Riesgo de lesión del ligamento cruzado anterior en fútbol femenino: valoración funcional y mecánicas de aterrizaje

The risk of anterior cross ligament injury is multifactorial and numerous tests have been used to locate possible factors that increase the risk of injury. The objective of the present study was to describe the functional and mechanical deficits of injury risk for the anterior cross ligament (ACL) in semi-professional soccer players, as well as to correlate the risk of injury of women players through a functional test and another of ability. In this case study, 17 women's football players from the First Autonomous and Preferential Autonomous Women of the F.C. Cartagena SAD Females with age range from 14 to 23 years (mean age 17.05 ± 3.24 years) participated. A normal training day was used to perform the following tests: Over Head Squat and Tuck Jump. The outstanding results were that most players showed average risk of functional test injury, on the other hand, no significant associations were shown between Overhead Squat test (OHS) and Tuck Jump tests. Therefore, it is recommended to continue with this line of research in order to detect a possible system of optimal tests to identify the risk of injury of the ACL individually in soccer players. And so, offer coaches the possibility to prescribe individualized work to keep each player away from the LCA injury.El riesgo de lesión del ligamento cruzado anterior es multifactorial y son numerosas las pruebas que han ido utilizando para localizar posibles factores que incrementen el riesgo de lesión. El objetivo del presente estudio fue describir los déficits funcionales y las mecánicas del riesgo lesional para el ligamento cruzado anterior (LCA) en jugadoras de fútbol de categoría semiprofesionales, así como correlacionar el riesgo de lesión de las jugadoras a través de una prueba funcional y otra de habilidad. En este estudio de caso participaron 17 jugadoras de fútbol femenino de categoría Primera Autonómica y Preferente Autonómica Femenina de un club de fútbol con rango de edad de 14 a 23 años (edad media 17,05±3,24 años). Se utilizó un día de entrenamiento normal para realizar las siguientes pruebas: Over Head Squat y Tuck Jump. Los resultados destacados fueron que la mayoría de jugadoras mostraron riesgo medio de lesión en la prueba funcional, por otro lado, no se mostraron asociaciones significativas entre las pruebas de Overhead Squat test (OHS) y Tuck Jump. Por tanto, se recomienda continuar con esta línea de investigación con la finalidad de detectar un posible sistema de pruebas óptimo para identificar el riesgo de lesión del LCA de forma individual en jugadoras de fútbol, y de este modo, ofrecer a los entrenadores la posibilidad de prescribir trabajo individualizado para alejar a cada jugadora de la lesión del LCA

Formulación y validación de la pulpa de café ensilada con lactofermentos, para la preparación de complemento alimenticio para porcinos

In the research “Development and validation of pulp ensiled coffee lacto ferments as a dietary supplement for swine,” was proposed to evaluate coffee pulp silage as a non-traditional food in the process of feeding swine, assessing the level of consumption and acceptability of the product combined with commercial food for animals. The pilot phase was conducted at the farm located in the community El Naranjo in the department of Estelí with four female swine of the race “casco de mula” in the fattening phase. It was determined that you can use coffee pulp silage to supplement pig food, the digestibility was evident to a value greater than 70%. Similarly it could corroborate that it can not fulfill the nutritional demands that the commercial food for animals brings in the fattening stage, so it is recommended as a dietary supplement by up to 15% with commercial food for swine. The production cost of one quintal of pulp ensiled coffee is 272.7 net córdobas being this less than one quintal of food for animals, which costs C$600.00 córdobas, giving coffee producers an alternative to process coffee pulp by silage and provide it as a dietary supplement for those who have farms raising swine or people who want to try to feed swine with nutrional supplement cheaper than the commercial food.En la investigación “Formulación y validación de la pulpa de café ensilada con lacto fermentos para la preparación de un complemento alimenticio para porcinos”, se planteó evaluar la pulpa de café ensilada como un alimento no tradicional en el proceso de alimentación de porcinos, valorando el nivel de consumo y aceptabilidad del producto combinado con concentrado comercial. La fase experimental se realizó en la granja ubicada en la comunidad el Naranjo del Departamento de Estelí, con cuatro cerdos de raza criolla ¨casco de mula¨ y sexo hembras en la etapa de engorde. Se pudo determinar que se puede utilizar pulpa de café ensilada como complemento a la alimentación de cerdos, cuya digestibilidad se evidencio en un valor mayor al 70$600.00 córdobas, teniendo los productores de café una alternativa para procesar la pulpa de café mediante el ensilaje y brindarla como complemento alimenticio para aquellas fincas que tengan crianza de cerdos o las personas que desean intentar alimentar a cerdos con complementos alimenticios más baratos que el concentrado comercial

Implementación del Trabajo Fin de Grado del Grado en Medicina

Memoria ID-0283. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2014-2015

Interaction of prion protein with acetylcholinesterase: potential pathobiological implications in prion diseases

The prion protein (PrP) binds to various molecular partners, but little is known about their potential impact on the pathogenesis of prion diseases. Here, we show that PrP can interact in vitro with acetylcholinesterase (AChE), a key protein of the cholinergic system in neural and non-neural tissues. This heterologous association induced aggregation of monomeric PrP and modified the structural properties of PrP amyloid fibrils. Following its recruitment into PrP fibrils, AChE loses its enzymatic activity and enhances PrP-mediated cytotoxicity. Using several truncated PrP variants and specific tight-binding AChE inhibitors (AChEis), we then demonstrate that the PrP-AChE interaction requires two mutually exclusive sub-sites in PrP N-terminal domain and an aromatic-rich region at the entrance of AChE active center gorge. We show that AChEis that target this site impair PrP-AChE complex formation and also limit the accumulation of pathological prion protein (PrPSc) in prion-infected cell cultures. Furthermore, reduction of AChE levels in prion-infected heterozygous AChE knock-out mice leads to slightly but significantly prolonged incubation time. Finally, we found that AChE levels were altered in prion-infected cells and tissues, suggesting that AChE might be directly associated with abnormal PrP. Our results indicate that AChE deserves consideration as a new actor in expanding pathologically relevant PrP morphotypes and as a therapeutic target

Efficacy of a mental health app intervention on family members of OCD patients

INTRODUCION. Obsessive-compulsive disorder (OCD) has a high cost for families, who frequently take part in compulsions, reassure patients, assume part of their responsibilities, try to conceal the disorder, and show stigmatizing attitudes (Ociskova et al., 2013; Stengler-Wenzke et al., 2004). esTOCma is a gamified mental health mobile application (app) that offers information about OCD, suggests where to find help, and helps fight stigmatizing attitudes. The objective of this study is to test esTOCma efficacy in a sample of OCD family members. Specifically, we will analyze if, after using the app, there is a change in the following variables: mental health literacy about OCD, stigma and social distance associated with OCD, intention to seek help when having OCD. Furthermore, we will test families’ satisfaction with the app. METHOD. Participants were extracted from a total of 296 users who downloaded the app for free from Google Play Store or Apple’s App Store and identified themselves as a family member of a person diagnosed with OCD. From the initial sample, participants who used the app until completion and completed a pre- and post-intervention assessment were selected. The final sample comprised 109 participants of a mean age of 46.03 years old (SD=14.42; range 18-73), 69.7 % women. Participants completed the following measures in the app before and after the intervention: (1) mental health literacy about OCD (MHL) (7 items); (2) Attribution Questionnaire (AQ-27-E); (3) Social Distance Scale (SDS); (4) General Help-Seeking Questionnaire (GHSQ); (5) satisfaction with the app (3 items). RESULTS. On average, it took 20.61 days (SD=18.05) to complete the app. After intervention, participants showed significant changes with moderate to low effect sizes in the variables of interest. Specifically, after using the app, participants showed higher scores in mental health literacy about OCD (t (108) = -3.768, p= < .001, Cohen’s d= 0.389), lower stigma in the AQ-27-E total score (t (108) = -6.484, p= < .001, Cohen’s d= 0.50) and subscales, a lower desire for social distance (t (108) = 5.569, p= < .001, Cohen’s d= 0.618); and greater intention to seek treatment in case of OCD symptoms (t (108) = -5.194, p= < .001, Cohen’s d= 0.553). Most of them (88%) would recommend the app to a friend, appraised what they had learned using the app (96.3%) and stated that the app was very helpful (88.1%). DISCUSSION. Results show that the app is satisfactory and beneficial for family members of OCD patients as it significantly increased their knowledge about the disorder and dismissed stigmatizing beliefs about OCD. Accordingly, esTOCma could help families understand their relatives, obtain guidance to deal with their symptoms and help family members get efficacious treatment. Future studies should analyze strategies to improve the app to make it more attractive and facilitate continued use.RTI2018-098349-B-I0

esTOCma, an app developed to dismiss self-stigma and increase mental health literacy about obsessive-compulsive disorder: how does it perform in a clinical sample?

Introduction. Obsessive-compulsive disorder (OCD) is a disabling condition that can be treated successfully. However, individuals with OCD often fail to seek or delay seeking treatment. In order to overcome this gap and increase the intention to seek for help, a gamified mental health mobile application (app) called esTOCma has been developed with a focus on offering information about OCD and on discussing stigmatizing attitudes toward the disease. The general aim of this study is to analyze the impact of the intervention through esTOCma in a clinical OCD sample. The objective of the study was two-fold. First, to analyze if the intervention changes the following variables in a clinical OCD sample: (1) knowledge about OCD; (2) internalized stigma, guilt, empowerment; and (3) obsessive-compulsive symptoms. Second, to explore satisfaction with the app. Method. Participants were extracted from a total of 330 people who downloaded the app for free and identified themselves as being diagnosed with OCD. From the initial sample, only participants who played till the game was finished and completed a pre- and post-intervention assessment were selected. The final sample comprised 126 (37.4%) participants diagnosed with OCD (mean duration of the disorder 11.56 years; SD=9.73; range 1-45 years). Their mean age was 39.31 years (SD= 39.31; range 18-66), and half of them were women (51.6%). 98.3% had previously asked for help for a mental health problem, and 35.3% belonged to an OCD association. Pre- and post-intervention measures included: (1) mental health literacy about OCD (MHL); (2) the Internalized Stigma of Mental Illness (ISMI); (3) guilt about having OCD (1 item); (4) feeling of empowerment (1 item); (5) Obsessive-Compulsive Inventory-Revised (OCI-R); (6) satisfaction with the app (2 items). Results showed that the intervention produced significant but small effect size changes on the measured variables. After using the app, patients showed higher mental health literacy (t(125)= -3.998, p < .0001; Cohen’s d= .398); lower internalized stigma (t (125)= 3.517, p≤0.001, Cohen’s d=0.312); less guilt associated with OCD (t(125)= 3.592, p< .0001; Cohen’s d=0.265); greater empowerment (t(125)= 3,261, p= .001; Cohen’s d=0.429); and less distress associated with obsessive-compulsive symptoms (t(125)= 3.110, p=.002, Cohen’s d=0.122). Finally, 91.3% (n=115) found the app helpful, and 84.9% (n=107) would recommend it to a friend. Discussion. Results show that the intervention produced significant changes on the variables of interest and that most patients were satisfied with the app. Effect sizes were small, probably due to the fact that patients had already asked for help and had been or were undergoing treatment. Furthermore, a high percentage belonged to OCD associations. Thus, it is expected that participants with these characteristics had prior basic knowledge of OCD and lower stigma than people who have had no prior contact with mental health services.RTI2018-098349-B-I0

HIV/antiretroviral therapy–related lipodystrophy syndrome (HALS) is associated with higher RBP4 and lower omentin in plasma

AbstractVery little information is available on the involvement of newly characterized adipokines in human immunodeficiency virus (HIV)/antiretroviral therapy (ART)-associated lipodystrophy syndrome (HALS). Our aim was to determine whether apelin, apelin receptor, omentin, RBP4, vaspin and visfatin genetic variants and plasma levels are associated with HALS. We performed a cross-sectional multicentre study that involved 558 HIV type 1–infected patients treated with a stable highly active ART regimen, 240 of which had overt HALS and 318 who did not have HALS. Epidemiologic and clinical variables were determined. Polymorphisms in the apelin, omentin, RBP4, vaspin and visfatin genes were assessed by genotyping. Plasma apelin, apelin receptor, omentin, RBP4, vaspin and visfatin levels were determined by enzyme-linked immunosorbent assay in 163 patients (81 with HALS and 82 without HALS) from whom stored plasma samples were available. Student's t test, one-way ANOVA, chi-square test, Pearson and Spearman correlations and linear regression analysis were used for statistical analyses. There were no associations between the different polymorphisms assessed and the HALS phenotype. Circulating RBP4 was significantly higher (p < 0.001) and plasma omentin was significantly lower (p 0.001) in patients with HALS compared to those without HALS; differences in plasma levels of the remaining adipokines were nonsignificant between groups. Circulating RBP4 concentration was predicted independently by the presence of HALS. Apelin and apelin receptor levels were independently predicted by body mass index. Visfatin concentration was predicted independently by the presence of acquired immunodeficiency syndrome. HALS is associated with higher RBP4 and lower omentin in plasma. These two adipokines, particularly RBP4, may be a link between HIV/ART and fat redistribution syndromes

High-sensitivity troponin T: a potential safety predictive biomarker for discharge from the emergency department of patients with confirmed influenza

The purpose of the study was to analyze the relationship between the high-sensitivity troponin T levels in patients with confirmed influenza virus infection and its severity determined by mortality during the care process. In addition, a high-sensitivity troponin T cut-off value was sought to allow us to a safe discharge from the emergency department. An analytical retrospective observational study was designed in which high-sensitivity troponin T is determined as an exposure factor, patients are followed until the resolution of the clinical picture, and the frequency of mortality is analyzed. We included patients ? 16 years old with confirmed influenza virus infection and determination of high-sensitivity troponin T. One hundred twenty-eight patients were included (96.9% survivors, 3.1% deceased). Mean and median blood levels of high-sensitivity troponin T of survivors were 26.2 ± 58.3 ng/L and 14.5 ng/L (IQR 16 ng/L), respectively, and were statistically different when compared with those of the deceased patients, 120.5 ± 170.1 ng/L and 40.5 ng/L (IQR 266.5 ng/L), respectively, p = 0.012. The Youden index using mortality as the reference method was 0.76, and the cut-off value associated with this index was 24 ng/L (sensitivity 100%, specificity 76%, NPV 100%, PPV 4%) with AUC of 88,8% (95% CI: 79.8?92.2%), p < 0.001. We conclude that high-sensitivity troponin T levels in confirmed virus influenza infection are a good predictor of mortality in our population, and this predictor is useful for safely discharging patients from the emergency department

El valor de la simulación a través de juegos experimentales de aula: los recursos que cuestan poco y valen mucho

p. 763-778Hoy en día, la simulación clínica se ha incorporado tanto al entorno universitario (pregrado y postgrado) como a la formación continuada a nivel profesional. Este tipo de metodología educativa trata de introducir al estudiante en escenarios que imitan la realidad del entorno clínico, permitiéndoles adquirir destrezas y confianza en sí mismos (Astudillo-Araya et al., 2017; Urra-Medina, Sandoval-Barrientos, y Irribarren-Navarro, 2017), así como un afrontamiento positivo (Extremera-Pacheco, Durán-Durán, y Rey, 2007) antes de experimentar las situaciones reales. Responde a la necesidad de la Universidad de innovar en las metodologías activas (Robledo-Ramón, Fidalgo-Redondo, Arias-Gundín, y Álvarez-Fernández, 2015), y a la exigencia de una educación centrada en el aprendizaje por competencias, donde el estudiante es el objetivo de la formación (Astudillo-Araya et al., 2017; Miller et al., 2011), facilitándole un rol activo en el que sea protagonista de la construcción de su propio aprendizaje (López-Alonso, Fernández-Martínez, Liébana-Presa, Vázquez-Casares, y Castro-González, 2018). Su dificultad radica en que, para implementar este tipo de simulación son precisos recursos físicos a nivel de infraestructuras y equipamientos costosos (entornos y simuladores de alta fidelidad), y un soporte de personal técnico cualificado, además de la específica cualificación de los propios instructores o profesores (Urra-Medina et al., 2017). Al mismo tiempo, hay que reconocer que existen aspectos del cuidado integral, tales como las necesidades psicológicas, sociales, espirituales del cuidado de las personas enfermas y familias que las acompañan (Buceta-Toro et al., 2014), para los que este tipo de simulación ofrece ciertas limitaciones (Palés-Argullós y Gomar-Sancho, 2010). Este es el caso de la competencia de acompañar en el proceso de muerte física y proceso de duelo por las pérdidas que viven tanto el enfermo como la familia, e incluso el propio equipo de salud (Lopera-Betancur, 2015). En la asignatura de Cuidados Paliativos (C.P.) del Grado en Enfermería, los profesores, conocedores de estas metodologías de simulación, y comprometidos con la necesidad de buscar nuevas formas de motivación para los estudiantes (Miller et al., 2011), venimos investigando, y formándonos desde hace años (Trevitt, Brenan, y Stocks, 2012), buscando un modelo didáctico que incluya todos los beneficios de la simulación y que se pueda aplicar igualmente a los aspectos emocionales, sociales o espirituales de los cuidados (Aradilla-Herrero, Tomas-Sábado, y Gómez-Benito, 2013; March-Fernández, 2010). La propuesta de acción innovadora es utilizar el juego (Chacón, 2008)