Dance in Parkinson's disease. Systematic review

RESUMEN: Introducción. La enfermedad de Parkinson es un proceso neurodegenerativo del Sistema Nervioso Central y la segunda más frecuente a nivel mundial. En ella se manifiestan síntomas motores y síntomas no motores. Los tratamientos actuales están recomendados para frenar la evolución de la enfermedad, como el tratamiento farmacológico, quirúrgico y fisioterapia, que están enfocados principalmente para los síntomas motores. La danza, gracias a sus beneficiosas características, puede ser una nueva alternativa terapéutica que pueda ayudar a mejorar tanto sus síntomas motores como los no motores. Objetivo. Analizar los beneficios a nivel motor, cognitivo y en la calidad de vida que se obtienen a través de los programas de danza de los estudios. Metodología. Este trabajo se centró en la búsqueda de ensayos clínicos aleatorizados que utilizasen la danza como opción terapéutica. Las bases de datos seleccionadas fueron Web of Science, Dialnet, PEDro, Scopus, Cochrane y Pubmed, y las palabras clave utilizadas Parkinson’s disease, dance, dancing, dance therapy, movement therapy, body experience, rehabilitation. Esta búsqueda se realizó entre el 10 de febrero y el 22 de marzo de 2020. Se escogió la escala PEDro para evaluar la metodología de los estudios incluidos. Resultados. Se incluyeron un total de seis estudios. Todos ellos evaluaron la función motora, tres la función cognitiva y otros tres la calidad de vida. Se compararon los resultados del grupo de intervención sometidos a sesiones de danzaterapia, tango o bailes de salón, con el grupo control que no recibió ningún tratamiento y continuó con sus actividades cotidianas. Éstos concluyeron en los beneficios obtenidos, tanto a nivel motor como no motor. Conclusión. Mediante la danza se obtienen beneficios tanto en la función motora como en la no motora. Las mejoras principales en el equilibrio y la marcha repercuten en la disminución de caídas y, por tanto, en los síntomas depresivos. ABSTRACT: Introduction. Parkinson's disease is a neurodegenerative process of the Central Nervous System and the second most frequent worldwide. It manifests motor symptoms and nonmotor symptoms. Current treatments are recommended to slow down the evolution of the disease, such as pharmacological, surgical and physiotherapy treatment, which are mainly focused on the motor symptoms. Dance, thanks to its beneficial characteristics, can be a new therapeutic alternative that can help to improve both its motor and non-motor symptoms. Objective. To evaluate the benefits at the motor, cognitive and quality of life level obtained through the dance programs of the studies. Methodology. This project is focused on searching for randomized clinical trials using dance as a therapeutic option. The databases selected were Web of Science, Dialnet, PEDro, Scopus, Cochrane and Pubmed, and the keywords used were Parkinson's disease, dance, dancing, dance therapy, movement therapy, body experience, rehabilitation. This search was conducted between 10th February and 22nd March in 2020. The PEDro scale was chosen to assess the methodology of the included studies. Results. A total of six studies were included. All of them assessed the motor function, three assessed the cognitive function and three assessed the quality of life. The results of the intervention group undergoing dance therapy, tango or ballroom dancing sessions were compared with the control group that received no treatment and continued with their daily activities. These concluded in the benefits obtained, both at the motor and nonmotor level. Conclusion. Benefits are obtained through dance in both motor and non-motor functions. The main improvements in balance and gait have an impact on the decrease of falls and therefore on the depressive symptoms

Factores ambientales que influyen en el uso del espacio público para las personas mayores en Madrid/Environmental factors influencing the elderly’s use of public spaces in Madrid

Las políticas internacionales tienen el reto de crear entornos urbanos que fomenten un envejecimiento activo y saludable. Este estudio busca determinar los factores ambientales y de diseño que determinan el uso de los espacios públicos por parte de los adultos mayores, mediante una metodología mixta que incluye mediciones de los parámetros ambientales, observaciones y entrevistas a 200 personas mayores durante el año 2018 en tres espacios públicos del barrio Arapiles en Madrid. Para el análisis estadístico se han aplicado distintas pruebas de correlación entre las variables como la de Pearson, Spearman, U de Mann Whitney, H Kruskal Wallis y chi-cuadrado. Adicionalmente, se realiza un análisis estadístico multivariado con el fin de determinar el grado en que los factores ambientales condicionan el uso de los espacios públicos por parte de los adultos mayores. Los resultados evidencian que los mayores representan el 21% de los usuarios de estos espacios, su permanencia se ve influenciada por factores ambientales como temperatura, humedad, velocidad del viento y ruido, sin embargo, solamente la velocidad del viento resulta determinante dentro de un modelo de regresión. Existen otros elementos del diseño que también lo condicionan significativamente, como son bancos, fuentes de agua y juegos infantiles, que coinciden con las zonas de preferencia y mayor afluencia de personas mayores. El análisis de contextos exteriores es complejo debido al gran número de variables que intervienen, no obstante, se destaca la importancia de las variables ambientales y su control por medio de un diseño adecuado que propicie el bienestar general y fomente el uso de los espacios públicos por parte de los adultos mayores. Se abren importantes líneas de investigación ante los retos de las ciudades del siglo XXI, para adaptarse al cambio demográfico, garantizando la salud, el confort y calidad de vida de todos los ciudadanos.International policies are challenged to create urban environments that foster active and healthy aging. This study seeks to determine the environmental and design factors that determine the use of public spaces by the elderly, using a mixed methodology that includes measurements of environmental parameters, observations and interviews with 200 elderly people during 2018 in three public spaces in the Arapiles neighborhood in Madrid. For the statistical analysis, different correlation tests have been applied between variables such as Pearson, Spearman, Mann Whitney U, Kruskal Wallis H, and chi-square. Besides, a multivariate statistical analysis is carried out to determine the degree to which environmental factors condition the use of public spaces by the elderly. The results show that the elderly represent 21% of the users of these spaces, their permanence is influenced by environmental factors such as temperature, humidity, wind speed and noise, however, only wind speed is determinant within a regression model. Besides, some elements of the design also significantly influence it, such as benches, water fountains and children’s playgrounds, which coincide with the areas of preference and greater influx of elderly people. The analysis of external contexts is complex due to a large number of variables involved; however, the importance of environmental variables is highlighted and their control through an adequate design that promotes the general welfare and encourages the use of public spaces by the elderly. Important lines of research are being opened to face the challenges of 21st-century cities, to adapt to demographic change, guaranteeing the health, comfort, and quality of life of all citizens

Management and outcome of pregnancies in women with red cell isoimmunization: a 15-year observational study from a tertiary care university hospital

Isoimmunization; Newborn hemolytic disease; Intrauterine transfusionIsoinmunización; Enfermedad hemolítica del recién nacido; Transfusión intrauterinaIsoimmunització; Malaltia hemolítica del nounat; Transfusió intrauterinaBackground: The aims of this study were to determine the prevalence of the different anti-erythrocytic alloantibodies, to describe pregnancy outcomes according to a low-risk and high-risk classification for fetal anemia and to determine the factors that influence adverse perinatal outcomes. Methods: This retrospective observational study included women referred to our center following the identification of maternal anti-erythrocytic alloantibodies between 2002 and 2017. Pregnancies were classified as high risk for fetal anemia in cases with clinically significant antibodies, no fetal-maternal compatibility and titers ≥1:16 or any titration in cases of Kell system incompatibility. In high-risk pregnancies, maternal antibody titration and the fetal middle cerebral artery peak systolic velocity (MCA-PSV) were monitored. Low-risk pregnancies underwent routine pregnancy follow-up. Results: Maternal antibodies were found in 337 pregnancies, and 259 (76.9%) of these antibodies were clinically significant. The most frequent antibodies were anti-D (53%) and anti-K (19%). One hundred forty-three pregnancies were classified as low risk for fetal anemia, 65 (25%) cases were classified as no fetal-maternal incompatibility, 78 had clinically nonsignificant antibodies, 4 (2.8%) resulted in first-trimester pregnancy loss, and 139 (97.2%) resulted in livebirths. Of the 194 high-risk pregnancies, 38 had titers 1.5 MoM, resulting in 3 intrauterine deaths, 6 terminations and 48 livebirths. Ninety-two intrauterine transfusions were performed in 45 fetuses (87% anti-D). Adverse outcomes were related to a MCA-PSV > 1.5 MoM (p < 0.001), hydrops (p < 0.001) and early gestational age at first transfusion (p = 0.029) Conclusion: Anti-D remains the most common antibody in fetuses requiring intrauterine transfusion. A low or high-risk classification for fetal anemia based on the type of antibody, paternal phenotype and fetal antigen allows follow-up of the pregnancy accordingly, with good perinatal outcomes in the low-risk group. In the high-risk group, adverse perinatal outcomes are related to high MCA-PSV, hydrops and early gestational age at first transfusion

Risk factors of early spontaneous preterm birth despite carrying a cervical pessary in singleton pregnancies with a short cervix: Development of a risk prediction model

Cervical pessary; Short cervical length; Spontaneous preterm birthPesario cervical; Longitud cervical corta; Parto prematuro espontáneoPessari cervical; Longitud cervical curta; Part prematur espontaniIntroduction: We aimed to identify the incidence and risk factors of spontaneous preterm birth in pessary carriers with singleton pregnancies and a short cervix in the mid-trimester of pregnancy. Material and methods: Patient data were obtained from the PECEP Trial. We analyzed singleton pregnancies in pessary carriers with a short cervix (≤25 mm) between 18 and 22 gestational weeks. Demographics and obstetric history were compared to identify risk factors for spontaneous preterm birth < 34 gestational weeks. Each demographic and obstetric variable was compared between spontaneous preterm birth < 34 and ≥ 34 weeks of gestation.Regression analysis was used to identify risk factors. A risk score model was generated using the odds ratio for significant factors. The risk score model and spontaneous preterm birth risk were assessed using the receiver operating characteristic curve. Perinatal outcomes were compared by risk score. Results: Among 190 pregnant individuals, 12 (6.3%) had spontaneous preterm birth < 34 gestational weeks. In the bivariate analysis, statistically significant differences between those with and without spontaneous preterm birth were only observed for mean cervical length at diagnosis and mean cervical length after pessary placement. By multiple logistic regression analysis, maternal age (OR 0.818; 95% CI 0.69-0.97; P 0.020), cervical length at diagnosis (OR 0.560; 95% CI 0.43-0.73; P < 0.001) and smoking status (OR 7.276; 95% CI 1.02-51.80; P 0.048) remained significantly associated with spontaneous preterm birth.The ROC curve from the multiple logistic regression analysis, including cervical length, maternal age and smoking status, had an area under the curve (AUC) of 0.952 (P < 0.001). The ROC curve for the risk score model incorporating all three variables had an AUC of 0.864 (95% CI 0.77-0.96; P < 0.001). A high-risk score was predictive of spontaneous preterm birth with a sensitivity of 75%, specificity of 84%, positive predictive value of 24%, and negative predictive value of 98%.Women with a high-risk score had a significantly reduced latency to delivery and poorer neonatal outcomes than those with a low-risk score. Conclusions: Patients at a high risk for spontaneous preterm birth despite pessary therapy may be identified using cervical length at diagnosis added to maternal age and smoking status

Abnormal Maternal Body Mass Index and Customized Fetal Weight Charts : Improving the Identification of Small for Gestational Age Fetuses and Newborns

Background: Obesity and thinness are serious diseases, but cases with abnormal maternal weight have not been excluded from the calculations in the construction of customized fetal growth curves (CCs). Method: To determine if the new CCs, built excluding mothers with an abnormal weight, are better than standard CCs at identifying SGA. A total of 16,122 neonates were identified as SGA, LGA, or AGA, using the two models. Logistic regression and analysis of covariance were used to calculate the OR and CI for adverse outcomes by group. Gestational age was considered as a covariable. Results: The SGA rates by the new CCs and by the standard CCs were 11.8% and 9.7%, respectively. The SGA rate only by the new CCs was 18% and the SGA rate only by the standard CCs was 0.01%. Compared to AGA by both models, SGA by the new CCs had increased rates of cesarean section, (OR 1.53 (95% CI 1.19, 1.96)), prematurity (OR 2.84 (95% CI 2.09, 3.85)), NICU admission (OR 5.41 (95% CI 3.47, 8.43), and adverse outcomes (OR 1.76 (95% CI 1.06, 2.60). The strength of these associations decreased with gestational age. Conclusion: The use of the new CCs allowed for a more accurate identification of SGA at risk of adverse perinatal outcomes as compared to the standard CC

An integrated model of the geomorphological and topographic landscape of the necropolis at Dra Abu el‑Naga –

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An integrated model of the geomorphological and topographic landscape of the necropolis at Dra Abu el‑Naga

This paper describes the archaeological, topographical and geomorphological survey and modelling of the topography of Dra Abu el Naga from prior to the building of the New Kingdom tombs until today. The ancient topography of Dra Abu el Naga has been reconstructed, offering a more accurate and complete image of this part of the necropolis for the study of its organisation, and the distribution and placement of the tombs. This work opens up new lines of investigation into the landscape of the necropolis and this approach could be productively applied to other ancient Egyptian tombs, necropolises and funerary landscapes in general

Abnormal Maternal Body Mass Index and Customized Fetal Weight Charts: Improving the Identification of Small for Gestational Age Fetuses and Newborns

Maternal body mass index; Newborn weight; ObesityÍndice de masa corporal materno; Peso del neonato; ObesidadÍndex de massa corporal matern; Pes del nounat; ObesitatBackground: Obesity and thinness are serious diseases, but cases with abnormal maternal weight have not been excluded from the calculations in the construction of customized fetal growth curves (CCs). Method: To determine if the new CCs, built excluding mothers with an abnormal weight, are better than standard CCs at identifying SGA. A total of 16,122 neonates were identified as SGA, LGA, or AGA, using the two models. Logistic regression and analysis of covariance were used to calculate the OR and CI for adverse outcomes by group. Gestational age was considered as a covariable. Results: The SGA rates by the new CCs and by the standard CCs were 11.8% and 9.7%, respectively. The SGA rate only by the new CCs was 18% and the SGA rate only by the standard CCs was 0.01%. Compared to AGA by both models, SGA by the new CCs had increased rates of cesarean section, (OR 1.53 (95% CI 1.19, 1.96)), prematurity (OR 2.84 (95% CI 2.09, 3.85)), NICU admission (OR 5.41 (95% CI 3.47, 8.43), and adverse outcomes (OR 1.76 (95% CI 1.06, 2.60). The strength of these associations decreased with gestational age. Conclusion: The use of the new CCs allowed for a more accurate identification of SGA at risk of adverse perinatal outcomes as compared to the standard CCs

I Congreso de relaciones internacionales: El océano una tarea de todos. Día 1

Javier A. Valladares (Argentina) Capitán de Navío (R) Presidente de la Academia del Mar: “El mar y el desarrollo del futuro” / Nicolás Roncagliolo Higueras (Perú) Embajador del Servicio Diplomático de la República del Perú (SDR): “El dominio marítimo del Perú. Apuntes desde la práctica peruana” / Eduardo Marone (Italia) Instituto Nazionale di Oceanografia e di Geofisica Sperimentale: “Gobernanza y ciencias del océano. Desde la mirada de la geoética” / María Teresa Infante (Chile) Jueza del Tribunal Internacional del Derecho del Mar: “Aportaciones desde la jurisprudencia. Una mirada desde el Tribunal del Mar” / Wagner Menezes (Brasil) Profesor de la Facultad de Derecho de la Universidad de São Paulo: “Arresto del barco a los brazos abiertos: una contribución de los derechos humanos al derechoObjetivo: Contribuir a la reflexión y debate crítico en las demandas y desafíos del futuro del planeta a través de la protección del Océano y sus recursos, sobre la base de la Agenda 2030 y los Objetivos de Desarrollo Sostenible (ODS)

Geomorphology of Dra Abu el-Naga (Egypt): The basis of the funerary sacred landscape

A geological and geomorphological analysis has been performed in the necropolis of Dra Abu el-Naga in order to understand the role played by these two factors in the development of the sacred landscape. The investigation focuses upon two aspects of the development of the necropolis, the selection criteria for tomb location and the reconstruction of the ancient funerary landscape. Around 50 tombs were surveyed, analysing the characteristics of their host rock and classifying them according to a modified Rock Mass Rating Index, in order to understand how rock quality affected tomb construction. This analysis resulted in the definition of five rock-quality classes (I to V) from very good to very poor rock. The geological study also resulted in a proposed geological-geomorphological model for the evolution of this zone of the Theban necropolis that complements previous works by other authors. Due to the lack of precise dating evidence this chronology is a relative one and is based on the chronology given by other authors for similar deposits and events. Two catastrophic events, represented by mega-landslides, have been identified, the first one predates the deposition of early Pleistocene fluvial deposits, and the second one possibly occurred during the middle-late Pleistocene. Two weathering surfaces developed under wetter than present climatic conditions and have been tentatively correlated to the mid-late Pleistocene humid period and the African-Humid Period (early-mid Holocene).This work has been supported by the "Djehuty Association" led by Dr. José M. Galán