Relación entre polimorfismos en genes involucrados en la apoptosis y patologías neurodegenerativas de la retina: una revisión sistemática

Las alteraciones genéticas pueden causar cambios que contribuyen a la progresión de enfermedades neurodegenerativas de la retina. Estudiar los polimorfismos genéticos y su relación con la apoptosis en estas enfermedades es necesario para mejorar el diagnóstico, tratamiento y prevención, lo que a su vez mejora los resultados clínicos y el bienestar de los pacientes. Identificar polimorfismos en genes involucrados en la apoptosis que se asocien con el desarrollo y evolución de patologías neurodegenerativas de la retina. Revisión sistemática ajustada a la lista de verificación PRISMA. La búsqueda bibliográfica se ha llevado a cabo en bases de datos PubMed, Public Health Database y Scopus, con el objetivo de analizar estudios de casos controles, análisis de asociación, cohorte y antes y después publicados en los últimos diez años sobre los genes y polimorfismos vinculados con la apoptosis en la neurodegeneración retiniana y procesos asociados. Los resultados indican que veintitrés polimorfismos en los genes estudiados aumentan significativamente (p < 0.05) el riesgo y la progresión de la neurodegeneración retiniana en enfermedades como el glaucoma, la degeneración macular asociada a la edad (DMAE) y la retinopatía diabética (RD). Siete polimorfismos actúan como factores protectores, previniendo la progresión de la neurodegeneración mediante la apoptosis.Departamento de EnfermeríaMáster en Enfermería Oftalmológic

Bone mineral metabolism status, quality of life, and muscle strength in older people

Producción CientíficaAs the relationship between vitamin D and various diseases or health conditions has become known, interest in the contribution of vitamin D to overall health-related quality of life (QoL) has increased. We examined the relationship between vitamin D status and QoL in 273 participants aged 65 years and older. Serum levels of total calcium, phosphorus, intact parathyroid hormone, albumin, and 25-hydroxyvitaminD3 were analyzed. We also recruited data for QoL, physical activity, nutritional impairment, and muscular strength. Ninety percent of the subjects were classified as vitamin D deficient or insufficient. Participants with higher serum 25(OH)D3, calcium, phosphorous, and Alb levels were significantly less likely to self-report depression or anxiety after adjustment (p = 0.009, p = 0.005, p = 0.003, and p = 0.005, respectively). Additionally, we found an association between lower levels of albumin and self-reported problems with mobility or usual activities (p = 0.01). We also found associations between better muscle strength and higher levels of vitamin D, calcium, phosphorous, and albumin (p = 0.006, p = 0.003, p = 0.004 and p = 0.002, respectively). Overall, our data provide evidence that serum vitamin D and Alb levels are negatively related to self-reported anxiety or depression, usual activities, mobility, and three dimensions of QoL in older adults. Furthermore, vitamin D levels are positively related to hand grip strength in adults over 65 years old

Calidad de vida profesional de enfermería en urgencias de un hospital de referencia

Objective: The objective of this study was to measure the quality of professional life of nurses in their workplace in the emergency unit of a Hospital, through three dimensions intrinsic motivation, support and management workloads. Most studies on quality of life worldwide are made primarily in teaching groups and health professionals. According to various studies, this group is very likely to suffer burnout. If we improve the quality of care provided, we must start knowing how nursing professionals perceive quality of life, as well as whether there are constraining factors involved.Methods: Cross-sectional study survey of nurses working in an Emergency Unit of a Spanish public hospital. It was conducted between March and May of 2014. The sample consisted on 60 subjects. Data were collected using the CVP-35 questionnaire.Results: The response rate was high. The nurses perceived low quality of professional life. The professional quality of life correlates with management support and intrinsic motivation, although no association with the workload was found. Age is the demographic variable that influences how they perceive their quality of working life emergency nurses.Conclusion: Compared to other studies, if we improve the management support, perception of the quality of working life of nurses working in emergency increase.Objetivo: El objetivo de este estudio fue medir la Calidad de Vida Profesional de los enfermeros en la unidad de urgencias de un hospital en su puesto de trabajo, a través de tres dimensiones: motivación intrínseca, apoyo directivo y cargas de trabajo. La mayoría de estudios sobre calidad de vida a nivel mundial se hacen principalmente en colectivos de enseñanza y también los profesionales de la salud, sufren desgaste profesional, según estudios diversos. Si queremos mejorar la calidad de los cuidados prestados, debemos empezar conociendo cómo percibe el profesional de Enfermería dicha calidad de vida, así como si existen o no factores que la condicionen.Métodos: Estudio descriptivo transversal con análisis correlacional. El presente estudió investigó la calidad de vida profesional de los enfermeros de una Unidad de Urgencias de  un Hospital público español. Fue llevado a cabo entre Marzo y Mayo de 2014. Para ello se utilizó el “cuestionario CVP-35”.Resultados: La tasa de respuesta fue alta. Los enfermeros percibieron una baja calidad de vida profesional. La calidad de vida profesional se correlaciona con el Apoyo directivo y la Motivación intrínseca, aunque no se asocia con la Carga de Trabajo. La edad es la variable sociodemográfica que influye en cómo perciben su calidad de vida profesional los enfermeros de urgencias.Conclusión: En relación con otros estudios, si mejoramos el Apoyo directivo, la percepción de la calidad de vida profesional de los profesionales de enfermería que trabajan en urgencias aumentaría.

Endocannabinoids induce lateral long-term potentiation of transmitter release by stimulation of gliotransmission

Endocannabinoids (eCBs) play key roles in brain function, acting as modulatory signals in synaptic transmission and plasticity. They are recognized as retrograde messengers that mediate long-term synaptic depression (LTD), but their ability to induce long-term potentiation (LTP) is poorly known. We show that eCBs induce the long-term enhancement of transmitter release at single hippocampal synapses through stimulation of astrocytes when coincident with postsynaptic activity. This LTP requires the coordinated activity of the 3 elements of the tripartite synapse: 1) eCB-evoked astrocyte calcium signal that stimulates glutamate release; 2) postsynaptic nitric oxide production; and 3) activation of protein kinase C and presynaptic group I metabotropic glutamate receptors, whose location at presynaptic sites was confirmed by immunoelectron microscopy. Hence, while eCBs act as retrograde signals to depress homoneuronal synapses, they serve as lateral messengers to induce LTP in distant heteroneuronal synapses through stimulation of astrocytes. Therefore, eCBs can trigger LTP through stimulation of astrocyte-neuron signaling, revealing novel cellular mechanisms of eCB effects on synaptic plasticity.Ministerio de Economia y Competitividad, Spain (MINECO; BFU2010-15832), European Union (HEALTH-F2-2007-202167), and Cajal Blue Brain to A.A. Grants from Spain (MINECO; BFU-2009-08404 and CSD2008-00005) to R.L. Grants from Spain (MINECO; Consolider, CSD2010-00045; Ramón y Cajal Program, RYC-2012-12014; and BFU2013-47265) to G.P.Peer Reviewe

Mishel’s Model of uncertainty describing categories and subcategories in fibromyalgia patients, a scoping review

Producción CientíficaThe aim of this review was to demonstrate the presence of categories and subcategories of Mishel’s model in the experiences of patients with fibromyalgia by reviewing qualitative studies. Uncertainty is defined as the inability to determine the meaning of disease-related events. A scoping review of qualitative studies was carried out. Twenty articles were included, with sample sizes ranging from 3 to 58 patients. Articles from different countries and continents were included. Three categories of the model and eight subcategories could be shown to be present in the experiences of fibromyalgia patients through the scoping review. The first category, concerning antecedents of uncertainty in patients with fibromyalgia, is constituted by the difficulty in coping with symptoms, uncertainty about the diagnosis and uncertainty about the complexity of the treatment. The second concerns the cognitive process of anxiety, stress, emotional disorder and social stigma. The third category refers to coping with the disease, through the management of social and family support and the relationship with health care professionals

Electromyography: A Simple and Accessible Tool to Assess Physical Performance and Health during Hypoxia Training. A Systematic Review

Producción CientíficaHypoxia causes reduced partial pressure of oxygen in arterial blood and induces adaptations in skeletal muscle that may affect individuals&rsquo; physical performance and muscular health. These muscular changes are detectable and quantifiable by electromyography (EMG), an instrument that assesses electrical activity during active contraction at rest. EMG is a relatively simple and accessible technique for all patients, one that can show the degree of the sensory and motor functions because it provides information about the status of the peripheral nerves and muscles. The main goal of this review is to evaluate the scientific evidence of EMG as an instrument for monitoring different responses of skeletal muscles subjected to external stimuli such as hypoxia and physical activity. A structured search was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines in Medline/PubMed, Scielo, Google Scholar, Web of Science, and Cochrane Library Plus. The search included articles published in the last 25 years until May 2020 and was restricted to English- and Spanish-language publications. As such, investigators identified nine articles that met the search criteria. The results determined that EMG was able to detect muscle fatigue from changes in the frequency spectrum. When a muscle was fatigued, high frequency components decreased and low frequency components increased. In other studies, EMG determined muscle activation increased during exercise by recruiting motor units and by increasing the intensity of muscle contractions. Finally, it was also possible to calculate the mean quadriceps quadratic activity used to obtain an image of muscle activation. In conclusion, EMG offers a suitable tool for monitoring the different skeletal muscle responses and has sufficient sensitivity to detect hypoxia-induced muscle changes produced by hypoxic stimuli. Moreover, EMG enhances an extension of physical examination and tests motor-system integrity

Effects of Antioxidants on Pain Perception in Patients with Fibromyalgia—A Systematic Review

In recent years, antioxidant supplements have become popular to counteract the effects of oxidative stress in fibromyalgia and one of its most distressing symptoms, pain. The aim of this systematic review was to summarize the effects of antioxidant supplementation on pain levels perceived by patients diagnosed with fibromyalgia. The words used respected the medical search terms related to our objective including antioxidants, fibromyalgia, pain, and supplementation. Seventeen relevant articles were identified within Medline (PubMed), Scopus, Web of Science (WOS), the Cochrane Database of Systematic Review, and the Cochrane Central Register of Controlled Trials. This review found that antioxidant supplementation is efficient in reducing pain in nine of the studies reviewed. Studies with a duration of supplementation of at least 6 weeks showed a benefit on pain perception in 80% of the patients included in these studies. The benefits shown by vitamins and coenzyme Q10 are remarkable. Further research is needed to identify the effects of other types of antioxidants, such as extra virgin olive oil and turmeric. More homogeneous interventions in terms of antioxidant doses administered and duration would allow the effects on pain to be addressed more comprehensively

Electromyography: a simple and accessible tool to assess physical performance and health during hypoxia training. A systematic review

Hypoxia causes reduced partial pressure of oxygen in arterial blood and induces adaptations in skeletal muscle that may affect individuals’ physical performance and muscular health. These muscular changes are detectable and quantifiable by electromyography (EMG), an instrument that assesses electrical activity during active contraction at rest. EMG is a relatively simple and accessible technique for all patients, one that can show the degree of the sensory and motor functions because it provides information about the status of the peripheral nerves and muscles. The main goal of this review is to evaluate the scientific evidence of EMG as an instrument for monitoring different responses of skeletal muscles subjected to external stimuli such as hypoxia and physical activity. A structured search was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines in Medline/PubMed, Scielo, Google Scholar, Web of Science, and Cochrane Library Plus. The search included articles published in the last 25 years until May 2020 and was restricted to English- and Spanish-language publications. As such, investigators identified nine articles that met the search criteria. The results determined that EMG was able to detect muscle fatigue from changes in the frequency spectrum. When a muscle was fatigued, high frequency components decreased and low frequency components increased. In other studies, EMG determined muscle activation increased during exercise by recruiting motor units and by increasing the intensity of muscle contractions. Finally, it was also possible to calculate the mean quadriceps quadratic activity used to obtain an image of muscle activation. In conclusion, EMG offers a suitable tool for monitoring the different skeletal muscle responses and has sufficient sensitivity to detect hypoxia-induced muscle changes produced by hypoxic stimuli. Moreover, EMG enhances an extension of physical examination and tests motor-system integrity

Physical performance and quality of life in older adults: Is there any association between them and potential drug interactions in Polymedicated Octogenarians?

Producción CientíficaOlder adults are at increased risk of several cytochrome P450 (CYP) drug interactions that can result in drug toxicity, reduced pharmacological effect, and adverse drug reactions. This study aimed to assess the prevalence of potential CYP interactions referring to the most clinically relevant drugs and exploring the relationship between them and quality of life and physical performance in Spanish octogenarians. Institutionalized and community-dwelling octogenarians (n = 102) treated at three primary care centers, were recruited by a research nurse. Anthropometric measurements, chronic diseases, prescribed drugs, quality of life, physical performance, mobility skills, hand grip strength and cognitive status data were collected. Potential CYP drug-drug interactions (DDIs) were selected referring to the main CYP implicated in their metabolism. The 72.2% of recruited octogenarians presented potentially inappropriate CYP inhibitor-substrate or CYP inductor-substrate combinations. Analyzing the EuroQol Visual Analogue scale (EQ-VAS) results, patients with a potential CYP DDI perceived worse health status than patients without it (p = 0.004). In addition, patients with a potential CYP DDI presented worse exercise capacity, kinesthetic abilities, or mobility than those who didn’t present a potential interaction (p = 0.01, p = 0.047, and p = 0.02, respectively). To investigate and control factors associated with loss of muscle strength and poor quality of life, polypharmacy and DDIs could help institutions in the management of physical frailty.Fundación Científica Caja Rural de Soria (project 00200200227

Geriatric nursing on European Space for Higher Education

Producción CientíficaProblema: ¿Cómo se están estructurando las asignaturas relacionadas con la especialidad de Enfermería Geriátrica en la formación de Grado de Enfermería? Material y método: guías docentes de las universidades, escuelas/facultades de Enfermería, pertenecientes a la Conferencia Nacional de Directores de Centros Universitarios de Enfermería (CNDCUE). Análisis descriptivo de la asignatura que abordan los cuidados de enfermería durante la etapa de la vejez. Conclusiones: existe divergencia en el planteamiento de las asignaturas en las guías analizadas. Se ha modificado la denominación previa y común a todos los centros: Enfermería Geriátrica. El número de competencias propuestas es elevado, lo que puede complicar la evaluación formativa.Issue: how are subjects related to Geriatric Nursing being organized on Nursing degree education? Material and method: guidebooks about Shools/Faculties of Nursing wich belong to National Conference of Directors of University Centres of Nursing. A subject on nursing care descriptive analysis during old age. Conclusions: There are differences between the approach of the subjects on the guides we ve analized. The previous and common to all centres designation has been modified: Geriatric Nursing. The number of suggested competences is high, so formative evaluation will get complicated