Efectos de un Programa de Ejercicios y Educación en Dolor mediante Tele-rehabilitación en la Calidad de Vida de Mujeres Jóvenes con Dismenorrea Primaria / Effects of an Exercise and Pain Education Program via Telerehabilitation on the Quality of Life of Young Women with Primary Dysmenorrhea

Introducción. La dismenorrea primaria afecta la calidad de vida de mujeres jóvenes. Este estudio investiga los efectos de un protocolo de ejercicios y educación en dolor mediante telerehabilitación. Objetivo. Determinar los efectos de un protocolo de ejercicios y educación en dolor y su impacto en la calidad de vida mediante tele-rehabilitación en mujeres jóvenes con dismenorrea primaria. Métodos. Se realizó un estudio experimental pre y post test con un grupo control, utilizando tele-rehabilitación. Participaron 21 mujeres jóvenes con dismenorrea primaria, asignadas aleatoriamente a dos grupos: el grupo experimental (10 mujeres) y el grupo control (11 mujeres). Se utilizaron cuestionarios específicos de calidad de vida relacionada con la menstruación y dolor (cuestionario breve de McGill) para evaluar los efectos del programa de ejercicios y educación en dolor. Resultados. En el grupo control, no se observaron diferencias significativas en las puntuaciones de calidad de vida relacionada con la menstruación ni en la intensidad del dolor antes y después de la intervención (p>0,05). En contraste, el grupo experimental experimentó mejoras significativas en ambas áreas después de la intervención (todos los p<0,001). Conclusiones. Este estudio demuestra que un protocolo de ejercicios y educación en dolor realizado mediante telerehabilitación tiene un impacto positivo y significativo en la calidad de vida y la intensidad del dolor percibido en mujeres jóvenes con dismenorrea primaria. Estos resultados sugieren que la telerehabilitación puede ser una estrategia efectiva para abordar este problema de salud en esta población.

Background. Primary dysmenorrhea impacts the quality of life of young women. This study investigates the effects of an exercise and pain education protocol through telerehabilitation. Objective: To determine the effects of an exercise and pain education protocol and its impact on the quality of life through telerehabilitation in young women with primary dysmenorrhea. Methods: A pre and post-test experimental study with a control group was conducted using telerehabilitation. Twenty-one young women with primary dysmenorrhea participated, randomly assigned to two groups: the experimental group (10 women) and the control group (11 women). Specific questionnaires related to menstruation-related quality of life and pain (McGill short-form questionnaire) were used to assess the effects of the exercise and pain education program. Results: In the control group, no significant differences were observed in menstruation-related quality of life scores or pain intensity before and after the intervention (p>0.05). In contrast, the experimental group experienced significant improvements in both areas after the intervention (all p<0.001). Conclusion: This study demonstrates that an exercise and pain education protocol conducted through telerehabilitation has a positive and significant impact on the perceived quality of life and pain intensity in young women with primary dysmenorrhea. These results suggest that telerehabilitation can be an effective strategy for addressing this health issue in this population.

Associations between vitamin D, immunoglobulin E concentrations, and obesity.

The prevalence of allergies and obesity has been increased in parallel. Low vitamin D [25(OH)D] levels have been linked to both higher body mass index (BMI) and allergies. Since the activation of the 25(OH)D receptor inhibits IgE production and 25(OH)D influences the IgE response specifically, we tested the hypothesis that circulating 25(OH)D concentrations are negatively related to circulating allergen-specific IgE concentrations distinctly in a large adult population-based study cohort. Moreover, we studied VDR gene expression in paired biopsies of abdominal subcutaneous (SAT) and visceral adipose tissue (VAT). We investigated whether magnetic resonance imaging-estimated visceral (VFM) and subcutaneous fat mass (SFM) are related to 25(OH)D levels. We found gender differences in circulating 25(OH)D and IgE concentrations. Participants with obesity showed lower 25(OH)D concentrations and higher IgE concentrations were detected in women only. Interestingly, participants with high levels of 25(OH)D are leaner and have improved glucose metabolism. In women, 25(OH)D correlate significant with VFM and SFM. VDR expression is significantly higher expressed in VAT and is positive associated with circulating 25(OH)D concentration. There was no association between serum IgE and 25(OH)D in the entire cohort. Based on these data, we could confirm that low levels of 25(OH)D are linked to higher BMI but could not prove our hypothesis because there is no relationship between 25(OH)D and IgE in adults. Women with higher BMI tend to have higher IgE levels what may have clinical relevance. The association between obesity and circulating 25(OH)D/IgE is not straightforward, and further knowledge is needed.

Phloem wedges in Malpighiaceae: origin, structure, diversification, and systematic relevance.

BACKGROUND: Phloem wedges furrowing the wood are one of the most notorious, widespread types of cambial variants in Angiosperms. Many lianas in Malpighiaceae show these variations in the arrangement of the secondary tissues. Here we explore their ontogeny, structure, and evolution in Malpighiaceae, where phloem wedges appeared multiple times, showing how they have contributed to the anatomical diversification of the family. Using a broad sampling with 143 species from 50 genera, covering all major lineages in Malpighiaceae, we crossed data from ontogeny, stem anatomy, and phylogenetic comparative methods to determine ontogenetic trajectories, final anatomical architectures, and evolution within the most recent phylogeny for the family. RESULTS: Phloem wedges appeared exclusively in lianas and disappeared in shrub lineages nested within liana lineages. At the onset of development, the vascular cambium is regular, producing secondary tissues homogeneously across its girth, but soon, portions of the cambium in between the leaf insertions switch their activity producing less wood and more phloem, initially generating phloem arcs, which progress into phloem wedges. In the formation of these wedges, two ontogenetic trajectories were found, one that maintains the continuity of the cambium, and another where the cambium gets dissected. Phloem wedges frequently remain as the main cambial variant in several lineages, while in others there are additional steps toward more complex cambial variants, such as fissured stems, or included phloem wedges, the latter a novel type of interxylary phloem first described for the family. CONCLUSIONS: Phloem wedges evolved exclusively in lianas, with two different ontogenies explaining the 10 independent origins of phloem wedges in Malpighiaceae. The presence of phloem wedges has favored the evolution of even more complex cambial variants such as fissured stems and interxylary phloem.

High-Intensity Interval Training as a Tool for Counteracting Dyslipidemia in Women.

Sedentary overweight or obese adult (age<60 years) women, allocated in type 2 diabetes mellitus (T2DM, n=13), dyslipidemia alone (DYS, n=12), dyslipidemia associated with hyperglycaemia (DYSHG, N=12), or healthy control (CON, n=10) groups, had their lipid, glucose, blood pressure, endurance performance, and anthropometry variables assessed before and after 16 weeks of a thrice-weekly high-intensity interval training (HIIT) program. Triglycerides reduced significantly (P<0.05) in all groups, and high-density lipoprotein increased (P<0.01) in T2DM, DYS and DYSHG; however, low-density lipoprotein reduced (P<0.05) only in DYSHG, and total cholesterol reduced (P<0.01) only in DYS and DYSHG. Fasting glucose reduced (P<0.05) significantly in T2DM, DYS and DYSHG, but with higher decreases in T2DM and DYSHG. Blood pressure, endurance performance and body composition improved (P<0.05) in all groups. The HIIT program was effective for restoring lipid profile of DYS and DYSHG, and fasting glucose of DYSHG to levels similar to those of CON, with a weekly time commitment 25% to 56% lower than the minimum recommended in current exercise guidelines. These findings suggest that HIIT may be a time-efficient intervention for counteracting dyslipidemia.

Association of Single-Nucleotide Polymorphisms in Immune-Related Genes with Development of Dengue Hemorrhagic Fever in a Mexican Population.

Single-nucleotide polymorphisms (SNPs) occurring in immune-related genes have been associated with risk or protection for development of dengue, depending on ethnicity. Here, we genotyped seven SNPs located in immune response-related genes to identify their association with severe forms of dengue in patients from an endemic region in Mexico. One hundred and thirty-eight patients with dengue fever (DF), thirty-one dengue hemorrhagic fever (DHF) patients, as well as 304 healthy donors were genotyped by using a TaqMan-based approach. SNP analysis, including rs1800629 (TNF), rs4804803 (CD209), rs2780831 (JAK1), rs1801274 (FCGR2A), rs231775 (CTLA4), rs12979860, and rs8099917 (IFNL3), was performed. The rs1800629 A-allele in the TNF gene was associated with an increased risk of DHF (OR = 3.4, CI = 1.235-9.284 p = 0.0212) whereas SNPs rs4804803, rs2780831, rs1801274, rs231775, rs12979860, and rs8099917 showed no association in this cohort. These results show that allelic variations in TNF can play an important role in the development of DHF. However, the lack of association between all remaining SNPs and DHF suggests that the genetic background might directly modify the role of these immune-related molecules, leading to the milder illness often observed in a Mexican population.

Expresión de mucinas: MUC1, MUC2, MUC5AC, MUC6, HGM y CD10 en carcinomas gástricos y lesiones pre-neoplasicas adyacentes / MUCIN EXPRESSION: MUC1, MUC2, MUC5AC, MUC6, HGM AND CD10 IN GASTRIC CARCINOMAS AND ADJACENT PRE-NEOPLASTIC LESIONS

Introducción: Las mucinas son glicoproteínas y desempeñan funciones biológicas. Diversas anormalidades genéticas y epgenéticas han sido descritas en el cáncer gástrico. El objetivo de la investigación fue observar la inmuno-expresión de mucinas en cánceres difusos e intestinales y las lesiones pre-neoplásicas limítrofes. Métodos: Se evaluaron 18 cánceres difusos (56.3%) y 14 intestinales (43.7%) y las lesiones precursoras adyacentes al cáncer gástrico. Se realizó inmunohistoquímica para los siguientes marcadores: MUC-1, MUC-2, MUC5-AC, MUC-6, HGM y CD10. Resultados: La inmune-expresiones fue: MUC-1 (54.5%), de los cánceres intestinales y (45.5%) de los cánceres difusos. MUC-2 (50%) de los cánceres difusos y (50%) de los cánceres del tipo intestinal. MUC-5AC (39.3%) del tipo difuso (60.7%) del tipo intestinal. HGM (37.5%) del tipo intestinal y (62.5%) del tipo difuso. MUC-6 (57.9%) del tipo difuso (42.1%) los del tipo intestinal. CD10 (55.6%) del tipo intestinal, y (44.4%) en los difusos.En las lesiones pre- cursoras adyacentes al cáncer gástrico la MUC-1 se inmunoexpresa en metaplasia intestinal (9.7%). MUC-2 (83.9%) en metaplasia intestinal. MUC5-AC (90,6%) en foveolas MUC-6 (100%) positiva en glándulas. CD10 (54.8%) positiva en metaplasia intestinal.HGM (75%) en foveolas y el (64.5%) en metaplasia intestinal. MUC-6 (100%) en glándulas profundas y (64,5%) en metaplasia intestinal. Las dis- plasias expresaron MUC-2 y MUC-5AC, en el 80% y 100% respectivamente. Conclusiones: La inmunotipificación del cáncer gástrico permitirá una clasificación más exacta de los tumores asi como la identificación de posibles dianas terapéuticas y su relación con factores genético y epigeneticos.

Introduction: Mucins are glycoproteins and has diverse biological roles. Epi-genetic abnormalities have been described in gastric cancer. The aim of the research was evaluate immunoexpression of mucins in diffuse and intestinal cancers and pre-neoplastic lesions. Methods: We evaluated 18 diffuse cancers (56.3%) and 14 intestinal (43.7%) and adjacent precursor lesions to gastric cancer immunohistochemical markers used was MUC-1, MUC-2-AC MUC5, MUC-6, and CD10 HGM. Results: The immuno-expression was: MUC-1 (54.5%), and intestinal cancers (45.5%) diffuse cancers. MUC-2 (50%) and diffuse cancers (50%) of cancers of the intestinal type. MUC-5AC (39.3%) diffuse type (60.7%) of intestinal type.HGM (37.5%) intestinal type (62.5%) in diffuse type. MUC-6 (57.9%) diffuse type (42.1%) in the intestinal type. CD10 (55.6%) in intestinal type, and (44.4%) in the diffuse type In adjacent precursor lesions to gastric cancer we observed MUC-1 in intestinal metaplasia (9.7%). MUC-2 (83.9%) in intestinal metaplasia. MUC5-AC (90.6%) in foveolasMUC-6 (100%) positive glands. CD10 (54.8%) positive in intestinal.HGM metaplasia(75%) and in foveolae (64.5%) in metaplasia intestinal. MUC-6 (100%) deep glands (64.5%) in metaplasia.intestinal. Dys- plasias expressed MUC-2 and MUC-5AC, 80% and 100% respectively. Conclusions: The gastric cancer immunotyping allow more accurate classification of tumors and the identification of potential therapeutic targets and its relationship with genetic and epigenetic factors.

High-speed resistance training is more effective than low-speed resistance training to increase functional capacity and muscle performance in older women.

OBJECTIVE: To examine the effects of 12 weeks of high-speed resistance training (RT) versus low-speed RT on muscle strength [one repetition of maximum leg-press (1RMLP) and bench-press (1RMBP), plus dominant (HGd) and non-dominant maximum isometric handgrip], power [counter-movement jump (CMJ), ball throwing (BT) and 10-m walking sprint (S10)], functional performance [8-foot up-and-go test (UG) and sit-to-stand test (STS)], and perceived quality of life in older women. METHODS: 45 older women were divided into a high-speed RT group [EG, n=15, age=66.3±3.7y], a low-speed RT group [SG, n=15, age=68.7±6.4y] and a control group [CG, n=15, age=66.7±4.9y]. The SG and EG were submitted to a similar 12-week RT program [3 sets of 8 reps at 40-75% of the one-repetition maximum (1

Efficient recycling of a chiral palladium catalytic system for asymmetric allylic substitutions in ionic liquid.

Chiral carbohydrate-based diphosphites were used for Pd-catalysed asymmetric allylic substitution (alkylation, amination, phosphination) in neat ionic liquids (ILs). Pyrrolidinium-based IL led to the best activities, allowing an efficient catalyst immobilization. In the allylic amination (TOF > 3100 h(-1)), the catalyst could be recycled nine times preserving both activity and enantioselectivity.

Soy isoflavones versus placebo in the treatment of climacteric vasomotor symptoms: systematic review and meta-analysis.

OBJECTIVE: The incidence of vasomotor crises during the climacterium varies in women across different populations, and phytoestrogen consumption seems to play an important role in this problem. The aim of this study was to determine whether intervention with soy (dietary, extract, or concentrate), as compared with placebo, reduces the incidence of hot flashes in climacteric women. METHODS: Only published, randomized, placebo-controlled clinical trials were selected, with a 12-week duration of intervention, having selected postmenopausal women affected with hot flashes attributed to the climacterium (without cancer background). The intervention to be evaluated was soy, as "soy dietary supplement," "soy extract," or "isoflavone concentrate" (genistein or daidzein). The results were expressed as the number of hot flashes, average score of vasomotor symptoms, or average percent reduction in hot flashes within a time unit (day, week, or month). RESULTS: Nineteen studies were analyzed. The minimum heterogeneity was observed in the "isoflavone concentrate" group. In the "extract" and "dietary supplement" groups, heterogeneity reached an intermediate level, I(2) = 42% and 59.73%, respectively. The overall result showed a standardized mean difference of -0.39 (95% CI, -0.53 to -0.25) in favor of soy as well as -0.45 (95% CI, -0.64 to -0.25), -0.51 (95% CI, -0.79 to -0.22), and -0.20 (95% CI, -0.46 to -0.06) for the "concentrate," "extract," and "dietary supplement" subgroups, respectively. CONCLUSIONS: Although the overall combined results and the results by subgroups (according to the type of supplement used) showed a significant tendency in favor of soy, it is still difficult to establish conclusive results given the high heterogeneity found in the studies.

A nebulin ruler does not dictate thin filament lengths.

To generate force, striated muscle requires overlap between uniform-length actin and myosin filaments. The hypothesis that a nebulin ruler mechanism specifies thin filament lengths by targeting where tropomodulin (Tmod) caps the slow-growing, pointed end has not been rigorously tested. Using fluorescent microscopy and quantitative image analysis, we found that nebulin extended 1.01-1.03 mum from the Z-line, but Tmod localized 1.13-1.31 mum from the Z-line, in seven different rabbit skeletal muscles. Because nebulin does not extend to the thin filament pointed ends, it can neither target Tmod capping nor specify thin filament lengths. We found instead a strong correspondence between thin filament lengths and titin isoform sizes for each muscle. Our results suggest the existence of a mechanism whereby nebulin specifies the minimum thin filament length and sarcomere length regulates and coordinates pointed-end dynamics to maintain the relative overlap of the thin and thick filaments during myofibril assembly.

An outstanding palladium system containing a C2-symmetrical phosphite ligand for enantioselective allylic substitution processes.

The use of efficient Pd systems bearing C(2)-symmetric chiral diphosphite ligands derived from carbohydrates in asymmetric allylic substitution reactions is described here, reaching TOFs > 22 000 h(-1) in allylic alkylation and ca. 400 h(-1) in allylic amination, giving excellent enantioselectivities (ee > 99%) and kinetic resolution of the racemic substrate.

Metabolismo mineral óseo durante la gestación y efectos sobre la masa ósea de la madre / Bone mineral metabolism during gestation and its effects on maternal bone mass

La gestación y lactancia son periodos de alta demanda de calcio, para el crecimiento fetal y para la producción de leche materna. Durante la gestación, la madre transfiere al feto 25 a 30 g de calcio y durante la lactancia se secretan 200 a 240 mg de calcio diario en la leche materna. Durante la gestación, los mecanismos adaptativos más importantes son el incremento en la absorción de calcio y el incremento del recambio óseo materno; durante la lactancia, hay tendencia a conservar más calcio a nivel renal, pero la desmineralización temporal del esqueleto materno parece ser el mecanismo más importante. Los estudios que emplean absorciometría dual de rayos X (DXA) son escasos, por el riesgo de radiación materna y fetal; pero, con otras técnicas, como el ultrasonido cuantitativo, se ha descrito una pérdida de masa ósea durante la gestación predominantemente dependiente del hueso trabecular. Mediante marcadores bioquímicos del remodelamiento óseo se ha demostrado que los suplementos de calcio reducen la tasa de remodelamiento durante el embarazo y parecen tener efecto benéfico sobre la pérdida ósea materna. Estudios longitudinales que emplean ultrasonido cuantitativo también han encontrado una disminución de la pérdida ósea, entre las mujeres que recibieron aporte o suplemento adecuado de calcio durante la gestación.

Pregnancy and lactation are periods of high calcium demand for skeletal growth and maternal milk production. Approximately 25-30 g of calcium are transferred to the fetus during pregnancy, and breast-feeding mothers secrete 200-240 mg/day of calcium in breast milk every day. During pregnancy, major physiologic adaptations include increased both calcium intestinal absorption and rate of maternal bone turnover; during lactation, there is a contribution of renal calcium conservation, but temporary maternal bone demineralization is the main mechanism to meet calcium requirements. Data on bone mineral density assessed by dual energy x-ray absortiometry (DXA) are sparse mainly due to concern about potential risk of radiation exposure to the fetus. Other radiation-free techniques like quantitative ultrasound have been used to assess maternal bone mass changes during pregnancy. Maternal bone loss mainly depending on trabecular areas during pregnancy has been described. Calcium supplements reduce maternal skeletal-bone turnover as evaluated by bone resorption markers during pregnancy and seem to have beneficial effects on maternal bone loss. Longitudinal studies with repeated measurements of quantitative ultrasound during pregnancy have found decrease in bone loss in pregnant women with adequate calciumin take or supplementation.

Age at menopause in Latin America.

OBJECTIVE: To assess the age at menopause (AM) in Latin America urban areas. DESIGN: A total of 17,150 healthy women, aged 40 to 59 years, accompanying patients to healthcare centers in 47 cities of 15 Latin American countries, were surveyed regarding their age, educational level, healthcare coverage, history of gynecological surgery, smoking habit, presence of menses, and the use of contraception or hormone therapy at menopause. The AM was calculated using logit analysis. RESULTS: The mean age of the entire sample was 49.4 +/- 5.5 years. Mean educational level was 9.9 +/- 4.5 years, and the use of hormone therapy and oral contraception was 22.1% and 7.9%, respectively. The median AM of women in all centers was 48.6 years, ranging from 43.8 years in Asuncion (Paraguay) to 53 years in Cartagena de Indias (Colombia). Logistic regression analysis determined that women aged 49 living in cities at 2,000 meters or more above sea level (OR = 2.0, 95% CI: 1.4-2.9, P < 0.001) and those with lower educational level (OR = 1.9, 95% CI: 1.3-2.8, P < 0.001) or living in countries with low gross national product (OR = 2.1, 95% CI: 1.5-2.9, P < 0.001) were more prone to an earlier onset of menopause. CONCLUSIONS: The AM varies widely in Latin America. Lower income and related poverty conditions influence the onset of menopause.

Laparoscopía y dolor pélvico crónico / Laparoscopy and chronic pelvic pain

Se presenta un estudio de 96 pacientes sometidos a laparoscopía ginecológica en la Clínica San Pablo y Hospital Vitarte, EsSalud, en Lima Perú, por dolor pélvico crónico, quienes no respondieron al tratamiento médico, evaluándose la eficacia de esta metodología, la cual demuestra su aceptabilidad y confiabilidad.