48 research outputs found
Beneficial effects of physical exercise on the osteo-renal Klotho-FGF-23 axis in Chronic Kidney Disease: A systematic review with meta-analysis
The aim of this study was to investigate the efficacy of physical exercise in chronic kidney disease, describing its impact on the Klotho-FGF23 axis. PubMed, Web of Science and Scopus databases, updated to January 2023, were searched. The present study employed mean difference and a 95% confidence interval (CI) to examine the efficacy of the intervention. Heterogeneity was assessed through inconsistency statistics (I2). Out of the 299 studies identified, a total of 4 randomized controlled trials (RCTs), comprising 272 participants, met the eligibility criteria. Compared with the control group, physical exercise significantly decreased the concentrations of FGF23 (MD: -102.07 Pg/mL, 95% CI: -176.23.47, -27.91 I2= 97%, p = 0.001), and a significantly increased the concentrations of Klotho protein: (MD: 158.82 Pg/mL, 95% CI: 123.33, -194.31, I2 = 0%, p = 0.001). The results of our study indicated that the exercise has a direct relationship with Klotho-FGF23 axis. We can conclude that physical exercise in patients with CKD produces beneficial effects on the pathophysiological components related to this disease, including cardiorespiratory fitness and vascular functions. As observed, both endurance and aerobic physical exercise increase Klotho production and decrease FGF23 levels. Evidence indicates that exercise attenuates the progression of CKD, improves uremic parameters and down-regulates inflammation-related markers
Digital physiotherapy intervention in children in a low resource setting in Anantapur (India): Study protocol for a randomized controlled trial
Introduction: In rural India the scarcity of physiotherapists and inequalities
complicate the recovery of traumatized children. This study protocol will
explore a digital physiotherapy intervention in children with ankle fracture in
a low-resource setting to improve functional independence and quality of life.
Methods and analysis: A randomized clinical trial with a mixed
quantitative-qualitative design will be carried out. It is a single-blind
study, where the evaluator does not know the nature of the intervention.
Sixty subjects will be enrolled and randomly divided into two groups:
the experimental group (EG) will receive a 4-week digital physiotherapy
intervention through an app in a recycled mobile device after hospital
discharge; the control group (CG) will receive the physiotherapy standard care
recommended for patients discharged from the hospital. Subjects will receive
a baseline (T0-pre) assessment of Functional Independence and Quality of
Life. At the end of the 4-week intervention (T1-post) a new assessment of the
outcome will be performed adding data on adherence, satisfaction (ad hoc
questionnaire and TSQ), and barriers of use. Qualitative outcomes will also
be explored. The author’s hypothesized that the implementation of a digital
physiotherapy intervention is feasible and effective to improve functional
independence and quality of life. This study protocol is the first to explore
the effect of digital physiotherapy intervention in children’s patients in a low
resource setting (Anantapur).
Discussion: The successful delivery of the intervention, an optimal adherence
records, the absence of significant adverse effects, user satisfaction level
and the qualitative analysis of limitations, will demonstrate the effectiveness
of these procedure. This study will add more evidence in support the use
of digital physiotherapy practice as an effective tool. User particularities,
provider’s capacity, technological and cultural limitations, and considerations
for vulnerable populations will be taken into account
Study of weight and body mass index on graft loss after transplant over 5 years of evolution
Antonio Liñán González conceived paper,
oversaw data collection, conducted data analysis,
wrote manuscript and approved final version. Raquel GarcĂa PĂ©rez participated in study design, data
analysis and interpretation, critically revised
manuscript and approved final version. Juan Bravo
Soto participated in study design, data analysis, and
interpretation of data and revision of manuscript and
approved final version. Rafael Fernández Castillo
participated in study design, interpretation of data
and revision of manuscript and approved final
version.Patients frequently experience a weight gain after organ transplantation. This increase in weight is the
result of multiple factors, and is usually intensified by glucocorticoids and immunosuppressive drugs. It
can also delay graft function and cause serious health problems. The objective of this study was to study
the obesity as well as its causes and consequences in kidney transplant patients. The sample population
consisted of 282 renal transplant patients, 170 men and 112 women, 18-74 years of age, who were
monitored over a period of five years. For the purposes of our research, the patients were divided into
two groups: (1) normal weight 18.5 ≤ BMI <25; (2) overweight 25 ≤ BMI ≤30. The association between
BMI as an independent variable and graft survival was determined by means of a Cox regression analysis.
Overweight patients were characterized by a higher comorbidity prevalence. In the Cox multivariate
analysis, the initial BMI, evaluated as a continuous variable continued to be an independent predictor of
delayed graft function and chronic nephropathy. This study evaluated the BMI as a continuous value
instead of a categorical value. In conclusion, our results suggest that an increase in BMI without
categorical variation can be an independent risk factor for graft loss. Consequently, obesity prevention
for renal transplant patients should include dietary counseling and management, moderate physical
activity, and steroid minimization
Using “Diraya” System as a Complementary Tool in Nursing Process Education: A Controlled Clinical Study
The authors are grateful to all participants and to the TECNOVA company, especially for the assistance of Antonio J. Luna and Jose Caballero. The study was supported by the Educational Innovation Unit of the University of Granada (PI12-158, PI13-159).Background: Healthcare has been revolutionized by the application of information and communication technologies. The implementation of electronic health record systems improves the quality and safety of patient healthcare. Nursing students who start learning the nursing process without contact with real patients experience difficulties in its correct application. Purpose: To compare the acquisition of skills and competencies in the nursing process by undergraduate nursing students between conventional learning with books and learning with an academic electronic health record system (Diraya). Methods: A controlled experimental study was conducted and included 379 students with a mean age of 20.54 +/- 5.09 years, enrolled in the "Nursing Process and Basic Care" degree course at the School of Health Sciences in Granada. All participants gave their informed consent and were allocated by convenience sampling to a control group (n = 187; 21.20 +/- 5.77 years) or an experimental group (n = 192, 19.91 +/- 4.24 years). Findings: The experimental and control groups did not differ in sex distribution (p = 0.20), mean age (p = 0.01), or previous knowledge of the nursing process (p = 0.96). The groups did not significantly differ in multi-choice test results on the acquisition of theoretical knowledge (p = 0.13). However, the experimental group scored higher on clinical case planning (9.47 +/- 0.80 vs. 8.95 +/- 1.17; p < 0.001), took less time to complete it (46.9 +/- 8.76 min vs. 82.66 +/- 13.14 min; p < 0.001), and needed fewer autonomous learning hours to prepare for the final examination (2.26 +/- 2.41 vs. 9.58 +/- 3.83; p < 0.001). Satisfaction with the program and the rating of its quality were generally higher in the experimental group, while greater difficulty with most phases of the nursing process was reported by the control group. Conclusions: The academic electronic health record system "Diraya" is a useful tool to improve the learning and implementation of the nursing process by undergraduate nursing students.Educational Innovation Unit of the University of Granada PI12-158
PI13-15
Hajdu-Cheney Syndrome: A Novel NOTCH2 Mutation in a Spanish Child in Treatment with Vibrotherapy: A Case Report
A case report of an 11-year-old boy with a de novo variant in NOTCH2 and clinical features
characteristic of Hajdu-Cheney syndrome is reported, with acroosteolysis of the distal phalanges
of the feet and hands, generalized osteoporosis, musculoskeletal and craniofacial alterations, short
stature, bowing of long bones, vertebral anomalies, genu recurvatum, hypertrichosis, joint and
skin hyperlaxity, atopic dermatitis, megalocorneas, micrognathia and frequent respiratory infections,
among others. Treatment is with bisphosphonates in the framework of bone density improvement and
with focal vibration therapy for rehabilitation of the musculoskeletal system and gait improvement.
The three generalities of this pathology—phenotypic variability, degenerative character and the
presence of generalized osteoporosis and acroosteolysis of the distal phalanges—are seen in this case,
whose diagnostic confirmation was made by genetic study
Virtual reality to improve low-back pain and pelvic pain during pregnancy: a pilot RCT for a multicenter randomized controlled trial
A significant proportion of women experience low back and pelvic pain during
and after pregnancy, which can negatively impact their daily lives. Various factors
are attributed to these complaints, and many affected women do not receive
adequate healthcare. However, there is evidence to support the use of different
physiotherapeutic interventions to alleviate these conditions. Virtual reality is a
promising complementary treatment to physiotherapy, particularly in improving
pain perception and avoidance. The primary objective of this study is to evaluate
the efficacy of a four-week program combining VR and physiotherapy compared
to standard physiotherapy in pregnant women with low back and pelvic pain, in
terms of improving pain avoidance, intensity, disability, and functional level. The
study also aims to investigate patient satisfaction with the VR intervention. This
research will be conducted through a multi-center randomized controlled clinical
trial involving pregnant patients residing in the provinces of Seville and Malaga
with a diagnosis of low back and pelvic pain during pregnancy. The alternative
hypothesis is that the implementation of a Virtual Reality program in combination
with standard physiotherapy will result in better clinical outcomes compared to
the current standard intervention, which could lead to the development of new
policies and interventions for these pathologies and their consequence
Physical Therapies in the Treatment of Post-COVID Syndrome: A Systematic Review
Introduction: Several days to months after diagnosis of SARS-CoV-2, 35% of patients have
persistent symptoms in high incidence. This is referred to as post-COVID-19 Syndrome. There is
a pressing need to find a way to help patients with the manifested symptoms. Objective: To show
the different therapies that exist for post-COVID Syndrome and their efficacy. Methodology: A
systematic review of the scientific literature was carried out. The data search was carried out in
Scopus, PubMed, Cinahl, andWeb of Science. Of the 106 articles found, 12 articles were obtained after
applying the following eligibility criteria. Results: Interventions related to respiratory musculature
and moderate intensity exercise both in supervised face-to-face sessions and in supervised home
sessions led patients to a significant improvement in the symptoms presented. Conclusion: Physical
therapies significantly reduce fatigue and dyspnea as well as other symptoms related to quality of lif
COVID-19 in Pregnant Women, Maternal—Fetal Involvement, and Vertical Mother-to-Child Transmission: A Systematic Review
Pregnant women are included in the COVID-19 risk groups even if they do not have any
pathology. This requires an analysis of research focused on pregnant women to understand the
impact of SARS-CoV-2 on their condition. There is also a need to know whether there is vertical
mother-to-child transmission, as well as other consequences in case the pregnant woman is infected
and COVID-19 positive. A systematic review was carried out to analyze the existing information on
the complications of a pregnant woman infected with the SARS-CoV-2 coronavirus and the possibility
of vertical transmission from mother to child, registered in the PROSPERO website and searched in
the PubMed, Scopus, CINAHL, and Cochrane Library databases. Finally, 22 articles were included in
the review. The review suggests that vertical transmission from mother to child could be exceptionally
possible at the time of delivery or breastfeeding, but not through the placenta. It is interesting to
point out the good acceptance of vaccination by pregnant women, which may be the reason for the
low infectivity. Further research on pregnant women should be carried out to provide evidence on
vertical mother-to-child transmission and the role of breast milk in relation to SARS-CoV-2
Coping Strategies in Elderly Colorectal Cancer Patients
The author(s) disclose the receipt of the following financial support for the research, authorship and/or publication of this article: this study was supported by a grant from the Education Ministry (Program FPU16/01437), Madrid, Spanish Government.In Spain, 34,331 new cases of colorectal cancer were diagnosed in 2018 and 15,923 individuals
died from this disease in the same year. The highest incidence of colorectal cancer is among
individuals aged 65–75 years and the physiological consequences of aging, alongside the effects
of the disease and its treatment, can exacerbate their physical deterioration and cognitive impairment
and reduce their social relationships. The learning of coping strategies may help to improve
the quality of life of patients after cancer diagnosis. To test the hypothesis that the utilization of
coping strategies can improve the quality of life of elderly patients with colorectal cancer, PubMed
and EBSCO databases were searched, up to 2021, using the following terms: “coping strategies
and colorectal cancer” with “anxiety”, “quality of life”, “depression”, “unmet needs”, “optimism”,
“intimacy”, “distress”, “self-efficacy” and “self-esteem” with Boolean operators “AND”, “OR”. The
literature search retrieved 641 titles/abstracts written in English. After an exhaustive analysis, only
7 studies met the inclusion criteria. Randomized evidence was scant and was reported only in 3/7 of
the studies analyzed. Data from available randomized evidence support that patients improved
on their depression and quality of life and felt more prepared to deal with their cancer. Coping
strategies in patients with colorectal cancer were effective in improving patient adaptation to their
new situation. Healthcare professionals working with these patients should receive training in this
complementary treatment, to be able to conduct comprehensive care in order to improve the quality
of life of these patients.Education Ministry, Madrid, Spanish Government FPU16/0143
Differences between U23 and older semi-professional soccer players in perfectionism and passion: exploring determinant relationship between variables
AimAbundant studies have pointed out that perfectionism and passion are interrelated and that they both can influence performance in a variety of contexts, including sports, however, research on how these variables interact and might affect performance in team sports, such as soccer, is still scarce. The aim of this study is to analyze differences in perfectionism and passion between under-23 years-old (U23) and older semi-professional soccer players, as well as to study the possible relationship between these two psychological variables.MethodsParticipants (N = 130 healthy semi-professional Spanish soccer players) were divided into two equivalent groups according to the participants age, U23 (N = 65; 21.58 ± 1.91 years) and older than 24 years (N = 65; 30.03 ± 3.72 years) and completed self-reports on perfectionism and passion.ResultsIndependent samples t-test determined significant differences between the U23 Group and the >24 Group in perfectionism global score and concern over mistakes (maladaptive perfectionism), and in time, value, and passion. Multiple regression analyses revealed that obsessive passion predicted maladaptive subdimensions of perfectionism, while harmonious passion predicted adaptive perfectionism.DiscussionU23 soccer players show higher levels of maladaptive perfectionism, time, value, and passion in relation with soccer than older players, probably because at this stage pressure to become professionals and to develop their technical, tactical, and physical skills is higher than in later stages.ConclusionIdentifying differences between different age groups can help professionals in tailoring their interventions and strategies to address the specific needs of athletes at different stages of development more effectively, and to optimize mental focus, reduce stress, to promote a healthy mindset for optimal performance in soccer players, furthermore, the study of moderating effects of factors such as team dynamics or coaching styles on these constructs is advised