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

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

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

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

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

Producción CientíficaHypoxia 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

Therapeutic Exercise and Pain Neurophysiology Education in Female Patients with Fibromyalgia Syndrome: A Feasibility Study

Producción CientíficaBackground: We compared the effects of therapeutic exercise (TE) combined with pain neurophysiology education (PNE) to those of TE in isolation on pain intensity, general fibromyalgia impact, mechanical pain sensitivity, pain catastrophizing, psychological distress and quality of life in women with fibromyalgia syndrome (FMS). Methods: A feasibility study with a 3 month follow-up was designed. Thirty-two patients with FMS were randomly assigned to PNE + TE group (n = 16) or to TE group (n = 16). Both groups received 30 sessions of TE (3 per week), and the PNE + TE group received eight face-to-face educational sessions. The measuring instruments used were the visual analogue scale, a standard pressure algometer, the Revised Fibromyalgia Impact Questionnaire, the Pain Catastrophizing Scale, the Hospital Anxiety and Depression Scale and the Health Assessment Questionnaire. Results: The PNE + TE group showed a statistically significant decrease on pain intensity compared to TE group at short term (p = 0.015). No between-groups differences were found for mechanical pain sensitivity, general fibromyalgia impact, pain catastrophizing, psychological distress or quality of life (p > 0.05). Conclusions: The combination of PNE and TE was more effective than TE for reducing pain intensity in the short-term. No differences were found for psychological distress, pain catastrophizing and quality of life after the intervention or at 3 months of follow-up

Procesos urbanos en acción: ¿Desarrollo de ciudades para todos?

La presente colección Ciudades de la Gente representa a hombres y mujeres cuya cultura popular, producto de las mezclas de todos aquellos que vivían y otros que han llegado a nuestros territorios, han hecho de lugares declarados como no aptos, lugares donde vivir, y han creado dentro de nuestras ciudades, la extensión de lo distinto. Son hombres y mujeres cuyo trabajo, el que tienen para aportar, junto al de otros y otras de su misma condición, les ha permitido autoproducir interesantes y sin duda bellos espacios donde convivir. Los profesores e investigadores miembros del Grupo de Trabajo Hábitat Popular e Inclusión Social de CLACSO, nos unimos a todos aquellos hacedores que, superando los miedos y con deseos de avanzar, se atreven a caminar por lo desconocido y a no conformarse con lo conocido de otras realidades, buscando en conjunto afirmar, como derechos universales, las posibilidades de vidas dignas y de construcciones colectivas dentro de nuestras ciudades. Emprendemos la tarea de describir e interpretar el hábitat popular y la inclusión social, abriendo posibilidades para que, experimentados y debutantes líderes populares e investigadores, hablen sobre "las ciudades de la gente" de muy diversos modos

Optimizando el abordaje del asma bronquial

196 páginas.El asma bronquial es una enfermedad crónica que afecta a millones de personas en todo el mundo, siendo la primera enfermedad crónica en la edad pediátrica. Se caracteriza por una inflamación de las vías respiratorias que conduce a la obstrucción del flujo de aire y a la dificultad para respirar. El asma es una enfermedad que afecta a la calidad de vida de las personas que la padece y puede ser una condición potencialmente mortal si no se trata adecuadamente. A pesar de los avances significativos en el tratamiento del asma en las últimas décadas, todavía hay muchas personas que no logran controlar adecuadamente su enfermedad. Muchos pacientes continúan experimentando síntomas a pesar de tomar medicamentos y seguir las recomendaciones médicas. Esto puede deberse a multitud de factores, como una mala adherencia al tratamiento, una falta de comprensión de la enfermedad o una falta de seguimiento por parte de los profesionales sanitarios. Una formación adecuada de los profesionales sanitarios implicados en la atención al paciente asmático (Médicos de Familia, Médicos de urgencias, Pediatras, Neumólogos, Alergólogos, etc) ayudará a establecer una estrategia de tratamiento eficaz y eficiente que pueda traducirse en una mejora del control y por tanto de la calidad de vida de nuestros pacientes. En este libro, se abordan las últimas recomendaciones basadas en la evidencia para el diagnóstico, la evaluación y el tratamiento del asma, con un enfoque multidisciplinar. A lo largo de sus diez capítulos, se describe como llegar a establecer un diagnostico correcto del asma (interpretación de pruebas alérgicas, espirometria y técnicas de imagen), uso adecuado de los distintos dispositivos de inhalación, las peculiaridades del tratamiento en el embarazo y en la edad pediátrica, el importante papel de la inmunoterapia en el tratamiento del asma alérgica, así de como debemos actuar ante una crisis de asma o cuales son los avances actuales y futuros en el asma grave o de difícil control

Ambient air pollution and thyroid function in Spanish adults. A nationwide population-based study ([email protected] study)

Background Recent reports have suggested that air pollution may impact thyroid function, although the evidence is still scarce and inconclusive. In this study we evaluated the association of exposure to air pollutants to thyroid function parameters in a nationwide sample representative of the adult population of Spain. Methods The [email protected] study is a national, cross-sectional, population-based survey which was conducted in 2008-2010 using a random cluster sampling of the Spanish population. The present analyses included 3859 individuals, without a previous thyroid disease diagnosis, and with negative thyroid peroxidase antibodies (TPO Abs) and thyroid-stimulating hormone (TSH) levels of 0.1-20 mIU/L. Participants were assigned air pollution concentrations for particulate matter <2.5 mu m (PM2.5) and Nitrogen Dioxide (NO2), corresponding to the health examination year, obtained by means of modeling combined with measurements taken at air quality stations (CHIMERE chemistry-transport model). TSH, free thyroxine (FT4), free triiodothyronine (FT3) and TPO Abs concentrations were analyzed using an electrochemiluminescence immunoassay (Modular Analytics E170 Roche). Results In multivariate linear regression models, there was a highly significant negative correlation between PM2.5 concentrations and both FT4 (p<0.001), and FT3 levels (p<0.001). In multivariate logistic regression, there was a significant association between PM2.5 concentrations and the odds of presenting high TSH [OR 1.24 (1.01-1.52) p=0.043], lower FT4 [OR 1.25 (1.02-1.54) p=0.032] and low FT3 levels [1.48 (1.19-1.84) p=<0.001] per each IQR increase in PM2.5 (4.86 mu g/m(3)). There was no association between NO2 concentrations and thyroid hormone levels. No significant heterogeneity was seen in the results between groups of men, pre-menopausal and post-menopausal women. Conclusions Exposures to PM2.5 in the general population were associated with mild alterations in thyroid function.CIBERDEM (Ministerio de Economia, Industria y Competitividad-ISCIII), Ministerio de Sanidad, Servicios Sociales e Igualdad-ISCIII, Instituto de Salud Carlos III (PI17/02136, PI20/01322), Consejeria de Salud y familias (PI-0144-2018), European Regional Development Fund (ERDF) "A way to build Europe". GRM belongs to the regional Nicolas Monardes research program of the Consejeria de Salud (RC-0006-2016; Junta de Andalucia, Spain). CMA is recipient of a "Rio Hortega" research contract (CM19/00186, Instituto de Salud Carlos III). VKDG is recipient of a "Rio Hortega" research contract (CM21/00214, Instituto de Salud Carlos III)