métodos: Diseño cualitativo. La muestra elegida fue por conveniencia y el análisis de datos fue por análisis temático, el cual permite identificar, analizar y reportar temas relevantes. Las entrevistas se realizaron a pacientes atendidos en la División de Kinesiología. Criterios de inclusión: adultos> 18 años, diagnóstico de discapacidad motora, en tratamiento kinésico ≥ 1 mes de forma ambulatoria, con alta temprana de internación o internados en el momento de la realización del estudio y firma del consentimiento informado. Criterios de exclusión: alta kinésica por motivos diferentes a la COVID-19 y diagnóstico de enfermedad psiquiátrica. Resultados: La muestra se compuso de 16 participantes. El 31,2% era de sexo femenino. Doce presentaron diversas alteraciones neurológicas y 4, secuelas de amputación. Se identificaron 4 temas principales: importancia de la rehabilitación, modificaciones/interrupción del tratamiento, actividades de la vida diaria y telerrehabilitación. Conclusiones: Se describieron las percepciones sobre el proceso de rehabilitación y el impacto en las modificaciones experimentadas en las personas con discapacidad motora. Destacamos la importancia de la telerrehabilitación como un recurso alternativo.(AU)

Background and objective: The World Health Organization declared COrona VIrus Disease 19 (COVID-19) a pandemic and recommended social distancing as a preventive measure. This affected all medical–clinical treatments, including those related to the physical rehabilitation process. The objective was to describe the perceptions about the rehabilitation process due to the modifications experienced by people with motor disabilities in a rehabilitation hospital during the COVID-19 pandemic. Patients and methods Qualitative design. The sample chosen was for convenience and the data analysis was by thematic analysis, which allows to identify, analyze and report themes. The interviews were conducted with patients seen in the physiotherapy división of the hospital. Inclusion criteria: adults >18 years old, diagnosis of motor disability, undergoing physical treatment ≥1 month on an outpatient basis, with early discharge from hospitalization or hospitalization at the time of the study and signing of the informed consent. Exclusion criteria: physical discharge for reasons other than COVID-19 and diagnosis of psychiatric illness. Results: The sample consisted of 16 participants. 31.2% were female. Twelve presented various neurological alterations and 4 amputation effects. Four main themes were identified: importance of rehabilitation, treatment modifications/interruption, activities of daily living and tele-rehabilitation. Conclusions: Perceptions about the rehabilitation process and the impact on the modifications experienced in people with motor disabilities were described. We highlight the importance of tele-rehabilitation as an alternative resource.(AU)

[People's perceptions with motor disabilities of rehabilitation during the COVID-19 pandemic]. / Percepciones sobre la rehabilitación durante la pandemia por COVID-19 de las personas con discapacidad motora.

BACKGROUND AND OBJECTIVE: The World Health Organization declared COrona VIrus Disease 19 (COVID-19) a pandemic and recommended social distancing as a preventive measure. This affected all medical-clinical treatments, including those related to the physical rehabilitation process. The objective was to describe the perceptions about the rehabilitation process due to the modifications experienced by people with motor disabilities in a rehabilitation hospital during the COVID-19 pandemic. PATIENTS AND METHODS: Qualitative design. The sample chosen was for convenience and the data analysis was by thematic analysis, which allows to identify, analyze and report themes. The interviews were conducted with patients seen in the physiotherapy división of the hospital. INCLUSION CRITERIA: adults >18 years old, diagnosis of motor disability, undergoing physical treatment ≥1 month on an outpatient basis, with early discharge from hospitalization or hospitalization at the time of the study and signing of the informed consent. EXCLUSION CRITERIA: physical discharge for reasons other than COVID-19 and diagnosis of psychiatric illness. RESULTS: The sample consisted of 16 participants. 31.2% were female. Twelve presented various neurological alterations and 4 amputation effects. Four main themes were identified: importance of rehabilitation, treatment modifications/interruption, activities of daily living and tele-rehabilitation. CONCLUSIONS: Perceptions about the rehabilitation process and the impact on the modifications experienced in people with motor disabilities were described. We highlight the importance of tele-rehabilitation as an alternative resource.

Substantial oxygen consumption by aerobic nitrite oxidation in oceanic oxygen minimum zones.

Oceanic oxygen minimum zones (OMZs) are globally significant sites of biogeochemical cycling where microorganisms deplete dissolved oxygen (DO) to concentrations <20 µM. Amid intense competition for DO in these metabolically challenging environments, aerobic nitrite oxidation may consume significant amounts of DO and help maintain low DO concentrations, but this remains unquantified. Using parallel measurements of oxygen consumption rates and 15N-nitrite oxidation rates applied to both water column profiles and oxygen manipulation experiments, we show that the contribution of nitrite oxidation to overall DO consumption systematically increases as DO declines below 2 µM. Nitrite oxidation can account for all DO consumption only under DO concentrations <393 nM found in and below the secondary chlorophyll maximum. These patterns are consistent across sampling stations and experiments, reflecting coupling between nitrate reduction and nitrite-oxidizing Nitrospina with high oxygen affinity (based on isotopic and omic data). Collectively our results demonstrate that nitrite oxidation plays a pivotal role in the maintenance and biogeochemical dynamics of OMZs.

Propiedades psicométricas de instrumentos observacionales para evaluar habilidades en silla de ruedas en sujetos con lesión medular espinal: revisión sistemática / Psychometric properties of observational instruments to evaluate wheelchair skills in persons with a spinal cord injury: A systematic review

El 60% de las personas con lesión medular es completamente dependiente de una silla de ruedas; existe una gran variedad de instrumentos que evalúan las habilidades en la misma, pero no son específicos para esta población. Objetivo Identificar, evaluar, comparar y resumir las propiedades psicométricas de instrumentos que evalúen habilidades en silla de ruedas en sujetos con lesión medular. Se realizó una revisión sistemática y se incluyeron instrumentos observacionales que evaluaron habilidades en silla de ruedas en sujetos con lesión medular espinal. Se identificaron 11 artículos que evaluaron 8 instrumentos. La mayoría de los mismos reportaron actividades según la Clasificación internacional del funcionamiento, de la discapacidad y de la salud. La fiabilidad fue la propiedad psicométrica más evaluada. El Queensland Evaluation of Wheelchair Skills y el Adapted Manual Wheelchair Circuit presentaron los mejores grados de confianza en la evidencia; su utilización orientaría a seleccionar estrategias terapéuticas pertinentes (AU)

A total of 60% of people with a spinal cord injury are completely dependent on a wheelchair. There is a wide variety of instruments that assess wheelchair skills, but they are not specific for this population. Objective To identify, assess, compare and summarize the psychometric properties of instruments that assess wheelchair skills in persons with a spinal cord injury. A systematic review was conducted and observational instruments were included that assessed wheelchair skills in persons with spinal cord injury. Eleven articles were identified that evaluated eight instruments. Most of them reported activities according to the International Classification of Functioning, Disability and Health. Reliability was the most frequently evaluated psychometric property. The Queensland Evaluation of Wheelchair Skills and the Adapted Manual Wheelchair Circuit had the best degrees of confidence in the evidence, and their application could guide the selection of pertinent therapeutic strategies (AU)

[Psychometric properties of observational instruments to evaluate wheelchair skills in persons with a spinal cord injury: A systematic review]. / Propiedades psicométricas de instrumentos observacionales para evaluar habilidades en silla de ruedas en sujetos con lesión medular espinal: revisión sistemática.

A total of 60% of people with a spinal cord injury are completely dependent on a wheelchair. There is a wide variety of instruments that assess wheelchair skills, but they are not specific for this population. OBJECTIVE: To identify, assess, compare and summarize the psychometric properties of instruments that assess wheelchair skills in persons with a spinal cord injury. A systematic review was conducted and observational instruments were included that assessed wheelchair skills in persons with spinal cord injury. Eleven articles were identified that evaluated eight instruments. Most of them reported activities according to the International Classification of Functioning, Disability and Health. Reliability was the most frequently evaluated psychometric property. The Queensland Evaluation of Wheelchair Skills and the Adapted Manual Wheelchair Circuit had the best degrees of confidence in the evidence, and their application could guide the selection of pertinent therapeutic strategies. PROSPERO registration: CRD42020161430.

Rate of colorectal neoplasia in patients with Hodgkin lymphoma.

AIM: Survivors of Hodgkin lymphoma (HL) are at increased risk of breast, lung, thyroid, stomach, pancreatic and colon cancer. There is limited information on the utility of endoscopic screening for colon cancer. We aimed to describe the adenoma detection rate (ADR) in patients with HL to determine the appropriate timing of colonoscopy screening. METHOD: We retrospectively studied patients with HL who underwent colonoscopy between 2000 and 2017. RESULTS: A total of 251 patients underwent colonoscopy. Eighty (32%) patients had 151 colonic polyps. Thirty per cent of the polyps exhibited high-grade dysplasia, and invasive colon adenocarcinoma was found in 10 patients. Patients with the nodular sclerosing subtype of HL had a significantly lower ADR than others (P = 0.002). The ADR was 5% in patients younger than 35 years (n = 64), 23% in patients between 35 and 40 years of age (n = 22), 39% in patients between 40 and 50 years of age (n = 51) and 46% in patients older than 50 years (n = 114).

Comparative evaluation of in vitro human macrophage models for mycobacterial infection study.

Macrophages are phagocytic cells that play a key role maintaining the homeostasis of many tissues. Their function is essential for controlling and eradicating infecting mycobacteria. Human monocytic cell lines such as THP-1 and U937 have provided interesting insights into how mycobacteria subvert the host cell response. However, immortalized cell lines could bring some disadvantages. Here we compare the response of THP-1 and U937 cell lines with human monocyte-derived macrophages (hMDMs) to determine functional differences during infection with different mycobacterial phenotypes (virulent Mycobacterium tuberculosis H37Rv and Mycobacterium bovis, and attenuated M. bovis BCG). The findings of this study indicate that the U937 cell line displays a significantly lower phagocytic capacity than hMDMs and THP-1 macrophages, regardless of the mycobacterial strain. In all cell models, interferon-γ activation leads to up-regulation of interleukin-12 and nitrite production. However, the phorbol 12-myristate 13-acetate (PMA)-induced differentiation of U937 and THP-1 cell lines induces a significant tumor necrosis factor-α production in resting macrophages. However, this state of activation has no effect on the control of intracellular growth of mycobacteria. Moreover, U937 cells show more discrepancies with hMDM than THP-1. This study demonstrates that THP-1 macrophages exhibit closer functional similarities to hMDMs in response to mycobacterial infection, regardless of the strain.

HIV-1 Tat protein interacts with mammalian capping enzyme and stimulates capping of TAR RNA.

HIV gene expression is subject to a transcriptional checkpoint, whereby negative transcription elongation factors induce an elongation block that is overcome by HIV Tat protein in conjunction with P-TEFb. P-TEFb is a cyclin-dependent kinase that catalyzes Tat-dependent phosphorylation of Ser-5 of the Pol II C-terminal domain (CTD). Ser-5 phosphorylation confers on the CTD the ability to recruit the mammalian mRNA capping enzyme (Mce1) and stimulate its guanylyltransferase activity. Here we show that Tat spearheads a second and novel pathway of capping enzyme recruitment and activation via a direct physical interaction between the C-terminal domain of Tat and Mce1. Tat stimulates the guanylyltransferase and triphosphatase activities of Mce1 and thereby enhances the otherwise low efficiency of cap formation on a TAR stem-loop RNA. Our findings suggest that multiple mechanisms exist for coupling transcription elongation and mRNA processing.

Nucleocapsid incorporation into parainfluenza virus is regulated by specific interaction with matrix protein.

The paramyxovirus nucleoproteins (NPs) encapsidate the genomic RNA into nucleocapsids, which are then incorporated into virus particles. We determined the protein-protein interaction between NP molecules and the molecular mechanism required for incorporating nucleocapsids into virions in two closely related viruses, human parainfluenza virus type 1 (hPIV1) and Sendai virus (SV). Expression of NP from cDNA resulted in in vivo nucleocapsid formation. Electron micrographs showed no significant difference in the morphological appearance of viral nucleocapsids obtained from lysates of transfected cells expressing SV or hPIVI NP cDNA. Coexpression of NP cDNAs from both viruses resulted in the formation of nucleocapsid composed of a mixture of NP molecules; thus, the NPs of both viruses contained regions that allowed the formation of mixed nucleocapsid. Mixed nucleocapsids were also detected in cells infected with SV and transfected with hPIV1 NP cDNA. However, when NP of SV was donated by infected virus and hPIV1 NP was from transfected cDNA, nucleocapsids composed of NPs solely from SV or solely from hPIVI were also detected. Although almost equal amounts of NP of the two viruses were found in the cytoplasm of cells infected with SV and transfected with hPIV1 NP cDNA, 90% of the NPs in the nucleocapsids of the progeny SV virions were from SV. Thus, nucleocapsids containing heterologous hPIV1 NPs were excluded during the assembly of progeny SV virions. Coexpression of hPIV1 NP and hPIV1 matrix protein (M) in SV-infected cells increased the uptake of nucleocapsids containing hPIV1 NP; thus, M appears to be responsible for the specific incorporation of the nucleocapsid into virions. Using SV-hPIV1 chimera NP cDNAs, we found that the C-terminal domain of the NP protein (amino acids 420 to 466) is responsible for the interaction with M.

Human parainfluenza virus type 1 matrix and nucleoprotein genes transiently expressed in mammalian cells induce the release of virus-like particles containing nucleocapsid-like structures.

The matrix (M) protein plays an essential role in the assembly and budding of some enveloped RNA viruses. We expressed the human parainfluenza virus type 1 (hPIV-1) M and/or NP genes into 293T cells using the mammalian expression vector pCAGGS. Biochemical and electron microscopic analyses of transfected cells showed that the M protein alone can induce the budding of virus-like particles (vesicles) from the plasma membrane and that the NP protein can assemble into intracellular nucleocapsid-like (NC-like) structures. Furthermore, the coexpression of both the M and NP genes resulted in the production of vesicles enclosing NC-like structures, suggesting that the hPIV-1 M protein has the intrinsic ability to induce membrane vesiculation and to incorporate NC-like structures into these budding vesicles.

Cytoplasmic domain of Sendai virus HN protein contains a specific sequence required for its incorporation into virions.

In the assembly of paramyxoviruses, interactions between viral proteins are presumed to be specific. The focus of this study is to elucidate the protein-protein interactions during the final stage of viral assembly that result in the incorporation of the viral envelope proteins into virions. To this end, we examined the specificity of HN incorporation into progeny virions by transiently transfecting HN cDNA genes into Sendai virus (SV)-infected cells. SV HN expressed from cDNA was efficiently incorporated into progeny Sendai virions, whereas Newcastle disease virus (NDV) HN was not. This observation supports the theory of a selective mechanism for HN incorporation. To identify the region on HN responsible for the selective incorporation, we constructed chimeric SV and NDV HN cDNAs and evaluated the incorporation of expressed proteins into progeny virions. Chimera HN that contained the SV cytoplasmic domain fused to the transmembrane and external domains of the NDV HN was incorporated to SV particles, indicating that amino acids in the cytoplasmic domain are responsible for the observed specificity. Additional experiments using the chimeric HNs showed that 14 N-terminal amino acids are sufficient for the specificity. Further analysis identified five consecutive amino acids (residues 10 to 14) that were required for the specific incorporation of HN into SV. These residues are conserved among all strains of SV as well as those of its counterpart, human parainfluenza virus type 1. These results suggest that this region near the N terminus of HN interacts with another viral protein(s) to lead to the specific incorporation of HN into progeny virions.

Expression of leptin and beta 3-adrenergic receptors in rat adipose tissue in altered thyroid states.

The level of leptin [the obese (ob) gene product] mRNA is markedly elevated in hypothyroid male rats. The administration of tri-iodothyronine (T3) to hypothyroid rats resulted in a 40% decrease in leptin mRNA at 8 h. This decrease in leptin mRNA was associated with a parallel decline in circulating leptin levels of about 50% at 24 h. Conversely, beta 3-adrenergic receptor mRNA levels were markedly decreased in epididymal adipose tissue from hypothyroid rats. T3 administration resulted in a 147% increase at 12 h in beta 3-adrenergic receptor mRNA. There was a corresponding increase due to T3 in the lipolytic response to the specific beta 3-adrenergic agonist CL 316,243 that paralleled the increase in beta 3-adrenergic receptor mRNA. T3-mediated changes in leptin and beta 3-adrenergic receptor mRNAs were blocked by cycloheximide, suggesting the involvement of short-lived proteins in these effects. The present results indicate that T3 has opposite effects to those of insulin on the white adipose tissue of rats with respect to leptin mRNA expression.

Enhanced desensitization and phosphorylation of the beta 1-adrenergic receptor in rat adipocytes by peroxovanadate.

Peroxovanadate (PVN) is an insulin-like agent that inhibits the dephosphorylation of the insulin receptor kinase. PVN inhibited the lipolytic action of 0.1 microM isoproterenol by 88%, which is a relatively specific beta 1 catecholamine agonist at this concentration, but was largely ineffective against beta 3 agonists or forskolin. To determine whether PVN-mediated desensitization of the beta 1 AR was associated with enhanced phosphorylation, we immunoprecipitated the beta 1 AR from rat adipocytes that were metabolically labeled with 32PO4. Isoproterenol enhanced the net phosphorylation of the beta 1 AR by 8 +/- 2-fold over control. PVN increased the net phosphorylation of the beta 1 AR by 5 +/- 0.5-fold, and together with isoproterenol, they enhanced the phosphorylation of the beta 1 AR by 2-fold over isoproterenol alone. Phosphoamino acid analysis of the phosphorylated receptor revealed phosphate incorporation into serine that was proportional to the radioactivity incorporated into the immunoprecipitated receptor. PVN inhibited the serine/threonine phosphatase calcineurin, suggesting that inhibition of receptor dephosphorylation may play a role in the actions of PVN. Cyanogen bromide cleavage of the phosphorylated beta 1 AR generated a phosphoprotein with a molecular mass consistent with carboxyl-terminal phosphorylation. Furthermore, the magnitude of receptor phosphorylation by isoproterenol was 3-fold larger than that due to forskolin, suggesting that beta 1 AR is a substrate for the beta AR kinase that phosphorylates carboxyl-terminal residues in the beta(2) AR. Our findings suggest that PVN may be a powerful new tool with which to study the phosphorylation of other G protein-coupled receptors.

Insulin sensitizes beta-agonist and forskolin-stimulated lipolysis to inhibition by 2',5'-dideoxyadenosine.

In isolated rat adipocytes incubated in the absence of insulin, 2',5'-dideoxyadenosine blocked the increase in total adenosine 3',5'-cyclic monophosphate (cAMP) accumulation due to beta 1- or beta 3-catecholamine agonists and forskolin without affecting their stimulation of lipolysis. The inhibition of cAMP accumulation by 2',5'-dideoxyadenosine was not reflected in the total cytosolic cAMP-dependent protein kinase A activity, suggesting that the inhibition of cAMP occurred in cellular compartments distinct from those involved in the regulation of bulk protein kinase A activity. However, there was a good correlation between effects of lipolytic agents on cytosolic protein kinase A activity in fat cell extracts and lipolysis. Furthermore, it was possible to see an inhibition of the increase due to beta-agonists in cAMP accumulation, protein kinase A activity, and lipolysis by 2',5'-dideoxyadenosine in the presence of insulin. These data suggest that the readily measurable accumulation of cAMP seen with catecholamines in the absence of insulin is in a compartment separate from that involved in protein kinase A activation.

Western blotting and isoform analysis of cathepsin D from normal and malignant human breast cell lines.

Cathepsin D from normal (Hs578Bst) and malignant (MCF7, MDA-MB-231) breast cell lines has been characterized with regard to its kinetic properties, activity levels, precursor and processed M(r) forms, and isoform composition. Normal cell cathepsin D appears to have a more neutral pH optimum (pH 3.5) than the cancer cell line (pH 3.0-3.2) and greater activity between pH values of 4.0 to 4.5. The two cancer cell lines have approximately 1.5 to 2.0-fold increased total acid protease activity and 2 to 3-fold increased pepstatin-inhibitable protease activity (i.e. cathepsin D) when compared to the normal breast cell line. Western blotting indicates that a major processed form of cathepsin D for all three cell lines occurs at 31 kDa. The cancer cell lines contain significant amounts of cathepsin D precursors of 47 and 42 kDa whereas the normal cell line contains little if any of these precursors. Isoelectric focusing indicates that the normal cell line contains approximately 50% of its total acid protease activity at pIs above 4 whereas the cancer cell lines contain 70-80% of their protease activity at such pIs. In addition, the cancer cell lines contain two to three major isoforms between pIs of 5.5 and 6.3 which were not present in the normal cell line. The isoforms from pI values of 5.5 to 7.3 for all three cell lines are 100% pepstatin-inhibitable. In addition, Western blot analysis indicates that these isoforms contain the processed 31 kDa form of cathepsin D. The combined results indicate that the two breast cancer cell lines are similar to biopsied malignant breast tissue in exhibiting altered acid protease isoform profiles with increased relative amounts of pepstatin-inhibitable and immunoreactive acid protease activity (cathepsin D) compared to normal breast tissue or cells.

Immobilized pH gradient focusing of alkaline proteins: analysis of the isoform composition of purified human non-secretory ribonucleases from kidney, liver and spleen.

Previous studies on the isoform composition of human ribonucleases (RNAases) have resulted in confusing and inconsistent results, presumably due to methodological problems in electrofocusing of alkaline proteins. In the present study, immobilized pH gradient (IPG) carrier ampholyte (CA) isoelectric focusing (IEF) and conventional CA-IEF have been evaluated for the analysis of the isoforms of human non-secretory RNAases purified from kidney, liver and spleen. CA-IEF proved unsuitable since the alkaline RNAase isoforms migrated into the cathode. IPG-CA-IEF, however, resolved the RNAase isoforms and marker proteins in the basic region of the gel matrix. The three RNAases had comparable isoform profiles, each with two protein bands with approximate pI values of 10.3 and 10.4. Western blotting showed that the two protein bands of each RNAase were immunoreactive (with polyclonal antibodies that recognize RNAase), indicating that the protein bands are RNAase isoforms. The present results provide reliable pI data on human RNAase isoforms and suggest that IPG-CA-IEF should be a suitable technique for analysing the isoforms of other alkaline proteins.