Electroacupuncture efficacy in diabetic polyneuropathy: Study protocol for a double-blinded randomized controlled multicenter clinical trial.

BACKGROUND: Diabetic peripheral neuropathy (DPN) is the most common complication of type 2 diabetes mellitus (T2DM); its diagnosis and treatment are based on symptomatic improvement. However, as pharmacological therapy causes multiple adverse effects, the implementation of acupunctural techniques, such as electroacupuncture (EA) has been suggested as an alternative treatment. Nonetheless, there is a lack of scientific evidence, and its mechanisms are still unclear. We present the design and methodology of a new clinical randomized trial, that investigates the effectiveness of EA for the treatment of DPN. METHODS: This study is a four-armed, randomized, controlled, multicenter clinical trial (20-week intervention period, plus 12 weeks of follow-up after concluding intervention). A total of 48 T2DM patients with clinical signs and symptoms of DPN; and electrophysiological signs in the Nerve Conduction Study (NCS); will be treated by acupuncture specialists in outpatient units in Mexico City. Patients will be randomized in a 1:1 ratio to one of the following four groups: (a) short fibre DPN with EA, (b) short fibre DPN with sham EA, (c) axonal DPN with EA and (d) axonal DPN with sham EA treatment. The intervention will consist of 32 sessions, 20 min each, per patient over two cycles of intervention of 8 weeks each and a mid-term rest period of 4 weeks. The primary outcome will be NCS parameters, and secondary outcomes will include DPN-related symptoms and pain by Michigan Neuropathy Screening Instrument (MNSI), Michigan Diabetic Neuropathy Score (MDNS), Dolour Neuropatique Score (DN-4), Semmes-Westein monofilament, Numerical Rating Scale (NRS) for pain assessment, and the 36-item Short Form Health Survey (SF-36). To measure quality of life and improve oxidative stress, the inflammatory response; and genetic expression; will be analysed at the beginning and at the end of treatment. DISCUSSION: This study will be conducted to compare the efficacy of EA versus sham EA combined with conventional diabetic and neuropathic treatments if needed. EA may improve NCS, neuropathic pain and symptoms, oxidative stress, inflammatory response, and genetic expression, and it could be considered a potential coadjutant treatment for the management of DPN with a possible remyelinating effect. TRIAL REGISTRATION: ClinicalTrials.gov. NCT05521737 Registered on 30 August 2022. International Clinical Trials Registry Platform (ICTRP) ISRCTN97391213 Registered on 26 September 2022 [2b].

Wet anaerobic digestion of organic fraction of municipal solid waste: experience with long-term pilot plant operation and industrial scale-up.

This paper presents the analysis of a pilot anaerobic digestion plant that operates with organic fraction of municipal solid waste (OFMSW) from a wholesale market and can treat up to 500 kg d-1. The process was monitored for a period of 524 days during which the residue was characterized and the biogas production and methane content were recorded. The organic load rate (OLR) of volatile solids (VS) was 0.89 kg m-3 d-1 and the Hydraulic Retention Time (HRT) was 25 d during the process. The yield was 82 Nm3 tons OFMSW-1 biogas, equivalent to 586 Nm3 tons CH4 VS-1. The results obtained in the pilot plant were used to carry out a technical-economic evaluation of a plant that treats 50 tons of OFMSW from wholesale markets. A production of 3769 Nm3 d-1 of biogas and 2080 Nm3 d-1 of methane is estimated, generating 35.1 MWh d-1 when converted to electricity.

Facial infrared thermography as an index of social anxiety.

Previous research on physiological indices of social anxiety has offered unclear results. In this study, participants with low and high social anxiety performed five social interaction tasks while being recorded with a thermal camera. Each task was associated with a dimension assessed by the Social Anxiety Questionnaire for Adults (1 = Interactions with strangers. 2 = Speaking in public/Talking with people in authority, 3 = Criticism and embarrassment, 4 = Assertive expression of annoyance, disgust or displeasure, 5 = Interactions with the opposite sex). Mixed-effects models revealed that the temperature of the tip of the nose decreased significantly in participants with low (vs. high) social anxiety (p < 0.001), while no significant differences were found in other facial regions of interest: forehead (p = 0.999) and cheeks (p = 0.999). Furthermore, task 1 was the most effective at discriminating between the thermal change of the nose tip and social anxiety, with a trend for a higher nose temperature in participants with high social anxiety and a lower nose temperature for the low social anxiety group. We emphasize the importance of corroborating thermography with specific tasks as an ecological method, and tip of the nose thermal change as a psychophysiological index associated with social anxiety.

Ingestion of marine debris by juvenile Magellanic penguins (Spheniscus magellanicus) in wintering grounds of coastal Argentina.

The occurrence of marine debris in the stomach contents of young male and female Spheniscus magellanicus stranded along the Atlantic coast of northern Argentina during its post-breeding exodus is reported for the first time. Marine debris was found in 15.5 % of 148 dead penguins, with a higher proportion of debris found in females when compared to males. A total of 81 debris items was recorded; plastic and paper each contributed with an equal number of debris whereas rubber contributed with a single item. Chemical identification performed using FTIR/ATR revealed that plastic items were largely LDPE and PA; other polymers included HDPE, PP and PS. The average length of fragmented plastic debris are in line with those reported from penguins stranded along the southern Brazilian coasts. Our study indicates that loads of ingested marine debris were roughly five times lower when compared to the estimates for the species in Brazilian beaches.

Pain and Psychological Readiness to Return to Sport in Elite Volleyball Players: A Cross-Sectional Study.

Pain is modulated by multiple factors. A relevant psychological process peculiar to athletes and which could be associated with pain is Psychological Readiness to Return to Sport (PRRS). The analysis of this association in competition context is particularly important. OBJECTIVE: To determine the correlation between the PRRS and pain intensity in elite volleyball players during their participation in a continental sporting event. METHODS: A cross-sectional study was conducted. Data from 107 male volleyball players (23.50 ± 4.08 years of age) participating in the South American Volleyball Championship were used. The athletes answered a self-report questionnaire on the day the championship began regarding their history of injuries in the previous six months. The athletes who declared injuries were asked about the current pain intensity using the Pain Numeric Rating Scale (NRS) and Psychological Readiness to Return to Sport using the Injury-Psychological Readiness to Return to Sport scale (I-PRRS). RESULTS: 43.93% (n = 47) of the athletes (23.70 ± 3.54 years) reported an injury in the six months prior to the championship. They presented a median on the NRS of three (interquartile range (IQR), 2-5), and 54 (IQR, 46-58) on the I-PRRS. The Spearman's Rho correlation test showed an inversely and moderate correlation (rs = -0.36; p = 0.011; CI: -0.64--0.08) between pain intensity and PRRS. CONCLUSIONS: In male elite volleyball players who participate in a Continental Championship in South America, higher levels of PRRS was correlated to lower pain intensity.

The use of transcutaneous Vagal Nerve Stimulation as an effective countermeasure for Simulator Adaptation Syndrome.

This research focused on investigating the effectiveness of Transcutaneous Vagal Nerve Stimulation (tVNS) as compared to Galvanic Cutaneous Stimulation (GCS) at mitigating Simulator Adaptation Syndrome (SAS). Fifty drivers (mean age = 23.04 ± 17.71 years old, twenty-two men) participated in a driving simulation experiment. The total scores of the Simulator Sickness Questionnaire, head movements (body balance index), and driving performance variables were measured under five stimulation conditions: i) baseline (no stimulation delivered), ii) sham GCS, iii) sham tVNS, iv) active GCS, and v) active tNVS. The results showed that tVNS alleviated SAS and improved driving performance variables more effectively than GCS. We conclude that GCS and tVNS have similar neurological mechanisms to reduce SAS, providing possible explanations for the greater effectiveness of tVNS. We encourage the use of tVNS to decrease SAS.

Reablation in Atrial Fibrillation Recurrence and Pulmonary Vein Reconnection: Cryoballoon versus Radiofrequency as Index Ablation Procedures.

Pulmonary vein (PV) isolation is a well-established rhythm control therapy in atrial fibrillation (AF). Currently, there is no consensus on which ablation technique to use for the first procedure, cryoballoon (CB) or radiofrequency (RF). A retrospective cohort study was conducted on 1055 patients who underwent a first ablation, to assess both techniques based on the need for reablation. Patients with CB (n = 557) and RF (n = 498) ablations were clinically characterized and the need for reablation during a 30-month follow-up was used as the primary endpoint. Independent variables were analyzed to identify potential predictors. The need for reablation was significantly lower in the CB group than in the RF group (hazard ratio = 0.45 and 95% confident interval = 0.32−0.61; p < 0.001); in both paroxysmal and persistent AF, using a full-adjusted regression Cox model by age, sex, smoking, hypertension, diabetes mellitus, dyslipidemia, severe obstructive sleep apnea, dilated left atrium, persistent AF and early recurrence. RF ablation, dilated left atrium, persistent AF and early recurrence were identified as independent predictors of reablation. In addition, the CB-redo subgroup had a lower PV reconnection than the RF-redo subgroup. In conclusion, CB ablation suggests a reduction in the need for reablation and lower PV reconnection during the follow-up than RF ablation.

Psychometric Properties of the PCS and the PCS-4 in Individuals With Musculoskeletal Pain.

BACKGROUND: The factor structure of the Pain Catastrophizing Scale (PCS) has rarely been adequately analyzed (e.g., performing principal component analyses rather than factorial approximations). We aimed to evaluate the psychometric properties of the PCS through a variety of exploratory and confirmatory factorial approaches. METHOD: Three hundred ninety-four Chilean patients with musculoskeletal pain were included (age, M = 49.61, SD = 18.00; 71.57% women). Eight factorial models were proposed to analyze the structure of the data. In addition, validity evidence of the PCS based on relationships with other variables were analyzed considering pain intensity and kinesiophobia. RESULTS: The results suggest a unidimensional structure. Models with more than one dimension exhibited undesirable factor loadings or inadequate indices of fit. Based on these results, a short version of the scale composed of 4 items is proposed (PCS-4). The PCS-4 scores demonstrated high levels of invariance between sex, chronicity, and education groups and also were associated with pain and kinesiophobia. CONCLUSIONS: The results of the PCS-4 Spanish version showed evidence of reliability and validity for adequately measuring pain catastrophizing in Chileans who suffer from musculoskeletal pain. The PCS-4 is a short form that should be explored in future studies (e.g., in other Spanish-speaking populations).

Transcutaneous Vagal Stimulation in Knee Osteoarthritis (TRAVKO): Protocol of a Superiority, Outcome Assessor- and Participant-Blind, Randomised Controlled Trial.

Current treatments for knee osteoarthritis (KOA) are partially effective. It is, therefore, necessary to find new strategies that can complement the existing ones. In this scenario, transcutaneous vagal stimulation (TVS) neurophysiological effects could be a helpful solution. However, there is no evidence of the efficacy of TVS in KOA. This trial aims to assess the efficacy of TVS in decreasing pain in participants aged 55 years or older with KOA. A randomised controlled, two-arm, double-blind (participants and outcome assessors) and clinical superiority trial will be conducted for 70 patients with KOA. All the participants will carry out an exercise program. It consists of 12 sessions over four weeks. In addition, they will be randomly assigned to (1) active TVS plus physical exercise or (2) sham TVS plus physical exercise. The application of active TVS consists of electronic stimulation of the auricular concha using a portable device. Sham TVS condition consists of the stimulation of the earlobe that does not cause neurophysiological effects. The primary outcome is the reduction in pain intensity. Additionally, functional capacity, physical performance, pain-related interference, pain-related distress, quality of life in older adults and global change will be measured. Assessments will be conducted at the beginning of the study (baseline), at the end of the intervention and after 1 and 3 months of follow-up. This trial will generate evidence regarding the efficacy of TVS in pain perception in individuals with KOA. This information will serve as an input in the clinical decision-making on the use or non-use of TVS in individuals with KOA. Thus, if the efficacy of TVS is confirmed, a new therapeutic tool may be included in the rehabilitation of individuals with KOA.

Innovative problem-solving in a threatened gull species, the Olrog's Gull (Larus atlanticus).

Innovation, a process that plays an important role in the ecology and evolution of species, is considered an expression of behavioral flexibility in animals. Here we analyzed innovative problem-solving ability and performance enhancement through learning in the Olrog's Gull (Larus atlanticus), under controlled processes and experimental conditions. Trials were undertaken with nine adult individuals captured at a highly urbanized coastal area of Argentina. Each individual was presented with a Plexiglas box that could be opened by pushing or pulling two lids, each lid leading to a separated food reward. We measured problem-solving ability through consumption latency and the number of solved lids. As explanatory variables, we measured contact rate, as a measure of persistence, and the number of effective contacts. The results showed that the contact rate and effective contacts did not affect variables related to problem-solving ability during the first confrontation of the individuals with the closed box. Consumption latency decreased significantly throughout the trials, and with increasing contact rate and effective contacts. The number of solved lids increased through the trials independently of the contact rate and the total effective contacts with the box. Although persistence did not influence individuals' performance during the problem-solving test; this variable affected individuals' ability to solve the task throughout trials. Learning was evidenced by the decrease in the resolution time across experiments, suggesting that successful individuals improved their performance probably through a trial-and-error process. Evaluation of behavioral responses of a threatened seabird to a novel problem-solving task adds knowledge to previous field studies and provides a better understanding of the ability of individuals to adjust their foraging behavior in highly urbanized areas used during the non-breeding season.

Feather mercury levels in beached Magellanic penguin (Spheniscus magellanicus) in northern Argentina during the non-breeding season.

Mercury (Hg) is a great concern for marine environments. Bird feathers have been widely used to assess Hg pollution. In this study, we determine mercury concentrations in body feathers of juvenile Magellanic penguins (Spheniscus magellanicus) from the southeastern sector of Buenos Aires province, Argentina, during a non-breeding season, considering both sexes. Hg levels, considering both females and males together, ranged between 265.5 and 1515.52 ng/g. These levels are well below the concentrations in feathers suggested for taking actions focused on the protection of seabirds. Non-significant differences between sexes regarding Hg levels were found, probably because juveniles were sexually immature and females did not excrete Hg by egg laying yet. Hg concentrations found in this study were an order of magnitude higher than those reported 10 years ago for the species in breeding areas on the Argentine coast. Thus, the present study provides relevant information indicating a possible increase of Hg pollution in the southwestern region of the Atlantic Ocean and thus trigger for the development of monitoring programs and regional strategies to improve the conservation status of this species.

Synthesis and characterisation of acid/basic modified adsorbents. Application for chlorophenols removal.

A commercial activated carbon was modified with acid and basic reagents -an acidic one via treatment with sulphuric acid and a basic via treatment with pentaethylenehexamine- to yield adsorbents with different surface acid/base character. These modified adsorbents were characterised by elemental and immediate analysis, N2 adsorption, XPS and point zero charge measurements. The new adsorbents were tested for chlorophenols removal in water (4-chlorophenol, 3,5-dichlorophenol, 2,4,6-trichlorophenol, 2,3,4,6-tetrachlorophenol and pentachlorophenol) at different temperatures. Although the calculated process enthalpy was positive for all cases, indicating an endothermic process, the entropy was positive, resulting in a negative Gibbs free energy and spontaneous process. The adsorption capacity increases with temperature and decreases when the phenols' number of substituents increases. The modified acid-activated carbon demonstrated an exciting higher adsorbing capacity from 426.9 to 742.3 mg g-1 for 2,4,6-trichlorophenol, whereas the adsorption capacity for the basic ranged between 142.9 and 238.0 mg g-1. The Langmuir model satisfactorily fitted the adsorption equilibrium data for all chlorophenol contaminants.

Control penal y género. ¡Baracunátana!: una elegía al poder sobre la rebeldía femenina / Penal control and gender: Baracunátana: an elegy to power on female rebellion / Baracunátana!: uma elegia ao poder sobre a rebeldia femenina

Este artículo se centra en la letra de la canción popular titulada "Baracunátana" para describir y analizar la cultura machista en las relaciones de género. La historia narrada en la canción, con su entramado machista, a un nivel microsocial, es el punto de partida de una exploración sobre los conflictos de género. A continuación, el artículo examina las consecuencias macrosociales de la cultura machista y, en especial, su influencia en la violencia de género. Esas problemáticas, micro y macro, son las bases para emprender una revisión crítica de las principales políticas y acciones de control penal desarrolladas para combatir la violencia en las relaciones de género en el sistema jurídico colombiano. Como resultado, se identifican varios nodos críticos que neutralizan e impiden un manejo adecuado de este tipo ascendente de violencia. Esto permite demostrar que las políticas en materia penal han derivado, con preocupante ineficacia, pese al sensacionalismo y la algarabía política que hacen, en un inoficioso populismo penal. En contraposición, el artículo propone dar prioridad al desarrollo de políticas sociales contra el machismo, cuyo objetivo sería afectar las disposiciones de poder, porque el problema de Baracunátana no es de amor, ni de celos, es una cuestión de poder.

This article focuses on the lyrics of the popular song "Baracunátana" to describe and analyze the machista culture in gender relations. The story narrated in the song, with its machista framework, at a micro-social level, is the starting point for an exploration of gender conflicts. The article then examines the macro-social consequences of macho culture and, in particular, its influence on gender violence. These micro and macro issues are the basis for a critical review of the main policies and criminal control actions developed to combat violence in gender relations in the Colombian legal system. As a result, several critical nodes are identified that neutralize and impede an adequate management of this ascending type of violence. This allows demonstrating that criminal policies have derived, with worrying ineffectiveness, despite the sensationalism and political hullabaloo they make, in an ineffective criminal populism. In contrast, the article proposes to give priority to the development of social policies against machismo, whose objective would be to affect the dispositions of power, because the problem of Baracunátana is not one of love or jealousy, it is a question of power.

Este artigo enfoca a letra da canção popular "Baracunátana" para descrever e analisar a cultura machista nas relações de gênero. A história contada na canção, com sua estrutura machista, em nível micro-social, é o ponto de partida para uma exploração dos conflitos de gênero. O artigo examina então as conseqüências macro-sociais da cultura machista e, em particular, sua influência sobre a violência baseada no gênero. Essas questões micro e macro são a base para uma revisão crítica das principais políticas e ações de controle penal desenvolvidas para combater a violência nas relações de gênero no sistema jurídico colombiano. Como resultado, são identificados vários nós críticos que neutralizam e impedem uma gestão adequada deste tipo de violência. Isto torna possível demonstrar que as políticas de justiça criminal se tornaram, com preocupante ineficácia, apesar do sensacionalismo e do alarido político que geram, um populismo criminoso ineficaz. Em contraste, o artigo propõe dar prioridade ao desenvolvimento de políticas sociais contra o machismo, cujo objetivo seria afetar as disposições de poder, pois o problema de Baracunátana não é de amor ou ciúme, é uma questão de poder.

Psychometric Properties of the PCS and the PCS-4 in Individuals With Musculoskeletal Pain / Propiedades Psicométricas de la PCS y PCS-4 en Individuos con DolorMusculoesquelético

Background: The factor structure of the Pain Catastrophizing Scale (PCS)has rarely been adequately analyzed (e.g., performing principal componentanalyses rather than factorial approximations). We aimed to evaluate thepsychometric properties of the PCS through a variety of exploratory andconfirmatory factorial approaches. Method: Three hundred ninety-fourChilean patients with musculoskeletal pain were included (age, M = 49.61,SD = 18.00; 71.57% women). Eight factorial models were proposed toanalyze the structure of the data. In addition, validity evidence of the PCSbased on relationships with other variables were analyzed considering painintensity and kinesiophobia. Results: The results suggest a unidimensionalstructure. Models with more than one dimension exhibited undesirablefactor loadings or inadequate indices of fit. Based on these results, a shortversion of the scale composed of 4 items is proposed (PCS-4). The PCS-4scores demonstrated high levels of invariance between sex, chronicity, andeducation groups and also were associated with pain and kinesiophobia.Conclusions: The results of the PCS-4 Spanish version showed evidenceof reliability and validity for adequately measuring pain catastrophizing inChileans who suffer from musculoskeletal pain. The PCS-4 is a short formthat should be explored in future studies (e.g., in other Spanish-speakingpopulations).

Antecedentes: la estructura factorial de la Escala deCatastrofización del Dolor (PCS) rara vez se ha analizado adecuadamente. Elobjetivo de este estudio fue evaluar las propiedades psicométricas del PCSa través de diferentes enfoques factoriales exploratorios y confirmatorios.Método: se incluyeron trescientos noventa y cuatro pacientes chilenos condolor musculoesquelético (edad, M=49,61; DE=18,00; 71,57% mujeres). Sepropusieron ocho modelos factoriales. Asimismo, se analizó la evidencia devalidez de la PCS basada en relaciones con otras variables considerando laintensidad del dolor y la kinesiofobia. Resultados: los resultados sugierenuna estructura unidimensional. Los modelos con más de una dimensiónmostraron cargas factoriales o índices de ajuste inadecuados. A partir deestos resultados se propone una versión corta de la escala compuesta por4 ítems (PCS-4). Las puntuaciones de PCS-4 mostraron altos niveles deinvarianza entre sexos, cronicidad del dolor y niveles educativos. La PCS-4también se asoció con otras medias de dolor y kinesiofobia. Conclusiones:los resultados de la PCS-4 versión en español mostraron evidencia defiabilidad y validez para medir adecuadamente el catastrofismo del dolor enchilenos con dolor musculoesquelético. El PCS-4 es una forma corta quedebería explorarse en estudios futuros (por ejemplo, en otras poblacioneshispanoparlantes).

Terapia de reemplazo renal continua. Presentación de un caso / Continuous renal replacement therapy. Case report

RESUMEN La insuficiencia renal aguda es definida como la pérdida de función del riñón ocasionada por diversas causas, entre ellas infección e ingesta de fármacos. Esta entidad tiene alta morbilidad y mortalidad en las unidades de cuidados críticos. El tratamiento de la misma va desde la propia protección renal hasta la sustitución artificial de las funciones del riñón lesionado. En la actualidad la terapia de reemplazo renal continua se ha utilizado como soporte renal, y ofrece mayor estabilidad clínica a los pacientes más inestables. En esta revisión se comentan conceptos, indicaciones y los más recientes estudios que validan el uso de esta terapéutica, así como el método de programación que se utilizó en un paciente con diagnóstico de una leptospirosis icterohemorrágica (síndrome de Weil), que estuvo en shock séptico con disfunción multiorgánica, donde se empleó esta terapia con resultados satisfactorios (AU).

ABSTRACT Acute kidney failure is defined as the loss of kidney function caused by various causes, including infection and drug intake. This entity has high morbidity and mortality in critical care units. Treatment ranges from renal protection to artificial replacement of the functions of the injured kidney. Currently, continuous renal replacement therapy has been used as renal support, and offers greater clinical stability to the most unstable patients. In this review, authors discuss concepts, indications and the most recent studies that validate the use of this therapeutic, as well as the programming method that was used in a patient with diagnosis of icteric-hemorrhagic leptospirosis (Weil syndrome), who was in septic shock with multiorgan dysfunction, where this therapy was used with satisfactory results (AU).

The Effect of Sleep Quality on Pain in Chilean Individuals with Musculoskeletal Disorders.

Poor sleep quality (SQ) negatively affects pain associated with musculoskeletal disorders (MSD). As the level of economic development of a country determines its sanitary conditions, these can influence the sleep-pain relationship; therefore, it is relevant to generate evidence in the population with MSD in developing countries. This cross-sectional study sought to determine the effect of poor SQ on pain in Chilean individuals with MSD, controlling for sex and duration of pain (in months). METHOD: A total of 228 individuals were included. SQ was measured with the Pittsburg Sleep Quality Index (PSQI), pain (intensity, interference and distress relative to pain) was measured with visual analog scales. Structural equation modeling (SEM) was performed to analyze the effect of SQ on pain. RESULTS: A high frequency of poor SQ was present in the studied group, and was more prevalent in women. The SEM model evidenced that poor SQ predicts greater pain. Sex influences sleep quality and pain, but not pain duration. CONCLUSIONS: These findings indicate that poor SQ predicts higher pain in MSD and that women exhibit worse SQ and more significant pain than men. Our findings support that SQ should be considered in the comprehensive approach to pain in individuals with MSD.

Possible Role of Leptin in Atopic Dermatitis: A Literature Review.

Atopic dermatitis (AD) is the most frequent chronic inflammatory skin disease, and its incidence has been rapidly increasing in developed countries in the last years. AD presents a high degree of heterogeneity due to biases and confounding factors such as age range, sex, or ethnicity. For those reasons, the search for new biomarkers is crucial. At the same time, obesity, which is a global health problem, has also increased over the years. It has been associated with many pathophysiological states, including skin diseases such as AD, mostly in childhood. Obesity promotes a low grade inflammation driven by many different cytokines and adipokines, including leptin, which has a key role in many other diseases due to its pleiotropic effects. Leptin also has a role in both skin and allergic diseases very related to AD. Thus, this adipokine could have an important role in the pathogenesis of AD, especially in its chronicity. Despite the limited literature available, there is some evidence that leads us to consider leptin as an important adipokine in this skin disease. For this reason, here we have reviewed the role of leptin in the pathophysiology of AD.

Effect of adduction during glenohumeral external rotation exercises in the scapulohumeral muscles / Efecto de la adducción durante ejercicios de rotación externa glenohumeral en los músculos escapulohumerales

SUMMARY: The effect of adduction during glenohumeral external rotation (ER) exercises on the scapulohumeral muscles is controversial. The aim of this study was to evaluate the effect of carrying out adduction during external rotation exercises in low and high shoulder positions on the electromyographic (EMG) activity of the infraspinatus (IS), middle deltoid (MD), and posterior deltoid (PD) muscles. EMG activity of the IS, MD, and PD muscles of 20 healthy participants was evaluated. Subjects performed 6 ER exercises that combined two factors: i) different adduction pressures according to biofeedback unit (0, 5 and 10 mmHg), and ii) low and high shoulder position. The pressure was controlled using a biofeedback unit. The low and high shoulder positions were 20? and 90? of abduction. In the low shoulder position, the activity of the IS muscle increased as the pressure on the biofeedback unit increased and the MD and PD muscles presented the highest activity at 10 mmHg. In the high shoulder position, the activity of the IS muscle was higher at 0 and 10 mmHg, the MD muscle presented higher activity at 5 mmHg, and PD muscle activity did not vary with the pressure. The addition of adduction at a pressure of 5 mmHg in the low shoulder position promotes is activity. Likewise, adduction at a pressure of 10 mmHg will promote activity of the IS, MD, and PD.

RESUMEN: El efecto de la aducción durante los ejercicios de rotación externa (RE) glenohumeral sobre los músculos escapulohumerales es controversial. El objetivo de este estudio fue evaluar el efecto de la realización de la aducción durante los ejercicios de rotación externa en posiciones bajas y altas del hombro sobre la actividad electromiográfica (EMG) delos músculos infraespinoso (IS), deltoides medio (DM) y deltoides posterior (DP). Se evaluó la actividad EMG de los músculos IS, MD y PD de 20 participantes sanos. Los sujetos realizaron 6 ejercicios de RE que combinaron dos factores: i) diferentes presiones de aducción de acuerdo con la unidad de biorretroalimentación (0, 5 y 10 mmHg), y ii) posición del hombro baja y alta. La presión se controló mediante una unidad de biorretroalimentación. Las posiciones del hombro baja y alta fueron de 20? y 90? de abducción. En la posición del hombro bajo, la actividad del músculo IS aumentó a medida que aumentaba la presión sobre la unidad de biorretroalimentación y los músculos MD y PD presentaron la actividad más alta a 10 mmHg. En la posición del hombro alto, la actividad del músculo IS fue mayor a 0 y 10 mmHg, el músculo MD presentó mayor actividad a 5 mmHg y la actividad del músculo PD no varió con la presión. La adición de aducción a una presión de 5 mmHg en la posición baja del hombro promueve la actividad del músculo IS. Asimismo, la aducción a una presión de 10 mmHg promoverá la actividad del IS, MD y PD.