Cronología de la investigación sobre la dinámica cerebral de Justo Gonzalo / Chronology of Justo Gonzalo’s research on brain dynamics

Introducción: El neurocientífico español Justo Gonzalo y Rodríguez-Leal (1910-1986) investiga la organización funcional de la corteza cerebral durante más de cuatro décadas. Sus hallazgos le llevan a formular una teoría neurofisiológica basada en las leyes de la excitabilidad nerviosa, que denomina dinámica cerebral. En el presente trabajo se expone de forma cronológica cómo surgen las principales ideas sobre las que se articula.Desarrollo: En 1939 Gonzalo observa los denominados fenómenos de acción dinámica: desfasamiento, facilitación y repercusión cerebral. Le siguen dos principios: efecto cerebral de la lesión según la magnitud y posición (1941), y organización sensorial, según un desarrollo espiral (1947). Paralelamente, caracteriza lo que llama el síndrome central de la corteza cerebral. En la década de los cincuenta desarrolla los conceptos de gradiente cortical, similitud y alometría. En contraposición a las concepciones modulares de la corteza cerebral, en las que una región es responsable de una función, Gonzalo expresa que ‘los gradientes corticales dan la localización de los sistemas mientras la similitud y alometría revelan su trama funcional’.Conclusiones: La teoría de dinámica cerebral se articula en dos etapas. La primera (de 1938 a 1950) se caracteriza por una importante base clínica con observación de nuevos fenómenos y formulación de nuevos conceptos. La segunda (de 1950 a 1960) incluye la introducción de conceptos de mayor alcance, como el gradiente funcional cortical, y leyes de alometría que se basan en un cambio de escala. Actualmente, varios autores consideran que el concepto de gradiente es clave para entender la organización cerebral.(AU)

Introduction: The Spanish neuroscientist Justo Gonzalo y Rodríguez-Leal (1910-1986) investigated the functional organisation of the cerebral cortex over more than four decades. His findings led him to formulate a neurophysiological theory based on the laws of nervous excitability, which he called brain dynamics. This paper presents in chronological order how the main ideas on which it is based arose.Development: In 1939, Gonzalo observed the phenomena of dynamic action: asynchrony or disaggregation, facilitation and cerebral repercussion. This was followed by two principles: the cerebral effect of lesions according to their magnitude and position (1941), and spiral development of the sensory field (1947). At the same time, he characterised what he called the central syndrome of the cerebral cortex. In the 1950s he developed the concepts of the cortical gradient, similarity and allometry. In contrast to modular conceptions of the cerebral cortex, in which one region is responsible for one function, Gonzalo argued that ‘cortical gradients provide the location of systems, while similarity and allometry reveal their functional mechanism.’Conclusions: The theory of brain dynamics was established in two stages. The first (between 1938 and 1950) had an important clinical foundation, involving the observation of new phenomena and the formulation of new concepts. The second (between 1950 and 1960) included the introduction of more far-reaching concepts, such as the functional cortical gradient, and allometry laws based on a change of scale. Today, various authors believe that the concept of the gradient is crucial for understanding how the brain is organised.(AU)

[Chronology of Justo Gonzalo's research on brain dynamics]. / Cronología de la investigación sobre la dinámica cerebral de Justo Gonzalo.

INTRODUCTION: The Spanish neuroscientist Justo Gonzalo y Rodriguez-Leal (1910-1986) investigated the functional organisation of the cerebral cortex over more than four decades. His findings led him to formulate a neurophysiological theory based on the laws of nervous excitability, which he called brain dynamics. This paper presents in chronological order how the main ideas on which it is based arose. DEVELOPMENT: In 1939, Gonzalo observed the phenomena of dynamic action: asynchrony or disaggregation, facilitation and cerebral repercussion. This was followed by two principles: the cerebral effect of lesions according to their magnitude and position (1941), and spiral development of the sensory field (1947). At the same time, he characterised what he called the central syndrome of the cerebral cortex. In the 1950s he developed the concepts of the cortical gradient, similarity and allometry. In contrast to modular conceptions of the cerebral cortex, in which one region is responsible for one function, Gonzalo argued that 'cortical gradients provide the location of systems, while similarity and allometry reveal their functional mechanism.' CONCLUSIONS: The theory of brain dynamics was established in two stages. The first (between 1938 and 1950) had an important clinical foundation, involving the observation of new phenomena and the formulation of new concepts. The second (between 1950 and 1960) included the introduction of more far-reaching concepts, such as the functional cortical gradient, and allometry laws based on a change of scale. Today, various authors believe that the concept of the gradient is crucial for understanding how the brain is organised.

TITLE: Cronología de la investigación sobre la dinámica cerebral de Justo Gonzalo.Introducción. El neurocientífico español Justo Gonzalo y Rodríguez-Leal (1910-1986) investiga la organización funcional de la corteza cerebral durante más de cuatro décadas. Sus hallazgos le llevan a formular una teoría neurofisiológica basada en las leyes de la excitabilidad nerviosa, que denomina dinámica cerebral. En el presente trabajo se expone de forma cronológica cómo surgen las principales ideas sobre las que se articula.Desarrollo. En 1939 Gonzalo observa los denominados fenómenos de acción dinámica: desfasamiento, facilitación y repercusión cerebral. Le siguen dos principios: efecto cerebral de la lesión según la magnitud y posición (1941), y organización sensorial, según un desarrollo espiral (1947). Paralelamente, caracteriza lo que llama el síndrome central de la corteza cerebral. En la década de los cincuenta desarrolla los conceptos de gradiente cortical, similitud y alometría. En contraposición a las concepciones modulares de la corteza cerebral, en las que una región es responsable de una función, Gonzalo expresa que 'los gradientes corticales dan la localización de los sistemas mientras la similitud y alometría revelan su trama funcional'. Conclusiones. La teoría de dinámica cerebral se articula en dos etapas. La primera (de 1938 a 1950) se caracteriza por una importante base clínica con observación de nuevos fenómenos y formulación de nuevos conceptos. La segunda (de 1950 a 1960) incluye la introducción de conceptos de mayor alcance, como el gradiente funcional cortical, y leyes de alometría que se basan en un cambio de escala. Actualmente, varios autores consideran que el concepto de gradiente es clave para entender la organización cerebral.

Ejecución neuropsicológica y carga de enfermedad en sujetos en riesgo de desarrollar enfermedad de Huntington / Neuropsychological performance and disease burden in individuals at risk of developing Huntington disease

Introducción La enfermedad de Huntington (EH) es un trastorno neurodegenerativo y hereditario. Gracias al diagnóstico predictivo se han descrito características clínicas incipientes en la fase prodrómica. Objetivo Comparar la ejecución en tareas cognitivas de portadores (PEH) del gen de la huntingtina y no portadores (NPEH) y observar la variabilidad en la ejecución, dependiendo de la carga de la enfermedad y cercanía a la etapa manifiesta (edad de inicio de los síntomas). Método Los 146 participantes de un Programa de Diagnóstico Predictivo de EH (PDP-EH) fueron divididos en PEH (41,1%) y NPEH (58,9%). Mediante fórmulas matemáticas se obtuvo la carga de enfermedad y cercanía a la etapa manifiesta en el grupo PEH y se correlacionó con la ejecución neuropsicológica. Resultados Se observaron diferencias significativas entre los grupos con las pruebas Mini-Mental State Examination (MMSE), Stroop-B, SDMT y fluidez fonológica. En el grupo PEH se observaron correlaciones entre la carga de enfermedad con la MMSE, Stroop-B y SDMT. El grupo «Cerca» de la etapa manifiesta es el que obtuvo la puntuación más baja en las pruebas MMSE, Stroop-B, Stroop-C, SDMT y fluidez verbal semántica. De acuerdo al MANCOVA, el efecto MMSE evidencia diferencias estadísticamente significativas entre carga de la enfermedad y la cercanía de inicio de los síntomas. Conclusiones Se observa un nivel menor de desempeño en el grupo PEH con probabilidad de inicio cercano de la fase manifiesta en pruebas que evalúan la velocidad de procesamiento y atención. La disfunción cognitiva prefrontal se altera de manera precoz varios años antes del diagnóstico motor de la EH. (AU)

Introduction Huntington disease (HD) is a hereditary neurodegenerative disorder. Thanks to predictive diagnosis, incipient clinical characteristics have been described in the prodromal phase. Objective To compare performance in cognitive tasks of carriers (HDC) and non-carriers (non-HDC) of the huntingtin gene and to analyse the variability in performance as a function of disease burden and proximity to the manifest stage (age of symptom onset). Method A sample of 146 participants in a predictive diagnosis of HD programme were divided into the HDC (41.1%) and non-HDC groups (58.9%). Mathematical formulae were used to calculate disease burden and proximity to the manifest stage in the HDC group; these parameters were correlated with neuropsychological performance. Results Significant differences were observed between groups in performance on the Mini-Mental State Examination (MMSE), Stroop-B, Symbol-Digit Modalities Test (SDMT), and phonological fluency. In the HDC group, correlations were observed between disease burden and performance on the MMSE, Stroop-B, and SDMT. The group of patients close to the manifest stage scored lowest on the MMSE, Stroop-B, Stroop-C, SDMT, and semantic verbal fluency. According to the multivariate analysis of covariance, the MMSE effect shows statistically significant differences in disease burden and proximity to onset of symptoms. Conclusions Members of the HDC group close to the manifest phase performed more poorly on tests assessing information processing speed and attention. Prefrontal cognitive dysfunction appears early, several years before the motor diagnosis of HD. (AU)

Neuropsychological performance and disease burden in individuals at risk of developing Huntington disease.

INTRODUCTION: Huntington disease (HD) is a hereditary neurodegenerative disorder. Thanks to predictive diagnosis, incipient clinical characteristics have been described in the prodromal phase. OBJECTIVE: To compare performance in cognitive tasks of carriers (HDC) and non-carriers (non-HDC) of the huntingtin gene and to analyse the variability in performance as a function of disease burden and proximity to the manifest stage (age of symptom onset). METHOD: A sample of 146 participants in a predictive diagnosis of HD programme were divided into the HDC (41.1%) and non-HDC groups (58.9%). Mathematical formulae were used to calculate disease burden and proximity to the manifest stage in the HDC group; these parameters were correlated with neuropsychological performance. RESULTS: Significant differences were observed between groups in performance on the Mini-Mental State Examination (MMSE), Stroop-B, Symbol-Digit Modalities Test (SDMT), and phonological fluency. In the HDC group, correlations were observed between disease burden and performance on the MMSE, Stroop-B, and SDMT. The group of patients close to the manifest stage scored lowest on the MMSE, Stroop-B, Stroop-C, SDMT, and semantic verbal fluency. According to the multivariate analysis of covariance, the MMSE effect shows statistically significant differences in disease burden and proximity to onset of symptoms. CONCLUSIONS: Members of the HDC group close to the manifest phase performed more poorly on tests assessing information processing speed and attention. Prefrontal cognitive dysfunction appears early, several years before the motor diagnosis of HD.

High frequency of endoluminal thrombus in patients with ischaemic stroke following AARS-CoV-2 infection.

BACKGROUND: Ischaemic stroke may be a major complication of SARS-CoV-2 infection. Studying and characterising the different aetiological subtypes, clinical characteristics, and functional outcomes may be valuable in guiding patient selection for optimal management and treatment. METHODS: Data were collected retrospectively on consecutive patients with COVID-19 who developed acute focal brain ischaemia (between 1 March and 19 April 2020) at a tertiary university hospital in Madrid (Spain). RESULTS: During the study period, 1594 patients were diagnosed with COVID-19. We found 22 patients with ischaemic stroke (1.38%), 6 of whom did not meet the inclusion criteria. The remaining 16 patients were included in the study (15 cases of ischaemic stroke and one case of transient ischaemic attack). Median baseline National Institutes of Health Stroke Scale score was 9 (interquartile range: 16), and mean (standard deviation) age was 73 years (12.8). Twelve patients (75%) were men. Mean time from COVID-19 symptom onset to stroke onset was 13 days. Large vessel occlusion was identified in 12 patients (75%). We detected elevated levels of D-dimer in 87.5% of patients and C-reactive protein in 81.2%. The main aetiology was atherothrombotic stroke (9 patients, 56.3%), with the predominant subtype being endoluminal thrombus (5 patients, 31.2%), involving the internal carotid artery in 4 cases and the aortic arch in one. The mortality rate in our series was 44% (7 of 16 patients). CONCLUSIONS: In patients with COVID-19, the most frequent stroke aetiology was atherothrombosis, with a high proportion of endoluminal thrombus (31.2% of patients). Our clinical and laboratory data support COVID-19-associated coagulopathy as a relevant pathophysiological mechanism for ischaemic stroke in these patients.

Transmission ratio distortion detection by neutral genetic markers in the Pura Raza Española horse breed.

Transmission Ratio Distortion (TRD) is a genetic phenomenon widely demonstrated in several livestock species, but barely in equine species. The TRD occurs when certain genotypes are over- or under-represented in the offspring of a particular mating and can be caused by a variety of factors during gamete formation or during embryonic development. For this study, 126 394 trios consisting of a stallion, mare, and offspring were genotyped using a panel of 17 neutral microsatellite markers recommended by the International Society for Animal Genetics for paternity tests and individual identification. The number of alleles available for each marker ranges from 13 to 18, been 268 the total number of alleles investigated. The TRDscan v.2.0 software was used with the biallelic procedure to identify regions with distorted segregation ratios. After completing the analysis, a total of 12 alleles (out of 11 microsatellites) were identified with decisive evidence for genotypic TRD; 3 and 9 with additive and heterosis patterns, respectively. In addition, 19 alleles (out of 10 microsatellites) were identified displaying allelic TRD. Among them, 14 and 5 were parent-unspecific and stallion-mare-specific TRD. Out of the TRD regions, 24 genes were identified and annotated, predominantly associated with cholesterol metabolism and homeostasis. These genes are often linked to non-specific symptoms like impaired fertility, stunted growth, and compromised overall health. The results suggest a significant impact on the inheritance of certain genetic traits in horses. Further analysis and validation are needed to better understand the TRD impact before the potential implementation in the horse breeding programme strategies.

Valorization of wipe wastes for the synthesis of microporous carbons and their application in CO2 capture, gas separation and H2-storage.

Wipe wastes have been used as a cellulosic source to synthesize biochars. Prior to the synthesis of the adsorbents by the pyrolysis of wipes wastes, this waste was treated to remove the pathogenic agents. Then, the wipe wastes were pyrolyzed between 500 and 900 °C to obtain biochars, whose microporosity increased proportionally to the pyrolysis temperature, achieving a maximum CO2-adsorption uptake of 2.53 mmol/g at a pressure of 760 mm of Hg and 25 °C for the biochar pyrolized at 900 °C. The synthesized biochars are also highly selective towards CO2-adsorption in CO2/N2 or CO2/H2 mixtures. Hence, these adsorbents have shown a great potential to be used in flue gas treatment and H2-purification processes. Biochar treatment with KOH further improves microporosity due to chemical activation although the addition of a large amount of KOH leads to excessive microporosity causing a collapse in the pore structure and decreasing CO2-adsorption capacity.

Sun exposure practices, attitudes and knowledge among students and teachers at a University School of Health Sciences in Ecuador.

Skin cancer incidence is increasing worldwide. Late adolescence and young adulthood are fundamental stages of life to acquire good sun exposure practices, regarding both personal involvement in skin cancer prevention and being a role model for others, especially in a health education environment. This descriptive cross-sectional study is based on the validated CHACES questionnaire to study sun exposure and photoprotection behavior among students and teachers at the School of Health Sciences in the National University of Chimborazo, Riobamba (Ecuador). University members (814 students (89.8 %) and 93 teachers (10.2 %)) were studied, with a predominance of females and light-skin phototypes in both groups. Similar results were obtained regarding sun exposure, with higher recreative exposure in the teachers' group and higher occupational exposure in students. However, students significantly showed lower avoiding midday sun (41.9 % vs 60.9 %), and lower use of sunglasses (10.1 % vs. 41.6 %). Attitudes towards the sun and photoprotection knowledge issues were also equivalent between students and teachers (6.1/10 vs 6.2/10). Students' sunburn rate last year reaches 88.4 % and 52.7 % in teachers (p < 0.001). Using a multivariable logistic regression model, we identified risk factors associated with a greater risk of sunburn in our population. This study highlights areas to be improved regarding knowledge, attitudes and, especially, practices of photoprotection, among students and teachers at the University of Chimborazo. These results point out that awareness-raising campaigns should be implemented to reduce sunburns, morbidity and mortality of skin cancer in this environment.

Redescubriendo al paciente M: Justo Gonzalo Rodríguez-Leal y su teoría de la dinámica cerebral / Rediscovering patient M: Justo Gonzalo Rodríguez-Leal and his theory of the brain dynamics

Introducción: En el transcurso de la Guerra Civil española, Justo Gonzalo Rodríguez-Leal visita al paciente M en el Hospital de Sanidad Militar de Godella (Valencia). Este encuentro marca el inicio de una larga relación entre ambos, que brinda a Justo Gonzalo la oportunidad de estudiar la organización funcional cerebral y articular una original concepción de la neurofisiología basada en las leyes de la excitabilidad nerviosa. El objetivo de este trabajo es redescubrir al paciente M y la interpretación fisiológica de la dinámica cerebral de Gonzalo.Desarrollo: Tomando como piedra angular al paciente M, Gonzalo postula que el efecto de una lesión cortical depende de su magnitud y posición: la magnitud condiciona la intensidad del trastorno; la posición, el tipo de trastorno. Entre 1945 y 1950 desarrolla en profundidad estas y otras hipótesis, basadas en observaciones clínicas, en la obra Dinámica cerebral, La actividad cerebral en función de las condiciones dinámicas de la excitabilidad nerviosa (Vol. 1, 1945; Vol. 2, 1950). A partir de 1952 proporciona una versión ampliada de su teoría sobre dinámica cerebral, fundamentándola no sólo en conceptos fisiológicos, sino también en la idea de gradientes cerebrales, e introduciendo los conceptos de similitud y alometría de los sistemas dinámicos.Conclusiones: Durante siglos, el conocimiento sobre la organización funcional del cerebro se ha asentado en el estudio de casos únicos. El paciente M constituye un ejemplo más de esta tradición, ayudando a establecer las bases de la teoría de dinámica cerebral desarrollada por Justo Gonzalo.(AU)

Introduction: During the Spanish Civil War, Justo Gonzalo Rodríguez-Leal visited patient M at the Military Healthcare Hospital in Godella (Valencia). This meeting marked the beginning of a long relationship between the two, which gave Justo Gonzalo the opportunity to study the functional organisation of the brain and to develop an original conception of neurophysiology based on the laws of nervous excitability. The aim of this work is to rediscover patient M and the physiological interpretation of Gonzalo’s brain dynamics.Development: Taking patient M as the cornerstone, Gonzalo postulated that the effect of a cortical lesion depends on its magnitude and position: the magnitude conditions the intensity of the disorder, whereas the position determines the type of disorder. Between 1945 and 1950 he developed these and other hypotheses in depth, based on clinical observations, in his work Dinámica cerebral. La actividad cerebral en función de las condiciones dinámicas de la excitabilidad nerviosa (Vol. 1, 1945; Vol. 2, 1950). From 1952 onwards he provided an expanded version of his theory of brain dynamics, basing it not only on physiological concepts, but also on the idea of brain gradients, and introducing the concepts of similarity and allometry of dynamic systems.Conclusions: For centuries, knowledge about the functional organisation of the brain has been based on single case studies. Patient M is a further example of this tradition that helps to establish the basis of the theory of brain dynamics developed by Justo Gonzalo.(AU)

Survival analysis of productive life in Florida dairy goats using a Cox proportional hazards model.

Longevity is an economically important trait, since extending the functional life of a doe would allow us to keep the most productive females in the herd as long as possible, and this could result in the increased profitability of dairy farms. Thus, the objectives of this study were to determine the most important factors that influence the length of productive life (LPL) of female Florida goats and to estimate its genetic additive variance using a Cox proportional hazards model. The data consisted of 70,695 productive life records from 25,722 Florida females kidding between 2006 and 2020. A total of 19,495 does had completed their productive life while 6227 (24.2%) does had censored information. The pedigree contained information on 56,901 animals. The average censoring age and average failure age after first kidding for LPL were 36 and 47 months respectively. The model included, as time-independent effects, the age at first kidding and the interaction between herd, year and season of birth of the doe, and as time-dependent effects, the age at kidding, the interaction between herd, year and season of kidding, the within-herd class of milk production deviation, and the interaction between the lactation number and the stage of lactation. All fixed effects had a significant effect on LPL (p < 0.05). Does with older ages at the first kidding and an earlier age at kidding were at higher risk of being culled. A large difference among herds was observed in terms of culling risk, which highlighted the importance of adequate management practices. Also, high-producing does were less likely to be culled. The estimate of the additive genetic variance was 1.844 (in genetic standard deviation), with a heritability estimate of 0.58 ± 0.012. The results of this study are expected to contribute to the development of a genetic model for genetic evaluation of the length of the productive life of Spanish dairy goat breeds.

[Rediscovering patient M: Justo Gonzalo Rodriguez-Leal and his theory of the dynamic mind]. / Redescubriendo al paciente M: Justo Gonzalo Rodríguez-Leal y su teoría de la dinámica cerebral

INTRODUCTION: During the Spanish Civil War, Justo Gonzalo Rodriguez-Leal visited patient M at the Military Healthcare Hospital in Godella (Valencia). This meeting marked the beginning of a long relationship between the two, which gave Justo Gonzalo the opportunity to study the functional organisation of the brain and to develop an original conception of neurophysiology based on the laws of nervous excitability. The aim of this work is to rediscover patient M and the physiological interpretation of Gonzalo's brain dynamics. DEVELOPMENT: Taking patient M as the cornerstone, Gonzalo postulated that the effect of a cortical lesion depends on its magnitude and position: the magnitude conditions the intensity of the disorder, whereas the position determines the type of disorder. Between 1945 and 1950 he developed these and other hypotheses in depth, based on clinical observations, in his work Dinamica cerebral. La actividad cerebral en funcion de las condiciones dinamicas de la excitabilidad nerviosa (Vol. 1, 1945; Vol. 2, 1950). From 1952 onwards he provided an expanded version of his theory of brain dynamics, basing it not only on physiological concepts, but also on the idea of brain gradients, and introducing the concepts of similarity and allometry of dynamic systems. CONCLUSIONS: For centuries, knowledge about the functional organisation of the brain has been based on single case studies. Patient M is a further example of this tradition that helps to establish the basis of the theory of brain dynamics developed by Justo Gonzalo.

TITLE: Redescubriendo al paciente M: Justo Gonzalo Rodríguez-Leal y su teoría de la dinámica cerebral.Introducción. En el transcurso de la Guerra Civil española, Justo Gonzalo Rodríguez-Leal visita al paciente M en el Hospital de Sanidad Militar de Godella (Valencia). Este encuentro marca el inicio de una larga relación entre ambos, que brinda a Justo Gonzalo la oportunidad de estudiar la organización funcional cerebral y articular una original concepción de la neurofisiología basada en las leyes de la excitabilidad nerviosa. El objetivo de este trabajo es redescubrir al paciente M y la interpretación fisiológica de la dinámica cerebral de Gonzalo. Desarrollo. Tomando como piedra angular al paciente M, Gonzalo postula que el efecto de una lesión cortical depende de su magnitud y posición: la magnitud condiciona la intensidad del trastorno; la posición, el tipo de trastorno. Entre 1945 y 1950 desarrolla en profundidad estas y otras hipótesis, basadas en observaciones clínicas, en la obra Dinámica cerebral, La actividad cerebral en función de las condiciones dinámicas de la excitabilidad nerviosa (Vol. 1, 1945; Vol. 2, 1950). A partir de 1952 proporciona una versión ampliada de su teoría sobre dinámica cerebral, fundamentándola no sólo en conceptos fisiológicos, sino también en la idea de gradientes cerebrales, e introduciendo los conceptos de similitud y alometría de los sistemas dinámicos. Conclusiones. Durante siglos, el conocimiento sobre la organización funcional del cerebro se ha asentado en el estudio de casos únicos. El paciente M constituye un ejemplo más de esta tradición, ayudando a establecer las bases de la teoría de dinámica cerebral desarrollada por Justo Gonzalo.

Does fatigue affect the kinematics of endurance running? / ¿Afecta la fatiga a la cinemática de la carrera de resistencia?

The purpose of this study was to determine the foot strike pattern (FSP), inversion (INV) and spatial-temporal variables in a large sample of recreational runners during a long-distance competition, according to sex and changes in the classification race. A total of 368 men and 67 women, who participated in the XVII International Half Marathon of Cordoba (Spain) were analysed. It was recorded at km 5 and km 15, where high-speed camcorder and 2D-photogrammetric techniques were used to measure FSP, INV, contact time (CT) and flight time (FT). The group that worsened their classification at km 15 increase RFS prevalence and INV asymmetry. A Pearson analysis indicates that variation of the classification in the race between the marks km 5 and km 15 is related with CT (r=0.429, p<0.001) and FT (r=-0.360, p<0.001). RFS prevalence and spatial-temporal parameters showed different patterns depending on whether the runners improved or worsened their ranking. (AU)

El objetivo de este estudio fue determinar el patrón de pisada, inversión y variables espaciotemporales para una amplia muestra de corredores amateurs, durante una carrera de larga distancia, según sexo y posición de clasificación. Se analizaron 368 hombres y 67 mujeres, que participaron en la XVII Media Maratón Internacional de Córdoba (España). Se registró el km 5 y km 15, utilizando técnicas de fotogrametría 2D de alta velocidad para medir la pisada, la inversión, el tiempo de contacto (TC) y el tiempo de vuelo (TV). El grupo que empeoró su clasificación en el km 15 aumentó la prevalencia de FSP y la asimetría del INV. Un análisis de Pearson indica que la variación de la clasificación en la carrera está relacionada con TC (r=0,429, p<0,001) y TV (r=-0,360, p<0,001). La prevalencia de retropié y los parámetros espaciotemporales mostraron diferentes patrones dependiendo de si los corredores mejoraron o empeoraron su clasificación. (AU)

[Translated article] Efficacy and marginal cost of treatment with tocilizumab in COVID-19 patients.

OBJECTIVE: To describe the marginal cost and survival of patients treated with tocilizumab in a university hospital under real-life conditions and to evaluate factors that could influence costs and health outcomes will be evaluated. METHODS: Observational, single-center, retrospective study of a cohort of adult patients infected with SARS-COV2 treated with tocilizumab. The 1 year restricted mean survival time was analyzed in life-years gained (LYG). The influence of sex, age and severity on patient survival was evaluated. The marginal cost/LYG and marginal cost/survivor ratios were calculated. RESULTS: 508 patients (66 ±â€¯13 years; 32% women) were included. Seventeen percent were admitted to the ICU. Overall survival was 77%. Age older than 71.5 years (HR = 1.08; 95% CI 1.07-1.10; p < 0.001) and ICU admission at initiation of treatment (HR = 2.01; 95% CI 1.30-3.09; p = 0.002) were identified as risk factors. The total budgetary impact of tocilizumab in the period analyzed was 206,466 euros. The patients with the highest cost per unit of health outcome were those admitted to the ICU and those over 71.5 years, with a marginal cost/LYG of €966 and a marginal cost/survivor of €1136. CONCLUSION: The efficiency of treatment with tocilizumab is associated with the age and severity of the patients. The figures are lower in all subgroups than the thresholds usually used in cost-effectiveness evaluations. The results of the present study suggest that early first dose of tocilizumab is an efficient strategy.

[Bibliographic review of the efficacy of platelet-rich plasma treatment in lumbar disc herniation]. / Revisión bibliográfica de la eficacia del tratamiento con plasma rico en plaquetas en hernia de disco lumbar.

Platelet-rich plasma (PRP) is an autologous blood product containing growth factors and proteins, widely employed in the clinical setting for tissue repair. Robust evidence in basic science literature has facilitated clinical research involving PRP for patients with disc disease and lumbar pain. Degenerative disc disease (DDD) has been identified as a significant contributor to lower back pain, with approximately 40% of patients under 30 and 90% of those over 50 experiencing lumbar pain showing MRI findings consistent with degenerative changes in intervertebral discs. Regenerative medicine within the disc has primarily been studied in patients with chronic, untreatable lumbar pain. Objective: to understand the available evidence regarding the efficacy of PRP in lumbar disc herniation. By understanding the scientific evidence supporting PRP as a lumbar disc herniation treatment, a research project can be developed, providing the theoretical foundation for implementing this therapy in the Mexican population. A search was conducted using PUBMED, ClinicalKey (Elsevier), Medscape, Science Direct, and Google Scholar databases. Conclusions: despite promising results in several studies on intradiscal PRP injection, small sample sizes and non-standardized graft preparation procedures have hindered these research efforts.

El plasma rico en plaquetas (PRP) es un producto sanguíneo autólogo que contiene factores de crecimiento y proteínas y se ha utilizado en todo el entorno clínico para la reparación de tejidos. La fuerte evidencia en la literatura de ciencias básicas ha permitido la investigación clínica que involucra PRP para pacientes con enfermedad del disco y dolor lumbar. La enfermedad degenerativa del disco (DDD) se ha establecido como un importante contribuyente a la causa del dolor lumbar: aproximadamente el 40% de los pacientes menores de 30 años y el 90% de los pacientes mayores de 50 años que tienen dolor lumbar también muestran hallazgos de imágenes de resonancia magnética (IRM) que son consistentes con cambios degenerativos dentro de los discos intervertebrales. La medicina regenerativa intradiscal se ha estudiado principalmente en pacientes con dolor lumbar crónico intratable. Objetivo: conocer la evidencia disponible sobre la eficacia del PRP en hernias de disco lumbar. Al conocer la evidencia científica disponible del PRP como tratamiento de hernia discal lumbar se podrá desarrollar un proyecto de investigación, lo cual sustentará las bases teóricas para realizar esta terapia en la población mexicana. Se realizó búsqueda en base de datos PUBMED, ClinicalKey (Elsevier), Medscape, Science Direct, Google Scholar. Conclusiones: aunque varias investigaciones han arrojado resultados prometedores con respecto a la inyección intradiscal de PRP los tamaños de muestra pequeños y los procedimientos de preparación de injertos no estandarizados obstaculizaron estos esfuerzos de investigación.

Variables predictoras de la duración de la amnesia postraumática tras un traumatismo craneoencefálico / Predictors of the duration of post-traumatic amnesia following traumatic brain injury

Introducción: La duración de la amnesia postraumática (APT) ayuda a estimar el nivel de recuperación tras un traumatismo craneoencefálico (TCE). Sin embargo, apenas se dispone de información sobre qué variables sociodemográficas y clínicas influyen en su duración. Este estudio pretende identificarlas y crear un modelo predictivo que permita estimar el tiempo que un paciente tarda en emerger de la APT. Pacientes y métodos: La muestra estaba formada por 40 pacientes adultos en APT ingresados en un centro neurorrehabilitador. El 89,7% había sufrido un TCE grave; el 10,3% restante, un TCE moderado. Su estado cognitivo se valoró mediante el Galveston Orientation and Amnesia Test (GOAT) –escala que permite determinar en qué momento se puede considerar que un paciente emerge de la APT–. Resultados: Se encontró una ecuación de regresión (F = 8,511; p < 0,001; R2 = 0,415), en la que las siguientes variables (clasificadas por su orden de importancia) explicaron el 41,5% de la variabilidad observada en la duración de la APT: a) GOAT administrado a la llegada al centro neurorrehabilitador; b) años de formación reglada del paciente; y c) días que estuvo en APT antes de ingresar en el centro neurorrehabilitador. La ecuación de regresión derivada fue la siguiente: 104,284 + (–0,708 × GOAT-inicial) + (–4,124 × años formación reglada) + (0,219 × APT-hospital agudos). Conclusiones: El tiempo que un paciente tarda en emerger de la APT está condicionado por la puntuación que obtiene en el primer GOAT administrado al ingresar en el centro neurorrehabilitador, el nivel de estudios, y los días que permanece en APT entre el momento del TCE y el ingreso en el centro neurorrehabilitador.(AU)

Introduction: The duration of post-traumatic amnesia (PTA) helps estimate the level of recovery following traumatic brain injury (TBI). Yet, little information is available about which sociodemographic and clinical variables influence its duration. This study aims to identify them and create a predictive model that makes it possible to estimate the time it takes for a patient to emerge from PTA. Patients and methods: The sample consisted of 40 adult patients with PTA admitted to a neurorehabilitation centre. A total of 89.7% had suffered a severe TBI, whereas the remaining 10.3% had had a moderate TBI. Cognitive status was assessed using the Galveston Orientation and Amnesia Test (GOAT) – a scale for determining at what point a patient can be considered to be emerging from PTA. Results: A regression equation was found (F = 8.511; p < 0.001; R2 = 0.415), in which the following variables (ranked in order of importance) explained 41.5% of the variability observed in the duration of PTA: a) GOAT administered on arrival at the neurorehabilitation centre; b) years of formal education of the patient; and c) days with PTA prior to admission to the neurorehabilitation centre. The equation derived was as follows: 104.284 + (–0.708 × GOAT-initial) + (–4.124 × years formal education) + (0.219 × hospital acute-APT). Conclusions: The time it takes for a patient to emerge from PTA is conditioned by the score obtained in the first GOAT administered on admission to the neurorehabilitation centre, their level of education, and the number of days elapsed with PTA between occurrence of the TBI and admission to the neurorehabilitation centre.(AU)

Rehabilitation of social cognition impairment after traumatic brain injury: a systematic review.

INTRODUCTION: Many studies have described the presence of difficulty processing and generating social behaviour in patients who have suffered a traumatic brain injury (TBI). These difficulties in social cognition (SC) deteriorate personal relationships in the family, at work, or in the community. However, therapeutic programmes aiming to improve SC continue to be an outstanding issue in clinical practice. We performed a systematic review of the existing literature on the recovery of SC in patients with TBI, assessing the methodological quality of the included studies and the therapeutic effectiveness of the rehabilitation strategies used. DEVELOPMENT: We performed a bibliographic search of papers published before June 2018 in the Medline/PubMed, Google Scholar, PsycINFO, and ClinicalTrials.gov databases. Of the 198 potentially relevant articles, 10 met our eligibility criteria. Two of the authors independently and blindly assessed the methodological quality of these studies using the PEDro scale. CONCLUSIONS: The articles included in this systematic review essentially studied the effect of different interventions aimed at the rehabilitation of SC in patients with chronic TBIs. The analysis showed adequate methodological quality and an acceptable level of evidence. Future research should analyse the effect of these interventions in patients with TBIs in the sub- and post-acute phases.

[Predictors of the duration of post-traumatic amnesia following traumatic brain injury]. / Variables predictoras de la duración de la amnesia postraumática tras un traumatismo craneoencefálico.

INTRODUCTION: The duration of post-traumatic amnesia (PTA) helps estimate the level of recovery following traumatic brain injury (TBI). Yet, little information is available about which sociodemographic and clinical variables influence its duration. This study aims to identify them and create a predictive model that makes it possible to estimate the time it takes for a patient to emerge from PTA. PATIENTS AND METHODS: The sample consisted of 40 adult patients with PTA admitted to a neurorehabilitation centre. A total of 89.7% had suffered a severe TBI, whereas the remaining 10.3% had had a moderate TBI. Cognitive status was assessed using the Galveston Orientation and Amnesia Test (GOAT) - a scale for determining at what point a patient can be considered to be emerging from PTA. RESULTS: A regression equation was found (F = 8.511; p < 0.001; R2 = 0.415), in which the following variables (ranked in order of importance) explained 41.5% of the variability observed in the duration of PTA: a) GOAT administered on arrival at the neurorehabilitation centre; b) years of formal education of the patient; and c) days with PTA prior to admission to the neurorehabilitation centre. The equation derived was as follows: 104.284 + (-0.708 x GOAT-initial) + (-4.124 x years formal education) + (0.219 x hospital acute-APT). CONCLUSIONS: The time it takes for a patient to emerge from PTA is conditioned by the score obtained in the first GOAT administered on admission to the neurorehabilitation centre, their level of education, and the number of days elapsed with PTA between occurrence of the TBI and admission to the neurorehabilitation centre.

TITLE: Variables predictoras de la duración de la amnesia postraumática tras un traumatismo craneoencefálico.Introducción. La duración de la amnesia postraumática (APT) ayuda a estimar el nivel de recuperación tras un traumatismo craneoencefálico (TCE). Sin embargo, apenas se dispone de información sobre qué variables sociodemográficas y clínicas influyen en su duración. Este estudio pretende identificarlas y crear un modelo predictivo que permita estimar el tiempo que un paciente tarda en emerger de la APT. Pacientes y métodos. La muestra estaba formada por 40 pacientes adultos en APT ingresados en un centro neurorrehabilitador. El 89,7% había sufrido un TCE grave; el 10,3% restante, un TCE moderado. Su estado cognitivo se valoró mediante el Galveston Orientation and Amnesia Test (GOAT) ­escala que permite determinar en qué momento se puede considerar que un paciente emerge de la APT­. Resultados. Se encontró una ecuación de regresión (F = 8,511; p menor de 0,001; R2 = 0,415), en la que las siguientes variables (clasificadas por su orden de importancia) explicaron el 41,5% de la variabilidad observada en la duración de la APT: a) GOAT administrado a la llegada al centro neurorrehabilitador; b) años de formación reglada del paciente; y c) días que estuvo en APT antes de ingresar en el centro neurorrehabilitador. La ecuación de regresión derivada fue la siguiente: 104,284 + (­0,708 × GOAT-inicial) + (­4,124 × años formación reglada) + (0,219 × APT-hospital agudos). Conclusiones. El tiempo que un paciente tarda en emerger de la APT está condicionado por la puntuación que obtiene en el primer GOAT administrado al ingresar en el centro neurorrehabilitador, el nivel de estudios, y los días que permanece en APT entre el momento del TCE y el ingreso en el centro neurorrehabilitador.

Rehabilitación de la cognición social en el traumatismo craneoencefálico: una revisión sistemática / Rehabilitation of social cognition impairment after traumatic brain injury: A systematic review

Introducción: Múltiples estudios han descrito la presencia de dificultades para procesar y generar conductas de tipo social en pacientes que han sufrido un traumatismo craneoencefálico (TCE). Tales dificultades, englobadas bajo el término genérico de cognición social (CS), provocan un deterioro en las relaciones personales, tanto a nivel familiar como laboral o comunitario. No obstante, los programas terapéuticos dirigidos a la mejora de la CS continúan siendo una asignatura pendiente en la práctica clínica. El objetivo de este trabajo es realizar una revisión sistemática de la literatura existente sobre rehabilitación de la CS en pacientes con TCE, valorar su calidad metodológica y la efectividad terapéutica de las estrategias rehabilitadoras empleadas.DesarrolloSe realizó una búsqueda bibliográfica hasta junio de 2018 en las bases de datos Medline/PubMed, Google Scholar, PsycInfo y ClinicalTrials.gov. De los 198 artículos potencialmente interesantes, 10 cumplieron los criterios de elegibilidad. Dos de los autores evaluaron, de forma independiente y ciega, la calidad metodológica de los estudios incluidos en la revisión mediante la escala PEDro.ConclusionesLos artículos incluidos en esta revisión sistemática han estudiado esencialmente el efecto de diferentes intervenciones dirigidas a la rehabilitación de la CS en pacientes con TCEs en fase crónica. El análisis muestra que su calidad metodológica es adecuada y que el nivel de evidencia es aceptable. Se constata la necesidad de analizar el efecto de estas intervenciones en pacientes con TCE en fases subaguda y postaguda. (AU)

Introduction: Many studies have described the presence of difficulty processing and generating social behaviour in patients who have suffered a traumatic brain injury (TBI). These difficulties in social cognition (SC) deteriorate personal relationships in the family, at work, or in the community. However, therapeutic programmes aiming to improve SC continue to be an outstanding issue in clinical practice. We performed a systematic review of the existing literature on the recovery of SC in patients with TBI, assessing the methodological quality of the included studies and the therapeutic effectiveness of the rehabilitation strategies used.DevelopmentWe performed a bibliographic search of papers published before June 2018 in the Medline/PubMed, Google Scholar, PsycINFO, and ClinicalTrials.gov databases. Of the 198 potentially relevant articles, 10 met our eligibility criteria. Two of the authors independently and blindly assessed the methodological quality of these studies using the PEDro scale.ConclusionsThe articles included in this systematic review essentially studied the effect of different interventions aimed at the rehabilitation of SC in patients with chronic TBIs. The analysis showed adequate methodological quality and an acceptable level of evidence. Future research should analyse the effect of these interventions in patients with TBIs in the sub- and post-acute phases. (AU)