Lack of awareness of systemic lupus erythematosus and its consequences in a cohort of moderate and severe patients in Spain: The LupusVoice study.

BACKGROUND AND OBJECTIVES: Systemic lupus erythematosus (SLE) is an autoimmune condition that can highly impact patients' quality of life (QoL). However, there is a lack of knowledge about SLE, affecting the general population and health care professionals (HCPs) alike. This lack of knowledge has negative implications for patients and the healthcare system, worsening prognosis, negatively impacting QoL, and increasing healthcare utilization. The aim of this paper is to draw attention, according to the perspective of the participants of this study, to the lack of awareness of SLE and its consequences in Spain, and to suggest improvements. PATIENTS AND METHODS: This qualitative, descriptive, observational, multicenter, and cross-sectional study included 40 patients with moderate or severe SLE, recruited during their routine visits in six university hospitals in Spain. The study also included 11 caregivers and 9 HCPs. All participants were individually interviewed. Data from the interviews were coded and analyzed thematically by two anthropologists following a phenomenological perspective. RESULTS: Our study identified a lack of disease awareness among primary care physicians, emergency medicine doctors, and other specialists treating SLE symptomatology. This led to diagnostic delays, which had a clinical and emotional impact on patients. Furthermore, symptom awareness was found to be context dependent. Differences in symptom awareness between HCPs and patients led to a mismatch between the severity evaluation made by doctors and patients. Some HCPs did not consider the limitations of the current severity evaluation of SLE, and therefore attributed symptoms potentially caused by SLE to the unfavorable socioeconomic conditions patients lived in. Finally, a lack of social awareness among friends, family members, and romantic partners led to lower social support, increased isolation, and negative physical and emotional impact for patients. Gender differences in the provision of support were identified. CONCLUSION: This study highlights the need to increase SLE awareness among patients, HCPs, and the broader public in order to improve patient QoL. Being aware of the clinical and emotional impact of such lack of awareness, as well as the role played by context on the patient experience of SLE, is a crucial step towards achieving this goal.

Evaluation of bone-related mechanical properties in female patients with long-term remission of Cushing's syndrome using quantitative computed tomography-based finite element analysis.

BACKGROUND: Hypercortisolism in Cushing's syndrome (CS) is associated with bone loss, skeletal fragility, and altered bone quality. No studies evaluated bone geometric and strain-stress values in CS patients after remission thus far. PATIENTS AND METHODS: Thirty-two women with CS in remission (mean age [±SD] 51 ± 11; body mass index [BMI], 27 ± 4 kg/m2; mean time of remission, 120 ± 90 months) and 32 age-, BMI-, and gonadal status-matched female controls. Quantitative computed tomography (QCT) was used to assess volumetric bone mineral density (vBMD) and buckling ratio, cross-sectional area, and average cortical thickness at the level of the proximal femur. Finite element (FE) models were generated from QCT to calculate strain and stress values (maximum principal strain [MPE], maximum strain energy density [SED], maximum Von Mises [VM], and maximum principal stress [MPS]). Areal BMD (aBMD) and trabecular bone score (TBS) were assessed by dual-energy X-ray absorptiometry (2D DXA). RESULTS: Trabecular vBMD at total hip and trochanter were lower in CS as compared with controls (P < .05). Average cortical thickness was lower, and buckling ratio was greater in CS vs controls (P < .01). All strain and stress values were higher in CS patients vs controls (P < .05). 2D DXA-derived measures were similar between patients and controls (P > .05). Prior hypercortisolism predicted both VM (ß .30, P = .014) and MPS (ß .30, P = .015), after adjusting for age, BMI, menopause, delay to diagnosis, and duration of remission. CONCLUSIONS: Women with prior hypercortisolism have reduced trabecular vBMD and impaired bone geometrical and mechanical properties, which may contribute to an elevated fracture risk despite long-term remission.

A cross-sectional study to evaluate utility measure and health-related quality of life (HRQoL) among patients with severe uncontrolled asthma in Spain.

BACKGROUND AND PURPOSE OF THE STUDY: The utility measure is a method to quantify health-related quality of life according to the preference values that patients attach to their health status. This study aimed to estimate the utility measure of patients with controlled and uncontrolled severe asthma (SA) in Spain, separately. Additionally, other characteristics (sociodemographic, clinical, and healthcare resource use [HCRU]) were also assessed for both SA populations. METHODS: This cross-sectional study included 159 patients with SA in Spain. Data were collected from medical records and directly from the patients during the study visit. Asthma Control Questionnaire (ACQ)-5 was used to classify patients with controlled and uncontrolled SA. RESULTS: Most of the patients were female (72.0% uncontrolled SA and 63.6% controlled SA). The mean (SD) EuroQol-5D (EQ-5D-5L) score was 0.88 (0.14) and 0.70 (0.25) in controlled and uncontrolled SA, respectively. The mean (SD) Asthma Quality-of-Life-5D (AQL-5D) score was 0.93 (0.09) and 0.85 (0.09) in controlled and uncontrolled SA, respectively. Emergency visits (19.2 vs. 2.7%) and hospitalizations (7.7% vs. no hospitalization) were more common among uncontrolled SA than controlled SA. Mean (SD) number of visits to primary care and pneumologists in uncontrolled SA vs. controlled SA was 4.1 (2.8) vs. 2.5 (3.0) and 3.7 (3.5) vs. 2.8 (2.2), respectively. CONCLUSION: The study provides data on utility measures among patients with SA in Spain for the first time. Patients with uncontrolled SA had lower HRQoL and higher HCRU than patients with controlled SA. Therefore, the implementation of measures that improve HRQoL among patients with uncontrolled SA is highly recommended.

Despite the existence in Spain of validated asthma questionnaires, the impact of severe asthma on quality of life, depending on whether it is controlled or not, had never been assessed.This study, which included 159 patients, was conducted to fill the gap above by obtaining two utility measures for quality of life, a generic one using the EQ-5D questionnaire (which can be used for comparison with other chronic conditions) and an asthma-specific one using the AQL-5D questionnaire.Patients with uncontrolled SA had a lower utility measure than patients with controlled disease and, therefore, a lower quality of life. In addition, patients with uncontrolled SA also had higher use of healthcare resources.These results highlight that the implementation of measures that improve the quality of life among patients with uncontrolled SA is highly recommended.

El valor de la acupuntura en la práctica de la medicina tradicional complementaria en el sector salud de México / The value of acupuncture in the practice of complementary traditional medicine in Mexico's health sector

Introduction: Complementary traditional medicine acquires an essential value from the diversity and pluralism of care and therapy. In this logic, it is up to people to search for alternatives when it comes to caring for and improving their own health. Specifically, acupuncture has had rapid growth, largely due to processes derived from globalization, migration and cultural exchange, which in some way force countries to modify their health system towards one that takes into account the transculturality of its population and treatment preferences. Development: With the establishment of a comprehensive health model, physicians can assess the person as a homeodynamic process (information exchange process between environment and man, to keep an internal and external homeostasis to the individual) and pandimensional (spiritual and energetic care) that allows to identify the health problem's origin and thus determine an intervention more in line with the person's needs during the health-disease, life-death processes, with the corresponding conventional or non-conventional therapy. Conclusions: The value and interest of acupuncture in the population derives from the degree of development of a country, its origin and the incorporation of the West as part of the diagnostic and therapeutic arsenal, in order to respond to the population needs by incorporating low-cost complementary treatments with proven effectiveness, without ceasing to consider its unquestionable cultural heritage.

Introducción: la medicina tradicional complementaria adquiere un valor imprescindible desde la diversidad y el pluralismo de la asistencia y la terapéutica. En esa lógica, corresponde a las personas la búsqueda social de alternativas cuando se trata de atender y mejorar la propia salud. En específico la acupuntura ha tenido un rápido crecimiento, en gran parte debido a la globalización, la migración y el intercambio cultural, que de alguna forma obligan a los países a modificar su sistema de salud hacia uno que tome en cuenta la transculturalidad de su población y las preferencias de tratamiento. Desarrollo: con el establecimiento de un modelo de salud integral, los médicos pueden valorar a la persona como un proceso homeodinámico (intercambio de información entre el ambiente y el hombre para mantener una homeostasis interna y externa del individuo) y pandimensional (cuidado espiritual y energético) que permita identificar el origen real del problema de salud y determinar una intervención más acorde a las necesidades de la persona durante los procesos de salud-enfermedad, de vida-muerte, con la terapia convencional o no convencional que corresponda. Conclusiones: el valor e interés de la acupuntura en la población se deriva del grado de desarrollo de un país, de su origen y de la incorporación de occidente como parte del arsenal diagnóstico y terapéutico, para responder a las necesidades de la población al incorporar tratamientos complementarios de bajo costo y con efectividad demostrada, y sin dejar de considerar su herencia cultural incuestionable.

Is adenosine deaminase (ADA) activity in saliva and serum a more accurate disease detection tool than traditional redox balance parameters in early-lactating dairy cows?

Enzyme adenosine deaminase (ADA) is a marker of inflammation in domestic animals, but it is unclear whether it is a reliable marker of oxidative stress, especially in the transition period in dairy cows. This study aims to assess if ADA and redox status measurements in saliva provide the same utility to detect disease condition as that obtained from serum. Sixty-eight multiparous Holstein cows, between 2 and 3 weeks postpartum were selected. Five study groups were established: control (healthy), and cows with ketosis, mastitis, laminitis, and metritis. The parameters measured were ADA activity, total oxidants (TOS), antioxidants (TAC), and OSi ratio.Regarding redox status, no significant differences arise in both saliva and serum being the correlations negative and not significant. In saliva, ADA activity in healthy cows differs from those with pathological processes, having the lowest activities. In serum, ADA activity is similar in the healthy and ketosis cows, showing the lowest activities meanwhile animals with mastitis, laminitis, or metritis have significantly higher activities. In conclusion, the measurement of ADA activities and redox status in saliva does not give consistent results, being preferable to measure them in serum during the transition period.

Consumo Problemático Otras Respuestas Institucionales y Dispositivos ¿son posibles? / Problematic Consumption: Are Other Institutional Responses and Devices Possible?

Nos desempeñamos en el equipo de salud mental del H.I.G.A San Felipe de la ciudad de San Nicolás de los Arroyos y desde nuestra praxis desarrollaremos en este trabajo nuestra experiencia en el abordaje e implicancia de la Ley Nacional de salud mental n° 26657en la atención de personas adultas mayores de 16 años que han atravesado consumo problemático durante el año 2021. El campo de la atención a la salud mental es probablemente el ámbito asistencial sanitario en el que están más imbricados los problemas en casos complejos por la propia naturaleza del sufrimiento psíquico de un sujeto que plantea su malestar en su contexto relacional más cercano como lo es su familia y su entorno social. Todo ocurre en un tiempo determinado, con marcos jurídicos ­ institucionales específicos dentro de una perspectiva cultural; en una práctica social involucrada en significados inscriptos en una trama de tensiones envueltas en debates alrededor del eje homogeneidad cultural - heterogeneidad cultural al interior de los estados nacionales y de procesos de globalización. Trabajamos con sujetos que escriben su propia historia marcadas por la autonomía, la voluntad donde entran en juego conceptos como intervención, especificidad, nociones de cuidado, integralidad, perspectiva de derechos frente a los desafíos de la inclusión, integración, protección y la justicia social. El objetivo de este trabajo es describir nuestro quehacer cotidiano ante las diversas tensiones que obstaculizan el desarrollo de estrategias integrales de salud mental, las cuales generan una fuerte tensión entre estas prácticas y sus lógicas diversas, y muchas veces contrapuestas. Al mismo tiempo se pretende realizar una posible propuesta de abordaje a modo de reflexión que esta problemática nos inmiscuye.

Tecnoadicción y uso compulsivo de internet en estudiantes universitarios / Technology addiction and compulsive internet use in university

Introducción: uno de los efectos nocivos de las tecnologías de la información y la comunicación (TIC) es su uso sin control, lo que ha generado una adicción hacia ellas. Objetivo: conocer la prevalencia de tecnoadicción de las TIC en estudiantes universitarios de nivel superior, posgrado y profesionistas de diferentes áreas. Metodología: estudio descriptivo cuya población fueron universitarios de nivel superior, posgrado y profesionistas de diferentes áreas de la Universidad Nacional Autónoma de México (UNAM) y del Instituto Politécnico Nacional (IPN) durante el ciclo escolar 2020-2. El muestreo fue no probabilístico. Resultados: al analizar los datos de la Escala de adicción de internet, el 49% respondió que permanece en internet más tiempo del que desea y el 38.2% mencionó que intenta reducir la cantidad de tiempo que pasa en línea. En cuanto al uso compulsivo, el 32.8% mencionó que sigue usando internet a pesar de que su intención es reducir su uso; el 30.5% dice que está corto de sueño debido al uso de internet. Conclusiones: existe tecnoadicción entre profesionistas y estudiantes universitarios de nivel superior y posgrado de la UNAM y del IPN. El personal de salud debe establecer estrategias de prevención del uso del internet para evitar trastornos de salud mental como depresión y aislamiento, entre otros.

Background: One of the harmful effects of the information and communication technologies (ICTs) is their uncontrolled use, which has generated an addiction to them. Objective: To know the prevalence of technology addiction of ICTs in university students of higher level, postgraduate and professionals from different areas. Methodology: Descriptive study whose population was university students of higher level, postgraduate degrees and professionals from different areas of the National Autonomous University of Mexico (UNAM) and the National Polytechnic Institute (IPN) during the 2020-2 school year. The sampling was non-probabilistic. Results: When analyzing the data of the Internet addiction scale, 49% responded that they stay on the internet much more time than what they want to, and 38.2% mentioned that they try to reduce the amount of time they spend online. As for compulsive use, 32.8% mentioned that they continue to use the internet despite the fact that their intention is to use it less; 30.5% say they are short of sleep due to internet use. Conclusions: There is technology addiction among professionals and university students of higher and postgraduate levels of UNAM and IPN. Health personnel must establish prevention strategies for the use of internet, in orded to avoid mental health disorders such as depression, isolation, among others.

Effects of Calving Body Condition Score on Blood Acid-Base Balance of Primiparous Holstein-Friesian Dairy Cows in a Commercial Dairy Farm: A Case Study.

The study was carried out on 27 healthy primiparous Holstein heifers (620 ± 50 kg) kept in a commercial dairy herd. The animals were divided into two groups taking into account the body condition score (BCS) index: BCS < 3.5, n = 12; BCS > 3.5 n = 15. The study period started one month before calving (BC), and ran until one month after calving (AC). Venous blood samples were collected 1 month and 1 week BC, and 1 week and 1 month AC. This study had two objectives: (i) to assess whether a higher or lower BCS affected total milk production and its quality; (ii) to assess changes in the internal fluid (venous pH; partial pressure of CO2, ppCO2; bicarbonate; total CO2, TCO2; base excess, BE; electrolytes Na+, K+, Cl-; and anion gap, AG) that occur during this phase depending on the BCS. We can conclude that the BCS at calving does not affect the productive status during lactation, both in terms of the quantity and quality of milk produced. The excess of crude protein (CP) added through the ration in the lactation phase can trigger a tendency to an alkalotic state, in this case compensated by respiratory buffering mechanisms, as reflected by the TCO2. The changes in electrolytes are a reflection of the movement of free water for milk production, where a balance between measurable anions and cations is observed.

The COVID pandemic should introduce new habits for pet owners.

This article deals with the reality of the COVID situation as well as a series of hygienic measures that owners can adopt in relation to the handling and care of their pets (dogs, cats) including objects that can act as fomite.

Ruminal Fistulation and Cannulation: A Necessary Procedure for the Advancement of Biotechnological Research in Ruminants.

Rumen content is a complex mixture of feed, water, fermentation products, and living organisms such as bacteria, fungi, and protozoa, which vary over time and with different feeds. As it is impossible to reproduce this complex system in the laboratory, surgical fistulation and cannulation of the rumen is a powerful tool for the study (in vivo and in situ) of the physiology and biochemistry of the ruminant digestive system. Rumen fistulation in cattle, sheep, and goats has been performed extensively to advance our understanding of digestive physiology and development, nutrient degradability, and rumen microbial populations. The literature reports several fistulation and cannulation procedures in ruminants, which is not the focus of this paper. However, this method questions the ethical principles that alter the opinions of certain animal groups or those opposed to animal experimentation. In this article, we analyze the objectives of fistulation and cannulation of ruminants and the care needed to ensure that the welfare of the animal is maintained at all times. Due to the ethical issues raised by this technique, several in vitro digestion methods for simulating ruminal fermentation have been developed. The most relevant ones are described in this article. Independently of the procedure, we want to point out that research carried out with animals is obliged by legislation to follow strict ethical protocols, following the well-being and health status of the animal at all times.

Numerical modeling of bare and polymer-covered braided stents using torsional and tensile springs connectors.

Computational modeling of braided stents using the finite element (FE) method has become an essential tool in the design and development of these medical devices. One of the most challenging issues in such a task is representing in an accurate manner the interaction between the interlacing wires. With the goal of achieving a compromise between accuracy and computational affordability, we propose a new approach consisting in using 1D FE formulations equipped with torsional springs at the crossover points of the wires. In the case of covered braided stents, the model is enriched with a set of tensile springs (defined in the longitudinal direction), aimed at capturing the stiffening effect of the polymeric membrane. The predictive capabilities of the proposed model are evaluated using data of our own experimental tests, as well as data from other tests in the literature. The simulations demonstrate that the proposed model is able to predict the (markedly nonlinear) behavior of stents when subjected to radial and axial cycle loads, with errors at the end of the compression stage ranging from 0.5% to 10% in all cases.

Profesionalización de la acupuntura y sus implicaciones en la salud de los pacientes / Acupuncture professionalisation and patients health implications

Introducción: la acupuntura humana es una terapia complementaria en la atención para la salud. Derivado de su alta demanda en gran parte del mundo la OMS fijo su postura a favor de la Medicina Tradicional y Complementaria (MTC) con la publicación "Estrategia sobre medicina tradicional 2014-2023", ésta se centra en dos objetivos: brindar apoyo a los Estados Miembros en la contribución de la MTC en la salud, bienestar y atención centrada en las personas y promover su utilización de forma segura y eficaz; mediante la reglamentación de productos, prácticas y profesionales capacitados. Desarrollo: la estrategia plantea la necesidad de que toda práctica de MTC sea realizada con formación universitaria, sin embargo, solo el 30% de los países miembros (39) cuentan con ella universitaria y 56% (72) tienen reglamentos para su práctica en acupuntura. En México se imparten diversos cursos y diplomados de MTC, a nivel técnico, licenciatura, especialidad y posgrado, con diferentes horas curriculares. Asimismo, cuenta con políticas de regulación sobre acupuntura y sus técnicas. Conclusión: la acupuntura tiene sustento científico en la anatomía y neurofisiología. Debe ser aplicada por profesionales del área de salud y con formación certificada por una institución de reconocido prestigio.

Case report: multiple and atypical amoebic cerebral abscesses resistant to treatment.

BACKGROUND: The parasite Entamoeba histolytica is the causal agent of amoebiasis, a worldwide emerging disease. Amebic brain abscess is a form of invasive amebiasis that is both rare and frequently lethal. This condition always begins with the infection of the colon by E. histolytica trophozoites, which subsequently travel through the bloodstream to extraintestinal tissues. CASE PRESENTATION: We report a case of a 71-year-old female who reported an altered state of consciousness, disorientation, sleepiness and memory loss. She had no history of hepatic or intestinal amoebiasis. A preliminary diagnosis of colloidal vesicular phase neurocysticercosis was made based on nuclear magnetic resonance imaging (NMRI). A postsurgery immunofluorescence study was positive for the 140 kDa fibronectin receptor of E. histolytica, although a serum analysis by ELISA was negative for IgG antibodies against this parasite. A specific E. histolytica 128 bp rRNA gene was identified by PCR in biopsy tissue. The final diagnosis was cerebral amoebiasis. The patient underwent neurosurgery to eliminate amoebic abscesses and was then given a regimen of metronidazole, ceftriaxone and dexamethasone for 4 weeks after the neurosurgery. However, a rapid decline in her condition led to death. CONCLUSIONS: The present case of an individual with a rare form of cerebral amoebiasis highlights the importance of performing immunofluorescence, NMRI and PCR if a patient has brain abscess and a poorly defined diagnosis. Moreover, the administration of corticosteroids to such patients can often lead to a rapid decline in their condition.

The Influence of the Scout Movement as a Free Time Option on Improving Academic Performance, Self-Esteem and Social Skills in Adolescents.

The word scouting refers to the Scout movement, born more than a hundred years ago, which educates millions of young people between the ages of six and twenty-one in their leisure time. We aimed to study the effects of scouting on the academic results, social skills, and self-esteem of high school youths compared to a non-scout sample. The selected sample consisted of 430 secondary students aged between thirteen and seventeen. Self-esteem and social skills were measured, and the average mark of the total sample was analysed. After the study, it was shown that belonging to the scout movement significantly influences the improvement of academic results in formal education and conflict resolution; however, there are no statistically significant differences in self-esteem and other social skills.

Validation of the Lasher and Faulkender Anxiety about Aging Scale (AAS) for the Spanish Context.

Increased longevity has led to concerns and fears among the population about the inexorable process of ageing. This process causes individuals to become more anxious about the physical and psychosocial changes caused by the passage of time. However, there are currently no scales in the Spanish context that analyse ageing. Therefore, the aim of the present study is to validate the Anxiety about Aging scale to the Spanish context. In the present study, 594 subjects between 25 and 64 years old participated. Both exploratory and confirmatory factor analyses were used. The results revealed that the factor structure of the questionnaire shows adequate psychometric properties, showing a four-factor factor structure.

Validation of the Index for Inclusion Questionnaire for Parents of Non-University Education Students.

The perspective from the parents of non-university students is essential in determining inclusive education in a school. The Index of Inclusion is one of the most widely used self-assessment tools and strategies to help teaching teams self-assess their political cultures and practices from the perspective of the values and principles of educational inclusion worldwide. For this reason, the present study intends to show evidence of validity of the Index for Inclusion questionnaire for parents of non-university education students, in a quantitative way, through a confirmatory factor analysis (CFA). In this study, 108 fathers and 500 mothers took part, aged between 21 and 62 years (M = 43.59; SD = 6.64), whose children belonged to educational institutions throughout Spain. The results revealed adequate adjustment rates, showing invariant structure with respect to sex. The Index for Inclusion for families of non-university education students was shown to be a robust and adequate psychometric instrument to assess the degree of development of inclusive education in educational institutions from the perspective of the parents of said student body. The family is a basic pillar in the education of children and a reference for them. In addition, parents of non-university education students are configured as fundamental participatory elements of the child's educational institution thus; making the family a fundamental element that favors inclusive education. Precisely because of all this, the future administration of this questionnaire (to the parents of these students) is recommended.

Selection of Predatory Mites for the Biological Control of Potato Tuber Moth in Stored Potatoes.

Worldwide, the potato tuber moth (PTM), Phthorimaea operculella (Zeller), is one of the most severe pests affecting potato (Solanum tuberosum L.), whether in open-air crops or during tuber storage. This work examines the potential control of this pest by two species of predatory mites, Macrocheles robustulus (Berlese) and Blattisocius tarsalis (Berlese), on pest eggs under laboratory conditions. In the two first assays, the acceptance rate of the pest eggs was assessed for each predatory mite. Then, in a third assay, the functional response of B. tarsalis was studied. The results showed that Macrocheles robustulus did not prey on the pest eggs (number of eggs surviving = 4.33 ± 0.38), whereas B. tarsalis did (number of eggs surviving = 0.5 ± 0.5). Likewise, B. tarsalis showed a type II functional response when it killed the eggs. The results showed the potential use of Blattisocius tarsalis as a biological control agent of P. operculella in potato under storage conditions.