Profiling and assessing the risks of image- and performance-enhancing drugs use during the COVID-19 lockdown.

Background: Image and Performance-Enhancing Drugs (IPEDs) can enhance mental and physical capabilities and impact one's overall health. Initially confined in sport environments, IPEDs use has become increasingly widespread in a high-performing society. The present study was aimed at profiling IPEDs use during the COVID-19 lockdown among an international sample of young adults. Methods: A cross-sectional observational study was carried out in eight countries (United Kingdom, Italy, Lithuania, Hungary, Portugal, Spain, Brazil, and Japan) between April and May 2020. The survey questionnaire included validated measurements such as Exercise Addiction Inventory (EAI), Appearance Anxiety Inventory (AAI), and Self-Compassion Scale (SCS) as well as questions about the type of IPEDs, purchasing methods and socio-demographic information. Results: A total of 736 IPEDs users were included in the survey. Their mean age was 33.05 years (±SD = 10.06), and 64.2% were female participants. Overall, 6.8% were found at risk of exercise addiction (EAI >24), 27.6% presented high levels of appearance anxiety, and 24.9% revealed low levels of emotional regulation's self-compassion. Most participants (55.6%) purchased IPEDs through pharmacies/specialized shops, while 41.3% purchased IPEDs on the Internet. Online IPEDs buyers were mainly men who had higher scores on the Exercise Addiction Inventory. One or more IPEDs classifiable as "potentially risky" were used by 66.3% of the sample. Users of "potentially risky IPEDs" were younger and primarily men. They showed higher scores both on the Exercise Addiction Inventory and Appearance Anxiety Inventory. Conclusion: This study profiled users of IPEDs when the most restrictive COVID-19 lockdown policies were implemented in all the participating countries. More targeted post-COVID 19 prevention strategies should be implemented according to the emerged socio-demographic and psychopathological traits and cross-cultural differences emerged. Longitudinal studies will also be needed to determine the long-term effect of the COVID-19 lockdown on IPEDs consumption.

Exercise and Use of Enhancement Drugs at the Time of the COVID-19 Pandemic: A Multicultural Study on Coping Strategies During Self-Isolation and Related Risks.

Introduction: Little is known about the impact of restrictive measures during the COVID-19 pandemic on self-image and engagement in exercise and other coping strategies alongside the use of image and performance-enhancing drugs (IPEDs) to boost performance and appearance. Objectives: To assess the role of anxiety about appearance and self-compassion on the practice of physical exercise and use of IPEDs during lockdown. Methods: An international online questionnaire was carried out using the Exercise Addiction Inventory (EAI), the Appearance Anxiety Inventory (AAI), and the Self-Compassion Scale (SCS) in addition to questions on the use of IPEDs. Results: The sample consisted of 3,161 (65% female) adults from Italy (41.1%), Spain (15.7%), the United Kingdom (UK) (12.0%), Lithuania (11.6%), Portugal (10.5%), Japan (5.5%), and Hungary (3.5%). The mean age was 35.05 years (SD = 12.10). Overall, 4.3% of the participants were found to engage in excessive or problematic exercise with peaks registered in the UK (11.0%) and Spain (5.4%). The sample reported the use of a wide range of drugs and medicines to boost image and performance (28%) and maintained use during the lockdown, mostly in Hungary (56.6%), Japan (46.8%), and the UK (33.8%), with 6.4% who started to use a new drug. Significant appearance anxiety levels were found across the sample, with 18.1% in Italy, 16.9% in Japan, and 16.7% in Portugal. Logistic regression models revealed a strong association between physical exercise and IPED use. Anxiety about appearance also significantly increased the probability of using IPEDs. However, self-compassion did not significantly predict such behavior. Anxiety about appearance and self-compassion were non-significant predictors associated with engaging in physical exercise. Discussion and Conclusion: This study identified risks of problematic exercising and appearance anxiety among the general population during the COVID-19 lockdown period across all the participating countries with significant gender differences. Such behaviors were positively associated with the unsupervised use of IPEDs, although no interaction between physical exercise and appearance anxiety was observed. Further considerations are needed to explore the impact of socially restrictive measures among vulnerable groups, and the implementation of more targeted responses.

Prognostic utility of electrocardiograms in patients with hypertension older than 65 years. The PAFRES study. / Utilidad pronóstica del electrocardiograma en pacientes hipertensos mayores de 65 años. Estudio FAPRES.

OBJECTIVE: Left ventricular hypertrophy is the most common marker of target organ damage in arterial hypertension. Electrocardiograms are typically performed to identify left ventricular hypertrophy. The aim of this study was to analyse the prognostic utility of other electrocardiographic abnormalities in patients with arterial hypertension, beyond ventricular hypertrophy. MATERIALS AND METHODS: The study included 1003 patients older than 65years with arterial hypertension. We recorded risk factors, previous cardiovascular history and medical treatment and analysed various electrocardiographic abnormalities including the Sokolow-Lyon index, the Cornell index, ventricular overload and branch blocks. The study conducted a 2-year follow-up, recording the major cardiovascular events (mortality, myocardial infarction, stroke and hospitalisation for heart failure). RESULTS: The study population's mean age was 72.9±5.8years, 47.5% of whom were men. During the follow-up, 13.9% of the patients experienced a major cardiovascular event. These patients were older, more often smokers and engaged in less physical exercise, without presenting differences in the antihypertensive therapy or blood pressure control. The ventricular overload pattern (HR: 1.93; 95%CI: 1.160-3.196; P=.011) and the complete left bundle branch block (HR: 2.27; 95%CI: 1.040-4.956; P=.040) behaved as independent electrocardiographic predictors of major cardiovascular events; however, left ventricular hypertrophy using the Sokolow and/or Cornell index did not behave as such. CONCLUSIONS: For patients with hypertension, the presence in the baseline electrocardiogram of complete left bundle branch block or a pattern of ventricular overload identifies a population at increased cardiovascular risk.

Eficacia del Programa de reducción de estrés basado en atención plena (REBAP) aplicado a familiares de jugadores patológicos / No disponible

La adicción al juego conlleva situaciones de estrés para quienes sufren este trastorno y su entorno social próximo. 33 familiares voluntarios de jugadores en rehabilitación participaron en una intervención grupal de autoayuda (GAA), tras la cual iniciaron un Programa de reducción de estrés basado en atención plena (REBAP), de ocho semanas. Sus niveles de estrés fueron evaluados antes y después de cada intervención y en tres seguimientos (1, 3 y 6 meses). Mientras que el GAA no reducía significativamente el estrés de los familiares, el protocolo REBAP producía cambios de gran magnitud (η2= 0,88) y conseguía disminuir el estrés, desde niveles inicialmente moderados a bajos. Los efectos se mantuvieron en los tres seguimientos, durante los cuales se observaron niveles elevados de práctica de atención plena. No obstante, en el seguimiento a los 6 meses se apreció una disminución de la práctica, lo cual sugeriría la necesidad de introducir sesiones de refuerzo. Los resultados muestran la utilidad del programa REBAP en la intervención con familiares de personas con adicción al juego

Gambling addiction may lead to stressful situations for the gambler and their proximal social environment. 33 close relatives of disordered gamblers volunteered to attend a self-help group; afterwards, they participated in the Mindfulness-Based Stress Reduction (MBSR) program for 8 weeks. The participants' perceived stress was assessed before and after each treatment condition, and at 1-month, 3-months, and 6-months follow-ups. Participating in the self-help group did not significantly reduce the stress levels of pathological gamblers' relatives, whereas the MBSR training produced changes of great magnitude (η2= 0.88), decreasing stress levels from initially moderate scores to low values. Changes in stress levels were maintained at low levels throughout follow-ups, with participants reporting overall strong engagement with the practice of mindfulness. However, a decrease in practice (number of individuals practicing, frequency and time of exercises) was observed at 6-months follow-up, which suggest that including sessions to strengthen practice could be advisable. The MBSR program may be a useful protocol to reduce stress in pathological gamblers' families

Análisis de las buenas prácticas de participación ciudadana en las unidades de gestión clínica del Servicio Andaluz de Salud / Analysis of good practices for inhabitant participation in the clinical management units of the Andalusian Health Service (Spain)

Objetivo: Conocer buenas prácticas de participación ciudadana en las unidades de gestión clínica (UGC) del Servicio Andaluz de Salud (SAS) y explorar factores percibidos por profesionales de UGC del SAS que pueden influir en la existencia y la distribución de buenas prácticas de participación ciudadana. Método: Estudio con metodología mixta realizado en Andalucía en dos fases (2013-2015). En la fase 1 (estudio cuantitativo) se realizó un cuestionario online a directores/as de UGC con una comisión de participación ciudadana constituida. En la fase 2 (estudio cualitativo) se realizaron entrevistas semiestructuradas a profesionales del SAS con experiencia en participación ciudadana. Se realizó un análisis descriptivo de la información cuantitativa y un análisis de contenido semántico de la cualitativa. Resultados: En la fase 1 participaron 530 UGC. Las prácticas de participación ciudadana implementadas con mayor frecuencia en las UGC están circunscritas a los niveles de información y consulta. Otras prácticas que suponen una mayor implicación y delegación ciudadana son secundarias. En la fase 2 se entrevistó a 12 profesionales. Los obstáculos identificados por los/las profesionales que pueden afectar a la distribución de buenas prácticas están relacionados con las creencias y las actitudes de la ciudadanía, los/las profesionales, el sistema sanitario y el contexto. Conclusiones: Las principales prácticas de participación ciudadana en las UGC están relacionadas con los niveles más básicos de participación. No se reconocen claramente la manera y los mecanismos que facilitarían el empoderamiento ciudadano en el sistema sanitario (AU)

Objective: To discover good practices for inhabitant participation in the clinical management units (CMUs) of the Andalusian Health Service (AHS) (Spain) and to explore the reasons perceived by CMU and AHS professionals that may influence the presence and distribution of those good practices among the CMU. Methods: Study with mixed methodology carried out in Andalusia (Spain) in two phases (2013-2015). Firstly, an online survey was delivered to the Directors of the CMUs which had set up an inhabitant participation commission. In a second phase, a qualitative study was carried out through semi-structured interviews with professionals from the Andalusian Health Service with previous experience in inhabitant participation. A descriptive analysis of the quantitative information and a semantic content analysis of the qualitative information were carried out. Results: 530 CMUs took part in the survey. The inhabitant participation practices more often implemented in the CMUs are those related to the informing and consultation levels. Twelve professionals were interviewed in the second phase. Other practices with higher inhabitant involvement and delegation are secondary. The barriers which were identified by professionals are related to the beliefs and attitudes of the inhabitants, the professionals, the health system and the environment. Conclusion: The main practices for inhabitant participation in the CMUs are related to the most basic levels of participation. The method and dynamics which facilitate inhabitant empowerment within the health system are not clearly recognized (AU)

[Analysis of good practices for inhabitant participation in the clinical management units of the Andalusian Health Service (Spain)]. / Análisis de las buenas prácticas de participación ciudadana en las unidades de gestión clínica del Servicio Andaluz de Salud.

OBJECTIVE: To discover good practices for inhabitant participation in the clinical management units (CMUs) of the Andalusian Health Service (AHS) (Spain) and to explore the reasons perceived by CMU and AHS professionals that may influence the presence and distribution of those good practices among the CMU. METHODS: Study with mixed methodology carried out in Andalusia (Spain) in two phases (2013-2015). Firstly, an online survey was delivered to the Directors of the CMUs which had set up an inhabitant participation commission. In a second phase, a qualitative study was carried out through semi-structured interviews with professionals from the Andalusian Health Service with previous experience in inhabitant participation. A descriptive analysis of the quantitative information and a semantic content analysis of the qualitative information were carried out. RESULTS: 530 CMUs took part in the survey. The inhabitant participation practices more often implemented in the CMUs are those related to the informing and consultation levels. Twelve professionals were interviewed in the second phase. Other practices with higher inhabitant involvement and delegation are secondary. The barriers which were identified by professionals are related to the beliefs and attitudes of the inhabitants, the professionals, the health system and the environment. CONCLUSION: The main practices for inhabitant participation in the CMUs are related to the most basic levels of participation. The method and dynamics which facilitate inhabitant empowerment within the health system are not clearly recognised.

Estudio de caso. Terapia del movimiento inducido por restricción en parálisis cerebral infantil / Case report. Constraint-induced movement therapy in childhood cerebral palsy

Introducción. El caso trata de una niña de 30 meses de edad diagnosticada de parálisis cerebral con hemiparesia espástica. La intervención desde atención temprana se fundamenta en la aplicación de un protocolo modificado de terapia del movimiento inducido en entornos naturales (hogar y colegio). Objetivos. El objetivo es mejorar el desempeño ocupacional e incrementar el uso voluntario de la mano parética en actividades bimanuales, basándose en la estimulación neurológica implícita en el aprendizaje motor. Resultados. Mejora del desempeño en actividades de la vida diaria. Se registraron ganancias a nivel emocional y actitudinal. AHA incrementa 7 puntos. PDMS-2 suma 2 puntos en visual motora y 2 puntos en edad equivalente. A nivel funcional se alcanzan ganancias en 8 de los 10 objetivos (Goal Attainment Scale). Los resultados obtenidos invitan a seguir investigando el potencial de esta herramienta en entornos naturales (AU)

Introduction. We report the case of a 30-month-old girl with unilateral spastic cerebral palsy (CP). Early Intervention was based on an eco-modified protocol of constraint-induced movement therapy (mCIMT). Objectives. The objectives were to improve occupational development and to increase spontaneous upper limb use during bimanual activities by means of neurological stimulation involved in the leaning of motor skills. Results. There was improvement in the development of activities of daily living, as well as emotional and attitudinal gains. An increment of 7 points was recorded in the assisting hand assessment (AHA). The Peabody developmental motor sclaes-2 (PDMS-2) increased 2 points in the visual motor (VM) subtest and another 2 points in equivalent age (EA). In functional goals, progress was achieved in 8 of the 10 objectives (Goal Attainment Scale). The results obtained encourage us to keep investigating the potential of this tool in natural environments (AU)

Genetic structure of a phytophagous mite species affected by crop practices: the case of Tetranychus urticae in clementine mandarins.

Tetranychus urticae Koch is a cosmopolitan mite considered as the most polyphagous species among spider mites. This mite is a key pest of clementine mandarins in Eastern Spain, where Spanish clementine production concentrates. Crop management practices can affect the population dynamics of this mite and, consequently, its impact on the orchard. Microsatellite markers were used to study mite population genetics from two commercial orchards which had been managed differently following Integrated Pest Management (IPM) or Organic Pest Management (OPM) schemes during four consecutive years. A multiplex system including 20 microsatellite loci was designed specifically and allowed an efficient and inexpensive genotyping of individual mites. We found that the IPM population had a stronger fluctuation of population structure and higher genetic diversity compared to OPM population. Thus, our study concludes that crop management has an impact on the population genetics of T. urticae which may be related to the alternation of some acaricides under IPM.

Bone scintigraphy and secondary osteomalacia due to nephrotoxicity in a chronic hepatitis B patient treated with tenofovir.

Tenofovir is a nucleotide analogue used for the treatment of chronic hepatitis B and HIV infection. The safety of tenofovir is high but it has been described that tenofovir produces tubular toxicity and Fanconi's syndrome in some HIV-infected patients. To our knowledge this is the first documented case of bone involvement in Fanconi's syndrome in a patient treated with tenofovir for chronic hepatitis B without HIV coinfection. Bone scintigraphy has proven to be very useful for the diagnosis of secondary osteomalacia. Normalization of the bone scan after the withdrawal of the drug and the decline in alkaline phosphatase and phosphate serum levels reinforce the cause-effect relationship.

Effects of exposure to food images on physiological reactivity and emotional responses in women with bulimia nervosa / Efecto de la exposición a imágenes de comida sobre la reactividad psicofisiológica y las reacciones emocionales en mujeres con bulimia nerviosa

Background: The aim of this study is to compare the effectiveness of two exposure procedures on habituation of emotional responses to food stimuli: (a) exposure to external cues (food images) without eating forbidden food (CE) and (b) exposure to external cues eating forbidden food (with purge prevention). The influence of craving-trait and mood state on the habituation process is also studied. Method: Emotional modulation of the defense startle reflex was assessed in 26 women at risk of bulimia nervosa. After four exposure trials, changes in the following variables were measured: (a) food craving-state; (b) physiological measures: hearth rate (HR) and skin conductance response (SCR); (c) motivational patterns towards food (defense startle response); and (d) valence, arousal and dominance of the emotional response to food images. Results: After treatment, subjects tended to show non-significant lower SCR and heart orientation responses (vs. defense responses); defense startle response was also significantly lower. Conclusions: The exposure procedure, the induced emotional state and the number of exposure trials are analyzed (AU)

Antecedentes: en este estudio comparamos la eficacia de dos procedimientos de exposición sobre la habituación de reacciones emocionales a alimentos: a) claves externas (imágenes de comida) sin ingerir alimentos prohibidos, y b) claves externas en personas que sí los han ingerido (impidiendo que se produzca el vómito). Además consideramos la influencia de la intensidad del craving rasgo y del estado de ánimo. Evaluamos la modulación emocional del reflejo defensivo de sobresalto motor (RMS) en 26 mujeres con riesgo de padecer bulimia nerviosa. Método: tras cuatro bloques de exposición, se midieron los cambios en: a) craving estado por la comida; b) tasa cardíaca (TC) y respuesta electrodérmica de conductancia (SCR); c) patrones motivacionales ante la comida (RMS); y d) estimaciones afectivas de valencia, arousal y dominancia de las emociones producidas por las imágenes de los alimentos. Resultados: como consecuencia del tratamiento los sujetos tendían a mostrar de forma estadísticamente no significativa menores SCRs y una tendencia de cambio de patrón de respuesta de defensa cardíaca (RD) a respuesta de orientación (RO); sí se apreciaban diferencias significativas en RMS. Conclusiones: se comenta el papel desempeñado por el tipo de exposición utilizado, los estados emocionales inducidos y el número de ensayos de exposición (AU)

Isolation and characterization of polymorphic microsatellite markers in Tetranychus urticae and cross amplification in other Tetranychidae and Phytoseiidae species of economic importance.

Tetranychus urticae Koch is a cosmopolitan phytophagous mite considered as the most polyphagous species among spider mites. Population genetic studies using molecular markers such as microsatellites have proven to be extremely informative to address questions about population structure, phylogeography and host preferences. The aim of this study was to increase the available molecular tools to gain insight into the genetic structure of T. urticae populations of citrus orchards, which might help in their management. Five microsatellite DNA libraries were developed using probes with the motifs CT, CTT, GT and CAC following the FIASCO protocol. Positive clones, those that included the insert with the microsatellite, were detected using the PIMA-PCR technique. Combinations of primers were designed on 22 out of 32 new microsatellites loci and their polymorphism was tested in four populations sampled along the eastern coast of Spain. Eleven successful amplifications were obtained. Cross amplification was tested in the tetranychids Aphlonobia histricina, Eutetranychus banksi, E. orientalis, Oligonychus perseae, Panonychus citri, Tetranychus evansi, T. okinawanus and T. turkestani, and the phytoseiids Amblyseius swirskii, A. cucumeris, A. andersoni, Euseius stipulatus, Neoseiulus barkeri, N. californicus, Phytoseiulus persimilis and Typhlodromus phialatus. Eight successful cross amplifications were obtained.

PP078. Total antioxidant capacity in patients with pregnancy induced hypertension: Its relation to maternal and/or perinatal complications.

INTRODUCTION: Pregnancy-induced hypertension (PIH) is a major cause of maternal and perinatal mortality and morbidity, particularly in under-resourced countries, like Mexico. Studies on PIH have shown increased oxidative stress products such as malondialdehyde and decrease of total antioxidant capacity (TAC). In this research we measured one marker of oxidative stress (OS) the TAC in patients with PIH and we associated it with the development of maternal and/or fetal complications. OBJECTIVES: Determine whether the plasma level of total antioxidant capacity (as a marker of oxidative stress) influences the development of maternal and/or perinatal complications in patients with PIH. METHODS: A observational, analytical, clinical study was conducted in patients with gestational hypertension (GH), mild preeclampsia (MP), severe preeclampsia (SP) and normal pregnancy (NP) > or = 28weeks gestational age. Serum samples were collected and stored at -70°C until use for the determination of total antioxidant capacity. It was associated with the development of maternal and/or perinatal complications. RESULTS: TAC level in normotensive patients (NP) was mean of 2679 +/- 2014mEq/L while in hypertensive patients (GH, MP, SP) was on mean of 1502 +/-1340mEq/L (p<0.05), in the GH group was 1620 +/-1042mEq/L, in the MP group was 1977 +/-1865mEq/L, in the SP was 819 +/-305meq/L The mean TAC level in the 29 patients who had maternal and/or perinatal complications was 1521mEq/L, while in the 38 patients who showed no maternal and/or perinatal complications the mean was 2355mEq/L (p<0.05). Of the 29 patients who had complications 15 (52%) had greatly diminished TAC levels (less than 1000mEq/L), 9 (31%) had between 1000 and 2500mEq/L and only 5 (17%)>2500mEq/L. 72% (28/39) of PIH group had one or more maternal and/or perinatal complications, while only 1 patient (3.6%) of 28 patients with NP had one or more maternal and/or perinatal complications (p<0.05). CONCLUSION: Patients with decreased TAC level had a higher percentage of maternal and/or perinatal complications. Patients with PIH classified as mild preeclampsia, showing reduced TAC level should be in close observation as they have the risk of developing life-threatening complications since management is usually as outpatient.

Evaluación de la reactividad emocional ante imágenes de comida en bulimia nerviosa / Assessment of emotional reactivity to food images in bulimia nervosa

En este estudio evaluamos la influencia de la intensidad del craving rasgo, efecto de estado de ánimo y restricción de comida sobre la reacción ante imágenes de alimentos. Se evalúa la modulación emocional del reflejo defensivo de sobresalto motor (RMS) en 26 mujeres con riesgo de padecer bulimia nerviosa; fueron asignadas a dos grupos en base a la intensidad del craving rasgo. En cada uno de estos dos grupos se generó estado de ánimo positivo o negativo y los sujetos ingirieron o no alimentos antes del comienzo de la prueba. Se registra el electromiograma del músculo orbicular del ojo tras un estímulo auditivo, SCR, medidas de autoinforme para evaluar el deseo de comer (craving estado y rasgo) y emociones ante las imágenes de alimentos (SAM). Los resultados indican que el estado de ánimo negativo hace que las imágenes de comida sean valoradas como más desagradables, generadoras de emociones más intensas y de pérdida de control; además provocan mayores SCRs. Estos dos últimos efectos se produjeron en los grupos no deprivados. Las personas con bajos niveles en el FCQ-T disminuyeron su RMS ante imágenes de comida como consecuencia de experimentar emociones positivas; cuando las emociones eran negativas, su RMS se incrementaba (AU)

The aim of the study was to assess the influence on reactivity to food images of the following variables: craving-trait, positive or negative mood state, and food restriction. Emotional modulation of the defense startle reflex (RMS) was assessed in 26 women at risk of suffering from bulimia nervosa; they were assigned one of to two groups: high craving-trait and low craving-trait. Before the test, positive or negative mood and restriction vs. non-restriction states were induced in each of the groups. Skin conductance response (SCR) and electromyogram activity from the orbiculari oculi region were recorded after the auditory stimuli; questionnaires such as Food Craving Trait Questionnaire (FCQ-T) and the Self-assessment Manikin (SAM) were used. Results showed that negative affect produced a negative valence of food images, more arousal, and more loss of control, as well as higher SCRs. Subjects with low FCQ-T levels reduced their RMS to food images as a consequence of experiencing positive emotions; when emotions were negative, their RMS increased (AU)

Protocolo modificado de la terapia del movimiento inducido por restricción para un hospital de atención a crónicos y larga estancia / Modified protocol of constraint-induced movement therapy for a chronic and long term care hospital

Introducción. La terapia del movimiento inducido por restricción es una de las pocas terapias de rehabilitación del miembro superior que ha demostrado científicamente que tiene un impacto en las actividades de la vida diaria. El objetivo del ensayo clínico aleatorizado es comprobar si la modificación del protocolo original de la terapia del movimiento inducido por restricción mejora la elegibilidad del protocolo original y mantiene los beneficios del mismo. Material y método. Se realiza un estudio comparativo en una muestra de 32 pacientes que han sufrido un accidente cerebrovascular, divididos de manera aleatoria en un grupo experimental y otro control, para determinar si una modificación del protocolo original de la terapia del movimiento inducido por restricción tiene un impacto significativo en la mejora de las actividades de la vida diaria dentro del tratamiento global de pacientes ingresados en un Hospital de atención a crónicos y larga estancia, el Hospital «Pare Jofré» de la ciudad de Valencia. La técnica es comparada con el tratamiento tradicional de terapia ocupacional. Resultados. Se consigue aumentar la elegibilidad de un 1,6%, hasta un 26,22%. Se observa una mejora funcional en las actividades de la vida diaria por el impacto de la técnica dentro del período ingreso-alta con significación estadística (U de Mann-Whitney 0,001) y una diferencia significativa en los niveles de dependencia entre el grupo experimental y el grupo control, observándose que los pacientes que reciben la técnica tienen menores niveles de dependencia (Chi-cuadrado 0,038) y diferencias estadísticamente significativas para actividades de la vida diaria como la alimentación, el vestido, el aseo personal, la ducha, el uso del retrete las transferencias y el desplazamiento, por lo que podemos decir que se mantienen los beneficios del protocolo original. Conclusión. El protocolo modificado mejora la elegibilidad de los pacientes, así como los resultados de los pacientes en actividades de la vida diaria, tanto en alimentación, vestido, higiene, baño, uso del retrete y transferencias (AU)

Introduction. Constraint-induced movement therapy is one of the few therapies for upper limb rehabilitation that has been scientifically proven to have an impact on daily life activities. The purpose of this clinical trial is check whether the modification of the original protocol of constraint- induced movement therapy improves the eligibility restrictions of the original protocol and maintains the benefits. Material and methods. We performed a comparative study on a sample of 32 patients who had suffered a stroke. They were randomly divided into an experimental group and a control group to determine if a modification of the original protocol of constraint-induced movement therapy has a significant impact on improvement in daily living activities within the overall treatment of patients admitted to a chronic care, long stay, hospital, that is, the Hospital “Pare Jofre” of the city of Valencia. The technique was compared with the traditional treatment of occupational therapy. Results. Eligibility is increased from 1.6% to 26.22%. We observed functional improvement in activities of daily living with statistical significance (Mann-Whitney U Test: 0.001) and a significant difference in levels of dependence between the experimental and control group. It has been observed that patients receiving the technique have lower levels of dependency (Chi-square 0.038) and statistically significant differences for activities of daily life, such as eating, dressing, personal hygiene, showering, use of toilet, transfers and movements from one place to another, so we can say that the benefits of the original protocol are maintained. Conclusions. Eligibility is increased with this modified protocol and it has better results in activities of daily living, such as feeding, dressing, hygiene, bathroom, use of the toilet and transfers (AU)

Insuficiencia renal crónica oculta en el anciano con cardiopatía isquémica / Occult chronic kidney disease in the ederly coronaric heart disease

No disponible

No disponible