EPICAP: intervención educativa mediante cápsulas audiovisuales en pacientes con epilepsia. Ensayo clínico aleatorizado / EPICAP: educational intervention using instructional clips in patients with epilepsy. A randomised clinical trial

Objetivos La educación sanitaria en pacientes con epilepsia influye positivamente en el autocontrol de la enfermedad, mejora su pronóstico y favorece el bienestar del paciente. El objetivo de este estudio fue evaluar una intervención educativa mediante cápsulas audiovisuales en pacientes con epilepsia en una unidad de monitorización videoelectroencefalográfica.Sujetos y métodosEs un ensayo clínico aleatorizado con dos grupos (intervención y control). Se reclutó a pacientes adultos con epilepsia que ingresaron en la unidad de monitorización videoelectroencefalográfica. Se crearon nueve vídeos sobre el diagnóstico y el tratamiento de la epilepsia, y recomendaciones de estilo de vida, que se administraron al grupo de intervención durante el ingreso. Se evaluó el conocimiento del paciente sobre su enfermedad con un cuestionario diseñado específicamente para este estudio. Se realizó una evaluación previa en el inicio del estudio, en el alta hospitalaria y a los tres meses, y se comparó el conocimiento sobre la epilepsia en ambos grupos en cada momento del estudio.ResultadosSe incluyó a 66 pacientes, con edad media de 39 ± 14,7 años (rango: 17-76) y una mediana de 8 años de evolución de la enfermedad (rango: 1-60 años). Un 53% eran mujeres. El tipo de epilepsia más frecuente fue el focal (95,5%). La puntuación media en el test preintervención fue de 57,2 ± 15,3. Los pacientes que recibieron la intervención educativa mostraron mejores puntuaciones en el postest en el alta hospitalaria (81,8 ± 11,2 frente a 62,8 ± 13,7; p = 0,001) y a los tres meses (76 ± 9,6 frente a 63,2 ± 12,8; p = 0,001).ConclusionesLa intervención educativa EPICAP mediante píldoras audiovisuales mejora de forma significativa el conocimiento de los pacientes sobre aspectos diagnósticos, terapéuticos y estilo de vida relacionados con la epilepsia. (AU)

AIMS. In patients with epilepsy health education has a positive influence on self-management of the disease, improves prognosis and enhances patient well-being. The aim of this study was to evaluate an educational intervention using instructional clips in patients with epilepsy in a video-electroencephalographic monitoring unit.SUBJECTS AND METHODSWe conducted a randomised clinical trial with two groups (intervention and control). Adult patients with epilepsy admitted to the video-electroencephalographic monitoring unit were recruited. Nine videos about the diagnosis and treatment of epilepsy, together with recommendations on lifestyle, were produced and administered to the intervention group while admitted. Patients’ knowledge of their disease was assessed by means of a questionnaire designed specifically for this study. A pre-assessment was conducted at the beginning of the study, at hospital discharge and at three months, and the knowledge of epilepsy in the two groups was compared at each time considered in the study.RESULTSSixty-six patients were included, with a mean age of 39 ± 14.7 years (range: 17-76) and a median of 8 years since disease onset (range: 1-60 years). Fifty-three per cent of the patients were women. Focal epilepsy was the most frequent type (95.5%). The mean score on the pre-intervention test was 57.2 ± 15.3. Patients who received the educational intervention showed better post-test scores at discharge from hospital (81.8 ± 11.2 versus 62.8 ± 13.7; p = 0.001) and at three months (76 ± 9.6 versus 63.2 ± 12.8; p = 0.001).CONCLUSIONSThe EPICAP educational intervention using instructional clips significantly improves patients’ knowledge of epilepsy-related diagnostic, therapeutic and lifestyle issues. (AU)

Evolution of appraisal tool usage preferences in PROSPERO records: a study of non-Cochrane systematic reviews.

OBJECTIVES: This research-on-research substudy uses a data-driven approach to investigate the range of appraisal tools in non-Cochrane systematic reviews and meta-analyses registered in the International Prospective Register of Systematic Reviews (PROSPERO). STUDY DESIGN AND SETTING: A comprehensive web scraping of all completed non-Cochrane registrations in PROSPERO from February 2011 to December 2017 was performed. The focus was classifying the appraisal tools based on study type, assessment aspects, and research topics. RESULTS: After analyzing 17,708 complete records, we found a predominant use of methodological quality assessment tools compared to those for reporting quality or risk of bias (RoB). This indicates a greater emphasis on methodological rigor in the studied protocols. Various tools for assessing methodological quality were observed, reflecting the complexity of such evaluations. Instruments designed for evaluating methodological or reporting quality were mainly intended for non-randomized clinical trials or observational studies, unlike RoB tools more commonly used in randomized clinical trials. No distinct trends in tool usage were observed in specific research conditions or domains, suggesting that tool choice is influenced more by study design than research topic. CONCLUSION: This study provides insights into the preferential use of various assessment tools in conducting non-Cochrane systematic reviews, as evidenced in PROSPERO records. The findings reveal various methodological assessment tools, underscoring their versatility across different study designs and research areas.

Corneal Edema after Cataract Surgery.

This systematic review investigates the prevalence and underlying causes of corneal edema following cataract surgery employing manual phacoemulsification. A comprehensive search encompassing databases such as PubMed, Embase, ProQuest, Cochrane Library, and Scopus was conducted, focusing on variables encompassing cataract surgery and corneal edema. Two independent reviewers systematically extracted pertinent data from 103 articles, consisting of 62 theoretical studies and 41 clinical trials. These studies delved into various aspects related to corneal edema after cataract surgery, including endothelial cell loss, pachymetry measurements, visual performance, surgical techniques, supplies, medications, and assessments of endothelial and epithelial barriers. This review, encompassing an extensive analysis of 3060 records, revealed significant correlations between corneal edema and endothelial cell loss during phacoemulsification surgery. Factors such as patient age, cataract grade, and mechanical stress were identified as contributors to endothelial cell loss. Furthermore, pachymetry and optical coherence tomography emerged as valuable diagnostic tools for assessing corneal edema. In conclusion, this systematic review underscores the link between corneal edema and endothelial cell loss in manual phacoemulsification cataract surgery. It highlights the relevance of factors like patient demographics and diagnostic modalities. However, further research is essential to unravel the complexities of refractive changes and the underlying mechanisms.

[EPICAP: educational intervention using instructional clips in patients with epilepsy. A randomised clinical trial]. / EPICAP: intervención educativa mediante cápsulas audiovisuales en pacientes con epilepsia. Ensayo clínico aleatorizado.

AIMS: In patients with epilepsy health education has a positive influence on self-management of the disease, improves prognosis and enhances patient well-being. The aim of this study was to evaluate an educational intervention using instructional clips in patients with epilepsy in a video-electroencephalographic monitoring unit. SUBJECTS AND METHODS: We conducted a randomised clinical trial with two groups (intervention and control). Adult patients with epilepsy admitted to the video-electroencephalographic monitoring unit were recruited. Nine videos about the diagnosis and treatment of epilepsy, together with recommendations on lifestyle, were produced and administered to the intervention group while admitted. Patients' knowledge of their disease was assessed by means of a questionnaire designed specifically for this study. A pre-assessment was conducted at the beginning of the study, at hospital discharge and at three months, and the knowledge of epilepsy in the two groups was compared at each time considered in the study. RESULTS: Sixty-six patients were included, with a mean age of 39 ± 14.7 years (range: 17-76) and a median of 8 years since disease onset (range: 1-60 years). Fifty-three per cent of the patients were women. Focal epilepsy was the most frequent type (95.5%). The mean score on the pre-intervention test was 57.2 ± 15.3. Patients who received the educational intervention showed better post-test scores at discharge from hospital (81.8 ± 11.2 versus 62.8 ± 13.7; p = 0.001) and at three months (76 ± 9.6 versus 63.2 ± 12.8; p = 0.001). CONCLUSIONS: The EPICAP educational intervention using instructional clips significantly improves patients' knowledge of epilepsy-related diagnostic, therapeutic and lifestyle issues.

TITLE: EPICAP: intervención educativa mediante cápsulas audiovisuales en pacientes con epilepsia. Ensayo clínico aleatorizado.Objetivos. La educación sanitaria en pacientes con epilepsia influye positivamente en el autocontrol de la enfermedad, mejora su pronóstico y favorece el bienestar del paciente. El objetivo de este estudio fue evaluar una intervención educativa mediante cápsulas audiovisuales en pacientes con epilepsia en una unidad de monitorización videoelectroencefalográfica. Sujetos y métodos. Es un ensayo clínico aleatorizado con dos grupos (intervención y control). Se reclutó a pacientes adultos con epilepsia que ingresaron en la unidad de monitorización videoelectroencefalográfica. Se crearon nueve vídeos sobre el diagnóstico y el tratamiento de la epilepsia, y recomendaciones de estilo de vida, que se administraron al grupo de intervención durante el ingreso. Se evaluó el conocimiento del paciente sobre su enfermedad con un cuestionario diseñado específicamente para este estudio. Se realizó una evaluación previa en el inicio del estudio, en el alta hospitalaria y a los tres meses, y se comparó el conocimiento sobre la epilepsia en ambos grupos en cada momento del estudio. Resultados. Se incluyó a 66 pacientes, con edad media de 39 ± 14,7 años (rango: 17-76) y una mediana de 8 años de evolución de la enfermedad (rango: 1-60 años). Un 53% eran mujeres. El tipo de epilepsia más frecuente fue el focal (95,5%). La puntuación media en el test preintervención fue de 57,2 ± 15,3. Los pacientes que recibieron la intervención educativa mostraron mejores puntuaciones en el postest en el alta hospitalaria (81,8 ± 11,2 frente a 62,8 ± 13,7; p = 0,001) y a los tres meses (76 ± 9,6 frente a 63,2 ± 12,8; p = 0,001). Conclusiones. La intervención educativa EPICAP mediante píldoras audiovisuales mejora de forma significativa el conocimiento de los pacientes sobre aspectos diagnósticos, terapéuticos y estilo de vida relacionados con la epilepsia.

The activation of mGluR4 rescues parallel fiber synaptic transmission and LTP, motor learning and social behavior in a mouse model of Fragile X Syndrome.

BACKGROUND: Fragile X syndrome (FXS), the most common inherited intellectual disability, is caused by the loss of expression of the Fragile X Messenger Ribonucleoprotein (FMRP). FMRP is an RNA-binding protein that negatively regulates the expression of many postsynaptic as well as presynaptic proteins involved in action potential properties, calcium homeostasis and neurotransmitter release. FXS patients and mice lacking FMRP suffer from multiple behavioral alterations, including deficits in motor learning for which there is currently no specific treatment. METHODS: We performed electron microscopy, whole-cell patch-clamp electrophysiology and behavioral experiments to characterise the synaptic mechanisms underlying the motor learning deficits observed in Fmr1KO mice and the therapeutic potential of positive allosteric modulator of mGluR4. RESULTS: We found that enhanced synaptic vesicle docking of cerebellar parallel fiber to Purkinje cell Fmr1KO synapses was associated with enhanced asynchronous release, which not only prevents further potentiation, but it also compromises presynaptic parallel fiber long-term potentiation (PF-LTP) mediated by ß adrenergic receptors. A reduction in extracellular Ca2+ concentration restored the readily releasable pool (RRP) size, basal synaptic transmission, ß adrenergic receptor-mediated potentiation, and PF-LTP. Interestingly, VU 0155041, a selective positive allosteric modulator of mGluR4, also restored both the RRP size and PF-LTP in mice of either sex. Moreover, when injected into Fmr1KO male mice, VU 0155041 improved motor learning in skilled reaching, classical eyeblink conditioning and vestibuloocular reflex (VOR) tests, as well as the social behavior alterations of these mice. LIMITATIONS: We cannot rule out that the activation of mGluR4s via systemic administration of VU0155041 can also affect other brain regions. Further studies are needed to stablish the effect of a specific activation of mGluR4 in cerebellar granule cells. CONCLUSIONS: Our study shows that an increase in synaptic vesicles, SV, docking may cause the loss of PF-LTP and motor learning and social deficits of Fmr1KO mice and that the reversal of these changes by pharmacological activation of mGluR4 may offer therapeutic relief for motor learning and social deficits in FXS.

Evaluation of the susceptibility of Tritrichomonas foetus to extracts of Lantana camara (Verbenaceae) by flow cytometry.

Bovine Trichomonosis (BT), a sexually transmitted disease endemic in countries with extensive cattle farming and natural service, is one of the most common causes of reproductive failure. 5-nitroimidazoles and their derivatives are used for its treatment, mainly metronidazole. The emergence of drug resistance mechanisms and treatment failures raise the need to investigate the effectiveness of new active compounds that contribute to parasite control. In this regard, extracts of Lantana camara (Verbenacea) have shown high biocidal potential against isolates of Trypanosoma cruzi and Leishmania braziliensis in vitro assays, although their effect on Tritrichomonas foetus has not been demonstrated yet. The available information on in vitro susceptibility of trichomonicidal drugs comes from the use of a diversity of methodologies and criteria, especially the observation of parasite motility under the optical microscope to assess their viability. Recently, in our laboratory, the use of flow cytometry has been described for the first time as a rapid and efficient method to evaluate the viability of T. foetus against metronidazole. The present study aimed to evaluate the cytostatic effect of L. camara extracts against T. foetus isolates by flow cytometry. Under aerobic conditions, IC50 values of 22.60 µg/mL were obtained on average. Under anaerobic conditions, the IC50 oscilated around 29.04 µg/mL. The results obtained allowed describing the susceptibility exhibited by these protozoa, being a valuable information for the development of potential BT treatments.

Identifying gaps in the cascade of care for latent TB infection in a low-incidence setting.

BACKGROUND: The End TB Strategy calls for the global scale-up of treatment for latent TB infection (LTBI). We aimed to evaluate a nurse-led care programme for LTBI by identifying gaps in the care cascade in a low-incidence TB setting.METHODS: We included people at risk of TB over a 15-year period. We define three main outcomes in the LTBI care cascade: 1) attendance at the first appointment, 2) completion of the evaluation process, and 3) completion of treatment.RESULTS: We identified 6,126 individuals (2,369 TB contacts, 1,749 biological therapy candidates, and 2,008 transplant candidates). Overall, 5,938 (96.9%) attended, 5,872/5,938 (98.9%) completed the evaluation and 1,624/1,847 (87.9%) completed treatment. Pre-biological (aOR 2.32, 95% CI 1.54-3.49) and pre-transplant (aOR 1.82, 95% CI 1.20-2.76) candidates were more likely to attend the first appointment, while age was associated with completing the evaluation process (aOR 1.02, 95% CI 1.003-1.04). Female sex (aOR 1.47, 95% CI 1.08-1.99) was associated with completing the treatment.CONCLUSION: Successful assessment and treatment of LTBI is achievable when delivered as a part of a comprehensive, nurse-led, patient-centred programme in specialist TB clinics.

Propuesta para mejorar la formación en profesionalismo y en competencias transversales en los estudios de medicina de las universidades de Cataluña / Proposal to improve training in professionalism and transversal competences in medical studies at the universities of Catalonia

Introducción: En un grupo de trabajo de la Administración de la Generalitat de Cataluña y de los decanos de las facultades con estudios de Medicina de las universidades catalanas se creó una comisión para elaborar una propuesta para fomentar la formación en profesionalismo, en humanidades y en competencias transversales de los graduados en Medicina. Desarrollo: Dicha comisión, compuesta por docentes de todas las facultades, elaboró un documento con tres objetivos específicos: a) mostrar el estado real de dicha formación en los currículos; b) proponer actividades docentes concretas para mejorar dicha formación, considerando las buenas prácticas que se están realizando en las universidades; y c) sugerir criterios y métodos de evaluación de la formación en profesionalismo o de competencias transversales y, también, evaluar competencias específicas que pueden favorecer el desarrollo de las competencias genéricas. Conclusiones: Se espera que las sugerencias presentadas puedan servir para aumentar la formación en valores profesionales, en humanidades y en competencias transversales de los futuros profesionales de la medicina, con el objetivo final de mejorar la salud de la población.(AU)

Introduction: In a working group of the Administration of the regional government of Catalonia and the deans of the faculties with medical studies of the Catalan universities, a commission was created to prepare a document to promote training in professionalism and transversal competences of graduates in Medicine. Development: This commission, made up of teachers from all the faculties, prepared a document with three specific objectives: a) show the real state of said training in the curricula; b) propose specific teaching activities to improve said training, considering those good practices that are being carried out in universities; and c) suggest criteria and methods of evaluation of training in professionalism or of transversal competences and, also, evaluate specific competences that can improve the development of generic competences. Conclusions: It is hoped that the suggestions presented can serve to increase training in professional values, in the humanities and in transversal competences of future medical professionals with the ultimate goal of improving the health of the population.(AU)

Development of an automated colorimeter controlled by Raspberry Pi4.

A low-cost new instrument to carry out automated colorimetric analysis has been developed. The device consists of a carousel sampler, built by a 3D-printer, and a Raspberry Pi4-controlled signal measurement module based on the RGBC (red, green, blue and clear) responses of a TCS34725 color light-to-digital converter with IR filter. The device has been tested with calibration standards of different food dyes (Tartrazine, Red Allure AC and Brilliant Blue FCF) and three food samples containing one of each food dye. The new device provides R2 > 0.995 and a LOD of 1.1, 1.4 and 0.1 µmol L-1 for each food dye, respectively. The results are statistically comparable to those obtained with a conventional benchtop spectrophotometer. The proposed device achieves a reduction in sample and waste volume and in analysis time, minimizes the use of energy, and allows in situ measurements, being an automated method it is safer for operators in comparison to the reference method, yielding similar analytical results and following the principles of green analytical chemistry.

Examining the utility of pinhole-type screens for lightfield display.

The use of microlens arrays for lightfield display has the drawback of providing images with strong chromatic aliasing. To overcome this problem, pinhole-type lightfield monitors are proposed. This paper is devoted to evaluating the capability for such lightfield monitors to offer the user a convincing 3D experience with images with enough brightness and continuous aspect. Thus, we have designed a psychophysical test specifically adapted for lightfield monitors, which allowed us to confirm the usability of pinhole-type monitors.

Debilidad como complicación del paciente crítico por COVID-19: características clínicas y factores pronósticos en una serie de casos / Weakness as a complication of COVID-19 in critically ill patients: clinical features and prognostic factors in a case series

Introducción: La debilidad es una complicación frecuente en el enfermo crítico por COVID-19. Se describen sus características, y los factores que pueden condicionarla y predecirla. Pacientes y métodos: Estudio observacional descriptivo prospectivo con pacientes ingresados en la unidad de cuidados intensivos (UCI) por COVID-19 entre abril y mayo de 2020 con debilidad muscular. Se consideró una afectación clínica grave un equilibrio motor igual o inferior a 3/5 según la escala de fuerza muscular modificada del Medical Research Council. Se han realizado 25 estudios analíticos, 16 estudios neurofisiológicos y una biopsia muscular; seguimiento telefónico al mes; análisis comparativo entre los grupos con y sin afectación grave, y determinación de puntos de corte de parámetros analíticos para predecir afectación grave mediante curvas ROC. Resultados: Se incluyó a 25 pacientes con 58 años (desviación estándar ± 9) de edad media. La mediana de estancia en la UCI fue de 27,5 días. Todos los electromiogramas mostraban un patrón miógeno y el 75%, también una neuropatía. El grupo con afectación clínica grave tenía mayores niveles de dímero-D (p = 0,08), lactato deshidrogenasa (p = 0,03) e interleucina 6 (p = 0,10), y la combinación de la alteración de dos cualquiera de estos tres parámetros pronosticaba la afectación grave con una sensibilidad del 100% y una especificidad del 76,9%. Al mes de seguimiento, el 36% no podía deambular autónomamente y el 92% seguía con debilidad muscular. Conclusiones: La debilidad en el enfermo por COVID-19 grave tiene una repercusión clínica importante. Su detección y estudio precoces mediante predictores de su desarrollo pueden permitir un mejor manejo. La ausencia en algunos casos de los factores de riesgo clásicos para la debilidad adquirida en la UCI sugiere una fisiopatología diferente.(AU)

Introduction: Weakness is a frequent complication in those critically ill due to COVID-19. This study describes its characteristics and the factors that can condition and predict it. Patients and methods: We conducted a prospective, descriptive, observational study of patients admitted to the intensive care unit (ICU) due to COVID-19 between April and May 2020 with muscle weakness. A motor balance equal to or lower than 3/5 according to the modified Medical Research Council muscle strength scale was considered to be severe clinical impairment. Altogether 25 analytical studies, 16 neurophysiological studies and one muscle biopsy were performed, with a telephone follow-up at one month, a comparative analysis between the groups with and without severe compromise, and determination of cut-off points for analytical parameters to predict severe involvement using ROC curves. Results: The sample consisted of 25 patients with a mean age of 58 years (standard deviation ± 9). The median length of stay in the ICU was 27.5 days. All the electromyograms exhibited a myogenic pattern and 75% also showed neuropathy. The group with severe clinical involvement had higher levels of D-dimer (p = 0.08), lactate dehydrogenase (p = 0.03) and interleukin-6 (p = 0.10), and the combination of the alteration of any two of these three parameters predicted severe involvement with a sensitivity of 100% and a specificity of 76.9%. At one month of follow-up, 36% were unable to walk autonomously and 92% continued with muscle weakness. Conclusions: Weakness in severe COVID-19 patients has a major clinical impact. Its early detection and study by means of predictors of its development may allow for better management. The absence in some cases of classical risk factors for ICU-acquired weakness suggests a different pathophysiology.(AU)

The Moderating Role of Mathematical Skill Level when Using Curricular Methods to Learn Multiplication Tables / El papel moderador del nivel de habilidad matemática al emplear métodos curriculares para la enseñanza de las tablas de multiplicación

The present study explores the effect of two instructional methods for children with different levels of mathematical skills. One of these methods uses a conventional approach to learning multiplication and emphasizes the memorization of all arithmetic facts, whereas the other method is based on psychological principles and combines: a) the memorization of a small subset of problems aided by color cues and a portable time-table, with b) the use of single-step rules. One hundred and sixty second-grade children (aged 7-8) received instruction in one of these approaches – either the conventional method or the memory and rules method (M&R) – over the course of 6 months as part of their normal school education. Moderation analysis revealed that children with poor mathematical skills in the conventional group scored significantly better than their counterparts in the M&R group, whereas a significant advantage was observed in the M&R group for those children with strong mathematical skills. (AU)

El presente estudio explora el efecto de dos métodos de enseñanza de la multiplicación simple en alumnos de primaria con diferentes niveles de habilidades matemáticas. Un método se basa en el enfoque convencional para el aprendizaje de las multiplicaciones que enfatiza la memorización de todas ellas, mientras que el otro se basa en principios psicológicos y combina: a) la memorización de un pequeño subconjunto de multiplicaciones auxiliadas con claves de color y una tabla portátil con las multiplicaciones con b) el uso de reglas de un solo paso. Ciento sesenta niños y niñas de segundo de primaria (de 7 a 8 años) recibieron instrucción en uno de estos métodos, ya fuera el convencional o el método de memorización y reglas (M&R), durante 6 meses como parte de su educación escolar normal. El análisis de moderación reveló que los niños con habilidades matemáticas bajas en el grupo convencional obtuvieron puntuaciones significativamente mejores que sus pares en el grupo M&R, mientras que se observó una ventaja significativa en el grupo M&R para aquellos niños con altas habilidades matemáticas. (AU)

Informe de la Fundación del Cerebro. Impacto social de la enfermedad de Alzheimer y otras demencias / Report by the Spanish Foundation of the Brain on the social impact of Alzheimer disease and other types of dementia

INTRODUCCIÓN: El conocimiento del alcance socioeconómico de las enfermedades que cursan con demencia es esencial para la planificación de recursos y la concienciación social. DESARROLLO: Se ha realizado una revisión de los datos publicados hasta el momento sobre la epidemiología, morbilidad, mortalidad, discapacidad, dependencia e impacto económico de la demencia y la enfermedad de Alzheimer en España. CONCLUSIONES: La mayoría de estudios en población mayor de 65 años estiman una prevalencia entre el 4% y el 9%. La prevalencia es mayor en mujeres en casi todos los grupos de edad. La enfermedad de Alzheimer es la causa de demencia más frecuente (50-70% del total). La demencia provoca un aumento de la morbilidad, mortalidad, discapacidad y dependencia de los pacientes, con una importante disminución de la calidad de vida y la supervivencia. El 80% de los enfermos es cuidado por sus familias, que asumen de media el 87% del coste total, con la consiguiente sobrecarga y menoscabo de la salud y calidad de vida de los cuidadores. El impacto económico de la demencia es enorme, y de evaluación compleja, por la mezcla de costes sanitarios y no sanitarios, directos e indirectos. Es necesario desarrollar programas globales e incrementar los recursos enfocados a fomentar la investigación, prevención, diagnóstico precoz, tratamiento multidimensional y abordaje multidisciplinario, que permitan reducir la carga sanitaria, social y económica de la demencia

INTRODUCTION: Knowledge of the socioeconomic impact of dementia-related disorders is essential for appropriate management of healthcare resources and for raising social awareness. METHODS: We performed a literature review of the published evidence on the epidemiology, morbidity, mortality, associated disability and dependence, and economic impact of dementia and Alzheimer disease (AD) in Spain. CONCLUSIONS: Most population studies of patients older than 65 report prevalence rates ranging from 4% to 9%. Prevalence of dementia and AD is higher in women for nearly every age group. AD is the most common cause of dementia (50%-70% of all cases). Dementia is associated with increased morbidity, mortality, disability, and dependence, and results in a considerable decrease in quality of life and survival. Around 80% of all patients with dementia are cared for by their families, which cover a mean of 87% of the total economic cost, resulting in considerable economic and health burden on caregivers and loss of quality of life. The economic impact of dementia is huge and difficult to evaluate due to the combination of direct and indirect costs. More comprehensive programmes should be developed and resources dedicated to research, prevention, early diagnosis, multidimensional treatment, and multidisciplinary management of these patients in order to reduce the health, social, and economic burden of dementia

Report by the Spanish Foundation of the Brain on the social impact of Alzheimer disease and other types of dementia. / Informe de la Fundación del Cerebro. Impacto social de la enfermedad de Alzheimer y otras demencias.

INTRODUCTION: Knowledge of the socioeconomic impact of dementia-related disorders is essential for appropriate management of healthcare resources and for raising social awareness. METHODS: We performed a literature review of the published evidence on the epidemiology, morbidity, mortality, associated disability and dependence, and economic impact of dementia and Alzheimer disease (AD) in Spain. CONCLUSIONS: Most population studies of patients older than 65 report prevalence rates ranging from 4% to 9%. Prevalence of dementia and AD is higher in women for nearly every age group. AD is the most common cause of dementia (50%-70% of all cases). Dementia is associated with increased morbidity, mortality, disability, and dependence, and results in a considerable decrease in quality of life and survival. Around 80% of all patients with dementia are cared for by their families, which cover a mean of 87% of the total economic cost, resulting in considerable economic and health burden on caregivers and loss of quality of life. The economic impact of dementia is huge and difficult to evaluate due to the combination of direct and indirect costs. More comprehensive programmes should be developed and resources dedicated to research, prevention, early diagnosis, multidimensional treatment, and multidisciplinary management of these patients in order to reduce the health, social, and economic burden of dementia.

Impacto en el consumo de antibióticos del test de diagnóstico rápido de Streptococcus pyogenes en Atención Primaria / Impact of the rapid diagnostic test of Streptococcus pyogenes on the consumption of antibiotics in Primary Care

OBJETIVOS: analizar el empleo de los test de detección rápida de antígeno estreptocócico en Pediatría de Atención Primaria (AP), su impacto en la prescripción de antibióticos y la reducción de costes del tratamiento antibiótico. MATERIAL Y MÉTODOS: estudio descriptivo transversal, en menores de 15 años atendidos en AP, en 24 centros de salud, desde abril de 2017 hasta febrero de 2018. Se elaboró un protocolo de utilización del test de detección rápida de antígeno estreptocócico (TDRS). Se incluyeron pacientes con escala Centor mayor o igual a 2 puntos. Se extrajeron del sistema de facturación de recetas datos del número de dosis diaria definida (DDD) e importe de antibióticos en dicha temporada, comparándose con el gasto en los 12 meses previos. RESULTADOS: se realizaron 819 TDRS. Resultaron positivos 250 (30,5%), negativos 557 (68%) y 12 no valorables (1,5%). Se prescribió antibiótico al 33% de los pacientes (todos los positivos, 18 negativos, 3 no valorables). En 539 pacientes (97%) con resultado negativo no se instauró antibiótico. El número de DDD total disminuyó en 21 960 (12%), de las cuales 19 023 (86,6%) corresponden a los antibióticos más utilizados (penicilinas, amoxicilina, amoxicilina-clavulánico y azitromicina). La reducción económica fue de 11 320 € (12,5%) y el gasto en TDRS fue de 991 €, lo que supone un ahorro de 10 329€. CONCLUSIONES: la introducción del TDRS en consultas de Pediatría de AP ha permitido que se eviten un elevado número de tratamientos antibióticos. Su utilización ha demostrado ser eficiente en la optimización del consumo de antibióticos, consiguiendo reducir su utilización, evitar efectos adversos y reducir el gasto farmacéutico innecesario

OBJECTIVE: the aim of the study was to analyse the use of the rapid Streptococcus antigen detection test in primary care paediatrics, its impact on antibiotic prescription of and the associated decrease in antibiotic treatment costs. MATERIAL AND METHODS: we conducted a cross-sectional descriptive study in children aged less than 15 years managed in 24 primary care centres between April 2017 and February 2018. We developed a protocol for the use of the rapid strep test (RST). We included patients with a Centor score equal to or greater than 2 points. We collected data on the number of daily defined doses (DDDs) and amount antibiotics prescribed in the study period from the prescription billing system and compared it with the costs corresponding to the previous 12-month period. RESULTS: 819 TDRS were performed. The results were positive in 250 (30.5%), negative in 557 (68%) and inconclusive in 12 (1.5%). Antibiotics were prescribed to 33% of the patients (all patients with a positive test, 18 with a negative test and 3 with an inconclusive test). Antibiotherapy was not prescribed to 539 of the patients with a negative result (97%). The total number of prescribed DDDs decreased by 21 960 (12%), of which 19 023 (86.6%) corresponded to the most frequently prescribed antibiotics (penicillins, amoxicillin, amoxicillin-clavulanic acid and azithromycin). We found a reduction of €11 320 in antibiotherapy costs (12.5%), while the total cost of rapid testing was € 991, corresponding to total savings of €10 329. CONCLUSIONS: the introduction of the RST in primary care paediatrics has achieved a reduction in the frequency of antibiotherapy. Its use has proven effective in optimising antibiotic use, reducing antibiotic prescription and therefore preventing associated adverse events and reducing unnecessary pharmacotherapy costs

The protective effect of extra-virgin olive oil in the experimental model of multiple sclerosis in the rat.

This study has evaluated the effect of EVOO (Extra-Virgin olive oil), OA (oleic acid) and HT (hydroxytyrosol) in an induced model of MS through experimental autoimmune encephalomyelitis (EAE).Dark Agouti 2-month old rats (25 males) were divided into five groups: (i) control group, (ii) EAE group, (iii) EAE+EVOO, (iv) EAE+HT, and (v) EAE+OA. At 65 days, the animals were sacrificed and the glutathione redox system and bacterial lipopolysaccharide (LPS) and LPS-binding protein (LBP) products of the microbiota in brain, spinal cord, and blood were evaluated.Gastric administration of EVOO, OA, and HT reduced the degree of lipid and protein oxidation, and increased glutathione peroxidase, making it a diet-based mechanism for enhancing protection against oxidative damage. In addition, it reduced the levels of LPS and LBP, which appeared as being increased in the EAE correlated with the oxidative stress produced by the disease.

Estilo de interacción del entrenador, clima motivacional percibido y satisfacción de las necesidades psicológicas básicas en futbolistas jóvenes / Coach interactionstyle, perceived motivational climate and satisfaction of basic psychological needs in young soccer players / Estilo de interação do treinador, clima motivacional percebido e satisfação das necessidades psicológicas básicas em jovens futebolistas

El objetivo del presente trabajo fue analizar el clima motivacional percibido a través de las relaciones existentes entre el estilo de interacción del entrenador (apoyo a la autonomía o estilo controlador) con los constructos de la Teoría de las Metas de Logro (clima ego o clima tarea) y el grado de satisfacción con las necesidades psicológicas básicas en una muestra de jóvenes deportistas. Participaron 125 futbolistas de la provincia de Málaga (España), con edades comprendidas entre los 15 y 18 años (M= 16.66, DT= 1.13). Para recoger la información se utilizó la Escala de Estilo Controlador del Entrenador (CCBS), el Cuestionario de Percepción de Soporte de la Autonomía en el Proceso de Entrenamiento(ASCQ), el Cuestionario de Clima Motivacional Percibido en el Deporte (PMCSQ-2) y Escala de Medición de la Satisfacción de las Necesidades Psicológicas en el Ejercicio (PNSE). Los análisis efectuados pusieron de manifiesto relaciones negativas entre la satisfacción de las necesidades psicológicas básicas y el estilo controlador, pero positivas con el apoyo a la autonomía. Además, destaca las relaciones positivas entre el estilo controlador y la percepción del clima motivacional de implicación en el ego, siendo negativas con el clima de implicación en la tarea

The aim of this paper was to analyze the perceived motivational climate through the relationships between the coach's interaction style (autonomy support or controlling style) with the constructs of the Achievement Goal Theory (ego climate or task climate) and the degree of basic psychological needs satisfactionin a sample of young athletes. 125 players from the province of Málaga (Spain) participated in this research, aged between 15 and 18 years old (M= 16.66, SD= 1.13). To collect the information we used the Controlling Coach Behaviors Scale (CCBS), the Autonomy-Supportive Coaching Questionnaire (ASCQ), the Perceived Motivational Climate in Sport Questionnaire -2(PMCSQ-2) and the Psychological Need Satisfaction in Exercise scale (PNSE). Results revealed negative relationships between the satisfaction of basic psychological needs and the controlling style, but positive with autonomy support. In addition, it highlights the positive relationships between the controlling style and the perception of ego-involving climates, being negative with the task-involvingclimates

O objetivo deste estudo foi analisar o clima motivacional percebido através das relações entre treinador estilo de interação (apoio para a autonomia ou estilo controlador) com as construções da Teoria da Goal Achievement (clima ego ou o clima tarefa e o grau de satisfação com necessidades psicológicas básicas em uma amostra de jovens atletas. Participaram 125 jogadores da província de Málaga (Espanha), com idades compreendidas entre os 15 e os 18 anos (M = 16,66, DT = 1,13). Escala Estilo driver Trainer (CCBS) foi usado para coletar informações, Perceptions Questionnaire apoiar a autonomia no processo de formação (ASCQ) Questionário Percebida Motivacional Climatein Sport (PMCSQ-2) e Escala de Medida da Satisfação das Necessidades Psicológicas no Exercício (PNSE). As análises realizadas revelaram relações negativas entre a satisfação das necessidades psicológicas básicas e o estilo controlador, mas positivas com oapoio à autonomia. Além disso, destaca as relações positivas entre o estilo controlador e a percepção do clima motivacional de envolvimento no ego, sendo negativo com o clima de envolvimento na tarefa

Relationships between abstract features and methodological quality explained variations of social media activity derived from systematic reviews about psoriasis interventions.

OBJECTIVES: The aim of this study was to describe the relationship among abstract structure, readability, and completeness, and how these features may influence social media activity and bibliometric results, considering systematic reviews (SRs) about interventions in psoriasis classified by methodological quality. STUDY DESIGN AND SETTING: Systematic literature searches about psoriasis interventions were undertaken on relevant databases. For each review, methodological quality was evaluated using the assessing the methodological quality of systematic reviews tool. Abstract extension, structure, readability, and quality and completeness of reporting were analyzed. Social media activity, which consider Twitter and Facebook mention counts, as well as Mendeley readers and Google scholar citations were obtained for each article. Analyses were conducted to describe any potential influence of abstract characteristics on review's social media diffusion. RESULTS: We classified 139 intervention SRs as displaying high/moderate/low methodological quality. We observed that abstract readability of SRs has been maintained high for last 20 years, although there are some differences based on their methodological quality. Free format abstracts were most sensitive to the increase of text readability as compared with more structured abstracts (Introduction, Methods, Results, and Discussion or eight headings), yielding opposite effects on their quality and completeness depending on the methodological quality: a worsening in low quality reviews and an improvement in those of high quality. Both readability indices and preferred reporting items of systematic reviews and meta-analyses for Abstract total scores showed an inverse relationship with social media activity and bibliometric results in high methodological quality reviews but not in those of lower quality. CONCLUSION: Our results suggest that increasing abstract readability must be specially considered when writing free format summaries of high-quality reviews because this fact correlates with an improvement of their completeness and quality, and this may help to achieve broader social media visibility and article usage.

Chromatic and achromatic visual fields in relation to choroidal thickness in patients with high myopia: A pilot study.

PURPOSE: To analyse the relationship between the choroidal thickness and the visual perception of patients with high myopia but without retinal damage. METHODS: All patients underwent ophthalmic evaluation including a slit lamp examination and dilated ophthalmoscopy, subjective refraction, best corrected visual acuity, axial length, optical coherence tomography, contrast sensitivity function and sensitivity of the visual pathways. RESULTS: We included eleven eyes of subjects with high myopia. There are statistical correlations between choroidal thickness and almost all the contrast sensitivity values. The sensitivity of magnocellular and koniocellular pathways is the most affected, and the homogeneity of the sensibility of the magnocellular pathway depends on the choroidal thickness; when the thickness decreases, the sensitivity impairment extends from the center to the periphery of the visual field. CONCLUSIONS: Patients with high myopia without any fundus changes have visual impairments. We have found that choroidal thickness correlates with perceptual parameters such as contrast sensitivity or mean defect and pattern standard deviation of the visual fields of some visual pathways. Our study shows that the magnocellular and koniocellular pathways are the most affected, so that these patients have impairment in motion perception and blue-yellow contrast perception.