Short-term neuropsychiatric outcomes and quality of life in COVID-19 survivors.

BACKGROUND: The general medical impacts of coronavirus (COVID-19) are increasingly appreciated. However, its impact on neurocognitive, psychiatric health and quality of life (QoL) in survivors after the acute phase is poorly understood. We aimed to evaluate neurocognitive function, psychiatric symptoms and QoL in COVID-19 survivors shortly after hospital discharge. METHODS: This was a cross-sectional analysis of a prospective study of hospitalized COVID-19 survivors followed up for 2 months after discharge. A battery of standardized instruments evaluating neurocognitive function, psychiatric morbidity and QoL (mental and physical components) was administered by telephone. RESULTS: Of the 229 screened patients, 179 were included in the final analysis. Amongst survivors, the prevalence of moderately impaired immediate verbal memory and learning was 38%, delayed verbal memory (11.8%), verbal fluency (34.6%) and working memory (executive function) (6.1%), respectively. Moreover, 58.7% of patients had neurocognitive impairment in at least one function. Rates of positive screening for anxiety, depression and post-traumatic stress disorder were 29.6%, 26.8% and 25.1%, respectively. In addition, 39.1% of the patients had psychiatric morbidity. Low QoL for physical and mental components was detected in 44.1% and 39.1% of patients respectively. Delirium and psychiatric morbidity were associated with neurocognitive impairment, and female gender was related with psychiatric morbidity. CONCLUSION: Hospitalized COVID-19 survivors showed a considerable prevalence of neurocognitive impairment, psychiatric morbidity and poor QoL in the short term. It is uncertain if these impacts persist over the long term.

Hypothyroidism affects differentially the cell size of epithelial cells among oviductal regions of rabbits.

Oviductal regions show particular histological characteristics and functions. Tubal pathologies and hypothyroidism are related to primary and secondary infertility. The impact of hypothyroidism on the histological characteristics of oviductal regions has been scarcely studied. Our aim was to analyse the histological characteristics of oviductal regions in control and hypothyroid rabbits. Hypothyroidism was induced by oral administration of methimazole (MMI) for 30 days. For both groups, serum concentrations of thyroid and gonadal hormones were determined. Sections of oviductal regions were stained with the Masson's trichrome technique to analyse both epithelial and smooth muscle layers. The percentage of proliferative epithelial cells (anti-Ki67) in diverse oviductal regions was also quantified. Data were compared with Student t-test, Mann-Whitney U-test, or Fischer's test. In comparison with the control group, the hypothyroid group showed: (i) a low concentration of T3 and T4, but a high level of TSH; (ii) similar values of serum estradiol, progesterone and testosterone; (iii) a large size of ciliated cells in the ampulla (AMP), isthmus (IST) and utero-tubal junction (UTJ); (iv) a large size of secretory cells in the IST region; (v) a low percentage of proliferative secretory cells in the fimbria-infundibulum (FIM-INF) region; and (vi) a similar thickness of the smooth muscle layer and the cross-sectional area in the AMP and IST regions. Modifications in the size of the oviductal epithelium in hypothyroid rabbits could be related to changes in the cell metabolism that may impact on the reproductive functions achieved by oviduct.

Effects provoked by chronic undernourishment on the fibre type composition and contractility of fast muscles in male and female developing rats.

In this study, we compare the effects of pre- and post-natal food deprivation on the relative proportion of fibre types and contractile responses in the extensor digitorum longus (EDL) muscle of female and male rats at different post-natal ages. EDL muscles from undernourished male (UM) rats showed a higher proportion of Type IIB than IIA fibres and larger normalized twitch responses (with respect to muscle weight) than those of controls (CM). In contrast, EDL muscles from control (CF) and undernourished female rats (UF) showed no significant differences in their fibre type composition and normalized twitch forces at most of the ages analysed. Our data are indicative that the EDL muscles from undernourished males are more susceptible to the effects exerted by low food income than the EDL muscles from female rats. It is proposed that changes in the reactive oxygen species (ROS) concentration and hormonal factors, due to undernutrition, are involved in the alterations observed in the fibre type composition and force production of EDL muscles in undernourished male rats and that estrogens may have an antioxidant protective role on the undernourished EDL muscles in female rats.

The nutrition transition in the Venezuelan Amazonia: increased overweight and obesity with transculturation.

OBJECTIVES: Amerindians have a particularly high propensity to overweight and obesity as they change lifestyle and experience a nutrition transition. The aim of this study was to evaluate the effects of transculturation on nutritional status in three Amazonian Amerindian villages. METHODS: Nutritional status was assessed in 232 volunteers: 65 Yanomami from an isolated village and 167 Guahibo subjects from villages with intermediate and high levels of transculturation. RESULTS: There was a significant pattern of decreasing stunting and increasing overweight and obesity across the gradient of transculturation. From the jungle Yanomami to the intermediate and transculturated Guahibo, stunting was respectively 72, 55, and 39%, and children /adult overweight was 0, 3/44, and 15/89%. These anthropometric-based patterns were confirmed by bioimpedance vector analysis. CONCLUSIONS: Transculturation in these Amerindian populations is associated with an increase in overweight and obesity coexisting with undernourished children.

[Towards an early differential diagnosis in autism spectrum disorders and fragile X syndrome. A systematic review]. / Hacia un diagnóstico diferencial temprano en el trastorno del espectro autista y el síndrome de X frágil. Una revisión sistemática.

INTRODUCTION: Nearly 60% of those diagnosed with fragile X syndrome show comorbidity with autism. Thus, there are similarities and differences between both conditions that lead to very different clinical manifestations. However, an early differential diagnosis may help professionals to detect deficits and enhance strengths to apply the best suitable intervention. The purpose of this scoping review was to provide a comprehensive overview of the relation and the differences between autism and fragile X syndrome to orientate diagnosis and intervention. MATERIALS AND METHODS: The research for articles was carried out in PsycInfo, Medline, SCOPUS and Web of Science, including scientific articles published from 2010 to 2020 and children aged 0-6 years. The scoping review followed the PRISMA-ScR criteria. RESULTS: 22 studies were selected. Results were reviewed in terms of structural and morphological changes and cognitive, communicative, social-emotional and sensory-motor skills. CONCLUSIONS: Different growing cerebral patterns are observed in both conditions. Besides, there are early signs from the different developmental areas studied that show comorbidity or allow early differentiation. However, attentional function or repetitive mannerisms, among others, need further research.

TITLE: Hacia un diagnóstico diferencial temprano en el trastorno del espectro autista y el síndrome de X frágil. Una revisión sistemática.Introducción. Aproximadamente el 60% de las personas con síndrome de X frágil también reciben un diagnóstico de trastorno del espectro autista. Entre estos trastornos existen tantas semejanzas como diferencias, que provocan cuadros clínicos distintos, por lo que es importante el diagnóstico diferencial temprano, de cara a conocer los déficits y fortalezas de cada niño y ajustar el tipo de intervención lo mejor posible. El presente estudio tiene como objetivo realizar una aproximación al conocimiento de la relación y las diferencias de ambas condiciones, y contribuir al diagnóstico diferencial y la posterior intervención. Materiales y métodos. Siguiendo el protocolo PRISMA-ScR, se realizaron búsquedas en las bases de datos de PsycInfo, Medline, SCOPUS y Web of Science, incluyendo los artículos científicos empíricos centrados en la etapa de los 0 a los 6 años desde 2010 a 2020. Resultados. Se seleccionaron 22 estudios en los que se trata el desarrollo inicial de estos dos trastornos y su confluencia. Los resultados se reagruparon en función de cambios morfológico-estructurales, y de las áreas cognitivas, comunicativas, socioemocionales y sensoriomotoras. Conclusiones. A nivel morfológico-estructural, parecen existir ciertos patrones de crecimiento cerebral diferenciadores entre estos trastornos. Asimismo, existen ciertas señales de alarma en las distintas áreas del desarrollo que son indicativas de comorbilidad o permiten la discriminación entre patologías, y existe cierto debate en torno a algunas de ellas, como el nivel atencional o los manierismos repetitivos.

Expression of progranulin (Acrogranin/PCDGF/Granulin-Epithelin Precursor) in benign and malignant ovarian tumors and activation of MAPK signaling in ovarian cancer cell line.

It has been recently demonstrated that progranulin is overexpressed in ovarian cancer and that this protein is involved in the stimulation of cell proliferation, malignancy, and chemoresistance in ovarian cancer. The goal of the present study was to establish the differences in progranulin expression among normal, benign, and malignant ovarian tissues and to identify the signal transduction pathways activated by progranulin in an ovarian cancer cell line. Compared with benign tumors and normal ovarian tissue, progranulin mRNA and protein were overexpressed in malignant tumors. Survival analysis by the Kaplan-Meier method showed a correlation between high mRNA expression levels with poor survival outcome. Progranulin activated the MAPK-signaling pathway in NIH-OVCAR-3 cells. Progranulin expression may be potentially involved in the pathogenesis and malignant progression of ovarian cancer, and thus may represent a therapeutic target for this particular malignancy.

Study of M(iii)-cyclam (M = Rh, Ru; cyclam = 1,4,8,11-tetraazacyclotetradecane) complexes as novel methanol resistant electrocatalysts for the oxygen reduction reaction.

Transition metal macrocyclic complexes have acquired relevance as electrocatalysts to perform oxygen electroreduction in acid media as an alternative to platinum. This work presents two macrocyclic complexes using cyclam as ligand, which has a much simpler molecular structure (smaller size, no π-electrons, etc.) than the well studied porphyrins and phthalocyanines as transition metal complexes. Such compounds are usually subjected to thermal treatments at relatively high temperatures (800-900 °C) which result in ligand decomposition, leaving the so-called MN x active sites. In contrast, the complexes reported in this work are efficient electrocatalysts for the oxygen reduction reaction (ORR) in their original molecular structure, with no thermal treatments of any kind applied. The electrocatalytic activity of the Rh(iii)-cyclam and Ru(iii)-cyclam complexes during the ORR in the absence and presence of methanol (2 mol L-1) was evaluated by voltammetry techniques. The kinetic parameters of the novel materials for the reaction were determined. The exchange current density (j 0) values, directly related to the charge transfer velocity, are of the same order as or higher than those of platinum/Vulcan® nanoparticles. In addition, they are practically unaffected by methanol, therefore, becoming interesting candidates to be evaluated as cathodes in polymer electrolyte membrane and direct methanol fuel cells.

Acceptability of Chairside Screening for Racial/Ethnic Minority Older Adults: A Qualitative Study.

An aging and more racially and ethnically diverse population, coupled with changes in the health care policy environment, is demanding that the dental profession both redirect and expand its focus. Challenges include providing comprehensive care for patients with complicated medical needs while improving access to care for underserved groups. The purpose of this study is to examine the acceptability of screening for hypertension and diabetes in the dental setting for African American, Puerto Rican, and Dominican older adults who attend senior centers in northern Manhattan, New York City. Focus groups were conducted with 194 racial/ethnic minority men and women aged 50 y and older living in northern Manhattan who participated in 1 of 24 focus group sessions about improving oral health for older adults. All groups were digitally audio-recorded and transcribed for analysis. Groups that were conducted in Spanish were transcribed first in Spanish and then translated into English. Analysis of the transcripts was conducted using thematic content analysis. Five themes were manifest in the data regarding the willingness of racial/ethnic minority older adults to receive hypertension and diabetes screening as part of routine dental visits: 1) chairside screening is acceptable, 2) screening is routine for older adults, 3) the interrelationship between oral and general health is appreciated, 4) chairside screening has perceived benefits, and 5) chairside screening may reduce dental anxiety. Reservations centered on 4 major themes: 1) dental fear may limit the acceptability of chairside screening, 2) there is a perceived lack of need for dental care and chairside screening, 3) screening is available elsewhere, and 4) mistrust of dental providers as primary care providers. This study provides novel evidence of the acceptability of screening for hypertension and diabetes in the dental setting among urban racial/ethnic minority senior center attendees. Knowledge Transfer Statement: The results of this study may be used by oral health providers when deciding whether to conduct chairside screening for medical conditions such as hypertension and diabetes that could affect, or be affected by, the oral health of their patients. Patient experiences of care-along with clinical outcomes, avoidable hospital admissions, equity of services, and costs-are important outcomes to consider in meeting the needs of an aging and racially and ethnically diverse US population.

[Cognitive Reserve Scale: testing the theoretical model and norms]. / Escala de reserva cognitiva: ajuste del modelo teorico y baremacion.

INTRODUCTION: The cognitive reserve theory may contribute to explain cognitive performance differences among individuals with similar cognitive decline and among healthy ones. However, more psychometric analysis are needed to guarantee the usage of tests for assessing cognitive reserve. AIMS: To study validity evidences in relation to the structure of the Cognitive Reserve Scale (CRS) and to create reference norms to interpret the scores. SUBJECTS AND METHODS: A total of 172 participants completed the scale and they were classified into two age groups: aged 36-64 years (n = 110) and 65-88 years (n = 62). RESULTS: The exploratory factor analysis using ESEM revealed that the data fitted the proposed model. Overall, the discriminative indices were acceptable (between 0.21 and 0.50) and congruence was observed in the periods of young adulthood, adulthood and late adulthood, in both age group. Besides, the index of reliability (Cronbach's alpha: 0.80) and the typical mean error test (mean: 51.40 ± 11.11) showed adequate values for this type of instrument. CONCLUSION: The CRS seemed to be set under the hypothetical theoretical model, and the scores might be interpreted by the norms showed. This study provided guarantees for the usage of the CRS in research.

TITLE: Escala de reserva cognitiva: ajuste del modelo teorico y baremacion.Introduccion. La teoria de la reserva cognitiva contribuiria a explicar las diferencias en el rendimiento intelectual en sujetos con deterioro cognitivo similar y en sujetos sanos. Sin embargo, son necesarios mas datos psicometricos que garanticen el uso de los instrumentos de medicion de reserva cognitiva. Objetivo. Aportar evidencias de validez respecto a la estructura interna de la escala de reserva cognitiva (ERC) y establecer un baremo de referencia para la interpretacion de sus puntuaciones. Sujetos y metodos. Un total de 172 sujetos completaron la ERC y fueron distribuidos en dos grupos en funcion de la edad: 36-64 años (n = 110) y 65-88 años (n = 62). Resultados. El analisis factorial mediante modelos de ecuaciones estructurales exploratorios indico un moderado ajuste de los datos al modelo propuesto. En general, los indices de discriminacion fueron correctos (entre 0,21 y 0,50), y se registro congruencia entre los items a lo largo de los periodos de juventud, adultez y madurez para ambos grupos de edad. Se observaron valores adecuados del indice de fiabilidad (alfa de Cronbach: 0,80) y de los errores tipicos de medida (media: 51,40 ± 11,11). Conclusiones. La ERC se enmarcaria dentro del modelo teorico hipotetizado y las puntuaciones podrian interpretarse mediante el baremo ofrecido, lo que avalaria su empleo en la investigacion en este campo.

Hacia un diagnóstico diferencial temprano en el trastorno del espectro autista y el síndrome de X frágil. Una revisión sistemática / Towards an early differential diagnosis in autism spectrum disorders and fragile X syndrome. A systematic review

Introducción: Aproximadamente el 60% de las personas con síndrome de X frágil también reciben un diagnóstico de trastorno del espectro autista. Entre estos trastornos existen tantas semejanzas como diferencias, que provocan cuadros clínicos distintos, por lo que es importante el diagnóstico diferencial temprano, de cara a conocer los déficits y fortalezas de cada niño y ajustar el tipo de intervención lo mejor posible. El presente estudio tiene como objetivo realizar una aproximación al conocimiento de la relación y las diferencias de ambas condiciones, y contribuir al diagnóstico diferencial y la posterior intervención.Materiales y métodos: Siguiendo el protocolo PRISMA-ScR, se realizaron búsquedas en las bases de datos de PsycInfo, Medline, SCOPUS y Web of Science, incluyendo los artículos científicos empíricos centrados en la etapa de los 0 a los 6 años desde 2010 a 2020.Resultados: Se seleccionaron 22 estudios en los que se trata el desarrollo inicial de estos dos trastornos y su confluencia. Los resultados se reagruparon en función de cambios morfológico-estructurales, y de las áreas cognitivas, comunicativas, socioemocionales y sensoriomotoras.Conclusiones: A nivel morfológico-estructural, parecen existir ciertos patrones de crecimiento cerebral diferenciadores entre estos trastornos. Asimismo, existen ciertas señales de alarma en las distintas áreas del desarrollo que son indicativas de comorbilidad o permiten la discriminación entre patologías, y existe cierto debate en torno a algunas de ellas, como el nivel atencional o los manierismos repetitivos.(AU)

Introduction: Nearly 60% of those diagnosed with fragile X syndrome show comorbidity with autism. Thus, there are similarities and differences between both conditions that lead to very different clinical manifestations. However, an early differential diagnosis may help professionals to detect deficits and enhance strengths to apply the best suitable intervention. The purpose of this scoping review was to provide a comprehensive overview of the relation and the differences between autism and fragile X syndrome to orientate diagnosis and intervention. Materials and methods: The research for articles was carried out in PsycInfo, Medline, SCOPUS and Web of Science, including scientific articles published from 2010 to 2020 and children aged 0-6 years. The scoping review followed the PRISMA-ScR criteria. Results: 22 studies were selected. Results were reviewed in terms of structural and morphological changes and cognitive, communicative, social-emotional and sensory-motor skills. Conclusions: Different growing cerebral patterns are observed in both conditions. Besides, there are early signs from the different developmental areas studied that show comorbidity or allow early differentiation. However, attentional function or repetitive mannerisms, among others, need further research.(AU)

Microbial monitoring of the influence of the stabilization degree of sludge when applied to soil.

The aim of this study was to establish the degree of stabilization of sludge and its influence on the evolution of total aerobic micro-organisms and those of faecal origin when the sludge is applied to soil. Two different sludges were used, from a food industry (D) and from an urban treatment plant, (E). Both sludges were stabilized aerobically in laboratory conditions. The stabilization process was monitored by following the evolution of pathogenic micro-organisms and the content of total solids and volatile matter in suspension, while on the other hand the microbial evolution of the samples of soil plus sludge and control soil (S) were monitored over an incubation period of 80 days. After 20 or 40 days of incubation, in both sludge treatments the populations of pathogenic micro-organisms of faecal origin were below detectable limits, regardless of the degree of stabilization of the sludge. Soil without sludge treatment did not show pathogenic micro-organisms.

Quantitative analysis of hindlimbs locomotion kinematics in spinalized rats treated with Tamoxifen plus treadmill exercise.

Locomotion recovery after a spinal cord injury (SCI) includes axon regeneration, myelin preservation and increased plasticity in propriospinal and descending spinal circuitries. The combined effects of tamoxifen and exercise after a SCI were analyzed in this study to determine whether the combination of both treatments induces the best outcome in locomotion recovery. In this study, the penetrating injury was provoked by a sharp projectile that penetrates through right dorsal and ventral portions of the T13-L1 spinal segments, affecting propriospinal and descending/ascending tracts. Intraperitoneal application of Tamoxifen and a treadmill exercise protocol, as rehabilitation therapies, separately or combined, were used. To evaluate the functional recovery, angular patterns of the hip, knee and ankle joints as well as the leg pendulum-like movement (PLM) were measured during the unrestricted gait of treated and untreated (UT) animals, previously and after the traumatic injury (15 and 30days post-injury (dpi)). A pattern (curve) comparison analysis was made by using a locally designed Matlab script that determines the Frechet dissimilarity. The SCI magnitude was assessed by qualitative and quantitative histological analysis of the injury site 30days after SCI. Our results showed that all treated groups had an improvement in hindlimbs kinematics compared to the UT group, which showed a poor gait locomotion recovery throughout the rehabilitation period. The group with the combined treatment (tamoxifen+exercise (TE)) presented the best outcome. In conclusion, tamoxifen and treadmill exercise treatments are complementary therapies for the functional recovery of gait locomotion in hemi-spinalized rats.

The hippocampus participates in the control of locomotion speed.

The hippocampus role in sensory-motor integration remains unclear. In these experiments we study its function in the locomotor control. To establish the connection between the hippocampus and the locomotor system, electrical stimulation in the CA1 region was applied and EMG recordings were obtained. We also evaluated the hindlimbs and forelimbs kinematic patterns in rats with a penetrating injury (PI) in the hippocampus as well as in a cortex-injured group (CI), which served as control. After the PI, tamoxifen a selective estrogen receptor modulator (SERM) that has been described as a neuroprotector and antiinflammatory drug, or vehicle was administered. Electrical stimulation in the hippocampus produces muscle contractions in the contralateral triceps, when 6 Hz or 8 Hz pulse trains were applied. The penetrating injury in the hippocampus reduced the EMG amplitude after the electrical stimulation. At 7 DPI (days post-injury) we observed an increase in the strides speed in all four limbs of the non-treated group, decreasing the correlation percentage of the studied joints. After 15 DPI the strides speed in the non-treated returned to normal. These changes did not occur in the tamoxifen group nor in cortex-injured group. After 30 days, the nontreated group presented a reduction in the number of pyramidal cell layer neurons at the injury site, in comparison to the tam-treated group. The loss of neurons, may cause the interruption of the trisynaptic circuit and changes in the locomotion speed. Tamoxifen preserves the pyramidal neurons after the injury, probably resulting in the strides speed recovery.

Regulation of macrophage gene expression following invasion by Mycobacterium tuberculosis.

INTRODUCTION: Mycobacteria are intracellular pathogens which survive and grow in host macrophages. M. tuberculosis bacilli enter the macrophage via binding to several distinct cell surface molecules. Following phagocytosis, sustained intracellular bacterial growth depends on the ability to avoid destruction by macrophage-mediated host defences such as lysosomal enzymes, reactive oxygen and the reactive nitrogen intermediates. We used differential display reverse transcription polymerase chain reaction (DD RT-PCR) to identify host genes which are regulated during infection and hence which might be involved in the host-parasite cross talk. RESULTS: Live M. tuberculosis (strain H37Rv) was used to infect Balb/c peritoneal murine macrophages. mRNA from infected and uninfected macrophages was isolated at different time intervals after phagocytosis and subjected to DD RT-PCR. Oligo dT12NV and random 10mer primers were used for PCR amplification of cDNA. Macrophage genes which appeared to be differently regulated during infection were subjected to further reamplification by PCR in order to clone and sequence them. The differential expression of the selected bands was further analysed by an RNA protection assay and a Northern blot. RESULTS: Several differentially regulated bands were identified. One band, of 158 bp, was down regulated after infection. Sequencing of this band revealed a high level of homology (95% identity) to mouse cytochrome c oxidase subunit VIIc. The downregulation was specific for live virulent Mtb, while live BCG, heat killed Mtb and latex beads-mediated phagocytosis did not affect the transcriptional level of this enzyme. CONCLUSIONS: The cytochrome oxidase enzyme complex of the inner mytochondrial membrane catalyzes the reaction between ferrocytochrome c and oxygen. The reaction is the terminal event in the electron transport scheme. Downregulation of cytochrome c oxidase subunit VIIc could interfere with: (1) the host apoptotic programme; or (2) the host respiratory burst.

The survival of Escherichia coli, faecal coliforms and enterobacteriaceae in general in soil treated with sludge from wastewater treatment plants.

We monitored the effect of the application of treated sludge on the behaviour of enterobacteriaceae (mainly faecal coliforms and especially Escherichia coli) in the soil, and studied their evolution over time after application. Three different sludges were used: two from a municipal sewage plant, one of them had been subjected to anaerobic digestion and heat drying, and the other to anaerobic digestion and mechanical dehydration, and one from a dairy waste treatment to aerobic digestion and gravity thickening. Two types of tests were carried out: type O, in the open air, with no possibility of controlling humidity or temperature; and type L, under laboratory conditions, with controlled temperature and humidity. Sludge tests were also run on unscreened soil previously treated with chemical fertilizer. After 80 days of experimentation the populations of faecal coliforms and E. coli had decreased considerably or were undetectable in assays carried out on the soil/sludge mixtures, under both open-air and laboratory conditions, but that, over the same period, in the mixtures containing chemical fertilizer (calcium ammonium nitrate) there had been a considerable increase in the micro-organism populations studied.

Influence of the application of sewage sludge on the degradation of pesticides in the soil.

A study was made of the influence of the application of sewage sludge on the degradation of pesticides in the soil. Two kinds of sludge were used, with different characteristics, one from an urban treatment plant and one from a food processing plant. Three organophosphorus insecticides, fenitrothion, diazinon and dimethoate, were studied. The relative importance was determined of the chemical and biological degradation processes, which involved experiments on soil and sterile soil samples. A comparative study was also made of the degradation of pesticide residues and the evolution of the microbial population. The application of sludge seems to have a complex effect on the degradation of pesticides, determined by the bioavailability and biodegradability of their active ingredient. The biodegradation of pesticide residues brings about alterations in the microorganism population of the soil.

Efectividad de los protocolos de fisioterapia para pacientes con dolor lumbar crónico. Una revisión sistemática / Effectiveness of physiotherapy protocols for patients with chronic low back pain: A systematic review

Introducción: El dolor lumbar crónico es una de las principales causas de incapacidad laboral en el mundo. Requiere un abordaje interdisciplinario para la evolución del paciente. Hasta el momento, no existe consenso en el manejo del dolor lumbar crónico, lo que generó la inquietud de esta revisión sistemática. Objetivo: Identificar la efectividad de los protocolos de fisioterapia en el manejo del dolor lumbar crónico. Metodología: Se realizó una búsqueda sistemática en las bases de datos Pubmed, ScienceDirect, Scopus, Oxford, Wiley, Cochrane Library Plus, PEDro, Epistemonikos, Hinari y LILACS, Google Scholar, Teseo y PROSPERO, desde el inicio de las bases hasta agosto de 2021. Los criterios de selección se definieron según la intervención y el tema del artículo. Resultados: Se incluyeron 26 estudios en la síntesis cualitativa, se excluyeron artículos que no cumplieran con los criterios de inclusión. Se encontró efecto en el control del dolor y la disminución de la discapacidad y las principales intervenciones son: fortalecimiento muscular del Core y miembros inferiores, estiramiento de miembros inferiores, movilidad lumbopélvica y educación o escuela de espalda. La frecuencia en el tratamiento osciló entre 2 y 3 veces por semana durante 5 semanas. Conclusiones: Se encontró mayor efectividad en el tiempo de control del dolor y la disminución de la discapacidad, relacionados principalmente con el fortalecimiento muscular del Core y las estrategias educativas.(AU)

Introduction: Chronic low back pain is one of the main causes of incapacity for work in the world. It requires an interdisciplinary approach for the evolution of the patient. Until now, there is no consensus on the management of chronic low back pain, which generated the concern of this systematic review. Aim: To identify the effectiveness of physiotherapy protocols in the management of chronic low back pain. Methodology: A systematic search was carried out in the Pubmed, ScienceDirect, Scopus, Oxford, Wiley, Cochrane Library Plus, PEDro, Epistemonikos, Hinari and LILACS, Google Scholar, Teseo and PROSPERO databases, from the beginning of the databases until August, 2021. The selection criteria were defined according to the intervention and topic of the article. Results: Twenty-six studies were included in the qualitative synthesis, articles that did not meet the inclusion criteria were excluded. An effect was found in the control of pain and the reduction of disability and the main interventions are: muscular strengthening of the core and lower limbs, stretching of the lower limbs, lumbopelvic mobility and education or back school. The treatment frequency ranged from 2 to 3 times per week for 5 weeks. Conclusions: Greater effectiveness was found in pain control time and disability reduction, mainly related to core muscle strengthening and educational strategies.(AU)

Spinal neurons bursting in phase with fictive scratching are not related to spontaneous cord dorsum potentials.

Spontaneous cord dorsum potentials (spontaneous CDPs) are produced by the activation of dorsal horn neurons distributed along the L4 to S1 spinal cord segments, in Rexed's laminae III-VI, in the same region in which there are interneurons rhythmically bursting during fictive scratching in cats. An interesting observation is that spontaneous CDPs are not rhythmically superimposed on the sinusoidal CDPs generated during fictive scratching episodes, thus suggesting that the interneurons producing both types of CDPs belong to different spinal circuits. In order to provide experimental data to support this hypothesis, we recorded unitary activity of neurons in the L6 spinal cord segment. We found that the neurons firing rhythmically during the sinusoidal CDPs associated with the extensor, flexor or intermediate phases of scratching were not synchronized with the spontaneous CDPs. Moreover, we found that the neurons firing during the spontaneous CDPs were not synchronized with the sinusoidal CDPs. These results suggest that the neurons involved in the occurrence of spontaneous CDPs are not part of the spinal cord central pattern generators (CPGs). This study will be relevant for understanding the relationships between the spinal cord neuronal populations firing spontaneously and the CPGs, in the intact and injured spinal cord.

[Out of hospital emergencies towards a safety culture]. / Las emergencias extrahospitalarias ante la cultura de seguridad.

OBJECTIVES: The aim of this study is to measure the degree of safety culture (CS) among healthcare professional workers of an out-of-hospital Emergency Medical Service. Most patient safety studies have been conducted in relation to the hospital rather than pre-hospital Emergency Medical Services. The objective is to analyze the dimensions with lower scores in order to plan futures strategies. MATERIAL AND METHODS: A descriptive study using the AHRQ (Agency for Healthcare Research and Quality) questionnaire. The questionnaire was delivered to all healthcare professionals workers of 061 Advanced Life Support Units of Aragón, during the month of August 2013. RESULTS: The response rate was 55%. Main strengths detected: an adequate number of staff (96%), good working conditions (89%), tasks supported from immediate superior (77%), teamwork climate (74%), and non-punitive environment to report adverse events (68%). Areas for improvement: insufficient training in patient safety (53%) and lack of feedback of incidents reported (50%). CONCLUSIONS: The opportunities for improvement identified focus on the training of professionals in order to ensure safer care, while extending the safety culture. Also, the implementation of a system of notification and registration of adverse events in the service is deemed necessary.

Effect of multiparity on morphometry and oestrogen receptor expression of pelvic and perineal striated muscles in rabbits: is serum oestradiol relevant?

OBJECTIVE: To determine changes in morphometry and expression of oestrogen receptors (OR) in the pubococcygeus and bulbospongiosus muscles, and the concentration of serum oestradiol associated with multiparity. STUDY DESIGN: Twelve chinchilla-breed female rabbits were divided into multiparas who had undergone four consecutive deliveries and age-matched virgin nulliparas. Pubococcygeus and bulbospongiosus muscles were surgically removed from each rabbit and processed histologically. Fibre cross-sectional area, number of peripheral nuclei, and expression of ORα and ORß were measured for each muscle. Serum samples were obtained and the concentration of serum oestradiol was quantified. RESULTS: Multiparity increased (p ≤ 0.05) fibre cross-sectional area and the number of peripheral nuclei per fibre in pubococcygeus muscle, but not in bulbospongiosus muscle. Expression of both ORα and ORß was high (p ≤ 0.05) in both muscles from multiparous rabbits. A rise in serum oestradiol was measured at the end of the second pregnancy, which was absent (p ≤ 0.05) at the end of the fourth pregnancy. The concentration of serum oestradiol was similar (p > 0.05) in nulliparous and multiparous rabbits. CONCLUSIONS: Multiparity caused morphometric changes in pubococcygeus muscle but not in bulbospongiosus muscle. As OR expression was high for both muscles, some properties related to fibre composition or muscle physiology could be affected. The finding that serum oestradiol was not elevated at the end of the fourth pregnancy could be related to changes in pelvic and perineal muscles associated with multiparity.