Autopercepción de la imagen corporal en la obesidad infantojuvenil

La obesidad infantil es la nueva epidemia del siglo XXI en los países industrializados. La dieta inadecuada y el sedentarismo, el consumismo, y en general, unos hábitos de vida poco saludables se han convertido en el compañero de vida de muchas familias españolas. Además de los conocidos problemas físicos que la obesidad acarrea, ¿Cómo afecta en los niños un exceso de grasa corporal?, ¿Cómo se ven a sí mismos? y no menos importante ¿Cómo influye esto en sus relaciones interpersonales y en su vida social? Con este trabajo pretendemos estudiar cómo este problema tan frecuente, afecta al concepto que los niños tienen sobre sí mismos. Para ello, se ha utilizado la escala de Piers Harris normalizada para población española en un grupo de 70 niños (31 niños en normopeso y 39 niños con obesidad). Esta encuesta consta de 80 preguntas y su resultado nos aproxima a la visión que los niños tienen sobre sí mismos, tanto de manera global como específica, en las áreas de: conducta, estatus intelectual, apariencia física, ansiedad, popularidad y felicidad y satisfacción. Con los resultados obtenidos, que muestran una evidente baja estima en los niños obesos, con respecto a los niños con normopeso, pretendemos ir más allá de los datos que nos ofrecen la balanza y el tallímetro. Se realiza un intento, sin quitar importancia a las consecuencias físicas de la obesidad, para destacar las áreas psíquica y mental, subrayando la importancia que tiene la visión y el abordaje del niño en su conjunto.Grado en Medicin

Estrategias metodológicas enfocadas a la mejora del aprendizaje en estudiantes con diversidad

Diseño y desarrollo de estrategias metodológicas que faciliten el aprendizaje de los estudiantes en general y que permitan a los estudiantes con diversidad funcional la integración y participación en el proceso de aprendizaje, que refuercen su inclusión y que favorezcan la adquisición de competencias

Analysis and evaluation of the cost of the treatment anti-TNFα in rheumatoid arthritis and ankylosing spondylitis. Individualised front marketed dose

Objective: to assess the cost of different biological therapies through the analysis of the theoretical and actual annual costs in routine clinical practice. Materials and method: retrospective observational study in patients with rheumatoid arthritis (RA) or spondylitis (AS) who initiated treatment with any of the available anti-TNF-α may of 2013 to September 2015. The average annual cost per patient depending on the treatment and pathology analyzed. Results: 94 pharmaceutical records of patients with rheumatologic disease diagnosed were analyzed [49 (52.1%)] AR and 45 (47.9%) EA]. Treatment received during the period of study: patients with RA (49.0% adalimumab, 44.9% etanercept, 6.1% infliximab); patients with AD (44.4% adalimumab, 37.8% etanercept, 17.8% infliximab). The average annual cost per patient was €12.009,3. There were no differences in annual costs among the different treatments for RA [(11.977,8 € adalimumab, 11.015,2 € etanercept, 10.717,8 € infliximab; p>0,05), while in the case of the EA etanercept turned out to be the lowest cost treatment [(12.231,49 € adalimumab, 12.088,2 € etanercept, 14.598,7 € infliximab; p<0.05).]] Conclusions: the choice of etanercept appears to contribute to lower pharmaceutical spending in our environment. Would be necessary an optimization in the management of our patients to achieve a better adjustment of doses that allowed optimize the expenditure pharmaceutica

Germline Mutations in FAN1 Cause Hereditary Colorectal Cancer by Impairing DNA Repair

Identification of genes associated with hereditary cancers facilitates management of patients with family histories of cancer. We performed exome sequencing of DNA from 3 individuals from a family with colorectal cancer who met the Amsterdam criteria for risk of hereditary nonpolyposis colorectal cancer. These individuals had mismatch repair-proficient tumors and each carried nonsense variant in the FANCD2/FANCI-associated nuclease 1 gene (FAN1), which encodes a nuclease involved in DNA inter-strand cross-link repair. We sequenced FAN1 in 176 additional families with histories of colorectal cancer and performed in vitro functional analyses of the mutant forms of FAN1 identified. We detected FAN1 mutations in approximately 3% of families who met the Amsterdam criteria and had mismatch repair-proficient cancers with no previously associated mutations. These findings link colorectal cancer predisposition to the Fanconi anemia DNA repair pathway, supporting the connection between genome integrity and cancer risk

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Immediate Effects of TECAR Therapy on Gastrocnemius and Quadriceps Muscles with Spastic Hypertonia in Chronic Stroke Survivors: A Randomized Controlled Trial

Background: The aim of this study was to assess changes in muscle properties after a single session of capacitive and resistive energetic transfer (TECAR) therapy on spastic gastrocnemius and quadriceps muscles in chronic post-stroke. Methods: A total of 36 chronic stroke survivors with lower limb hypertonia were enrolled in a double-blind randomized controlled trial. The experimental group (n = 18) received a single 30 min session of TECAR therapy in combination with functional massage (FM) on the gastrocnemius and quadriceps muscles. The control group (n = 18) received a sham treatment of TECAR therapy (without electrical stimulation) in combination with real FM. The primary outcome was muscle tone of the lower limb muscles assessed with the Modified Ashworth Scale (MAS). The secondary outcomes were goniometric degrees of the MAS (goniometer), neuromuscular properties of the gastrocnemius/quadriceps (myotonometer), and passive range of motion (inclinometer). All measurements were performed at baseline (T0), immediately after treatment (T1), and at 30 min post-treatment (T2) by a blinded assessor. Results: The MAS score ankle dorsiflexion significantly decreased at T0–T1 (p = 0.046), and the change was maintained at T0–T2 (p = 0.019) in the experimental group. Significant improvements were noted in the passive range of motion for knee flexion (p = 0.012) and ankle dorsiflexion (p = 0.034) at T2. In addition, knee flexion improved at T1 (p = 0.019). Conclusion: A single session of Tecar therapy at the same time with FM on the gastrocnemius and rectus femoris immediately reduces muscle tone and increases the passive range of motion of both ankle and knee in chronic stroke survivors. There were no significant changes in the neuromuscular properties measured with myotonometer

The Immediate Effect of Informational Manual Therapy for Improving Quiet Standing and Bodily Pain in University Population

Background: The Informational Manual Therapy (IMT) is a therapeutic touch. This study aims to assess the effect of IMT on quiet standing, pain and health status in university population. Methods: An experiment was conducted on subjects utilizing a comparative paired analysis both before and after the intervention. One IMT session was performed on 57 healthy individuals aged from 18 to 65 years. The primary outcome was quiet standing assessed by the Satel 40 Hz stabilometric force platform. Secondary outcomes were bodily pain assessed by the 36-Item Short Form Survey (SF-36) and health status by EQ-5D-3L. The primary outcome was evaluated before and immediately after treatment. Results: The individuals were divided into 3 age groups, 18–35 (52.6%), 35–50 (29.8%) and 51–65 (17.6%). Statistically significant differences were immediately observed after the session ended when comparing the pre-post quiet stance scores in a number of length parameters: L, Lx, Ly and stabilometry amplitude on Y-axis with eyes open and closed. Significant differences were also found when testing bodily pain (SF-36) and anxiety (5Q-5D-3L). Conclusion: One session of IMT produced positive effects when testing quiet standing with eyes open and eyes closed, as well as a significant reduction in pain and anxiety for those tested. Further research is suggested