Activation and disease control of patients on chronic hemodialysis: An observational study.

BACKGROUND AND OBJECTIVE: Patient activation is a concept that refers to the willingness to manage one's health and medical care. To assess it, a patient activation measure (PAM) has been developed and validated. Several studies report low activation in patients with chronic diseases. However, information on activation in hemodialysis patients is scarce. The aim of the present study is to describe the activation level of patients on chronic treatment in an HD unit and its relationship with disease control parameters. MATERIALS AND METHODS: Cross-sectional observational study in patients with advanced chronic kidney disease on chronic HD treatment. Ninety-six patients were included. Activation was measured with the PAM-13 questionnaire. Its relationship with descriptive variables (age, sex, comorbidity, studies, habitat) and disease control variables (vascular access, blood flow, potassaemia, phosphataemia, interdialytic gain) was studied. For this purpose, Spearman's correlation test, multiple linear regression model and logistic model were used as statistical methods. RESULTS: The mean (SD) PAM-13 score was 63.19 (15.21). Activation was significantly associated with vascular access (P = 0.003), blood flow (P = 0.024), and interdialytic gain of patients (P = 0.008). CONCLUSIONS: Activation in patients on chronic hemodialysis treatment is low. Higher activation is related having an arteriovenous fistula, higher blood flow and lower interdialytic gain. Future studies are needed to confirm and apply our results.

Novel multifunctional nanoliposomes inhibit a-synuclein fibrillization, attenuate microglial activation, and silence the expression of SNCA gene / Nuevos nanoliposomas multifuncionales inhiben la fibrilización de la a-sinucleína, atenúan la activación de la microglía y silencian la expresión de SNCA

Introduction: The aim of this study was to compare the effect of five types of PEGlated nanoliposomes (PNLs) on α-synuclein (α-syn) fibrillization, attenuation of microglial activation, and silence of the SNCA gene, which encodes α-syn. Methods: To evaluate the inhibition of α-syn fibrillization, we used standard in vitro assay based on Thioflavin T (ThT) fluorescence. Next, to evaluate the attenuation of microglial activation, the concentration of TNF-a and IL-6 was quantified by ELISA assay in BV2 microglia cells treated with 100 nM A53T α-syn and PNLs. In order to determine the silencing of the SNCA, real-time PCR and Western blot analysis was used. Finally, the efficacy of PNLs was confirmed in a transgenic mouse model expressing human α-syn.Results: ThT assay showed both PNL1 and PNL2 significantly inhibited a-syn fibrillization. ELISA test also showed the production of TNF-a and IL-6 was significantly attenuated when microglial cells treated with PNL1 or PNL2. We also found that SNCA gene, at both mRNA and protein levels, was significantly silenced when BV2 microglia cells were treated with PNL1 or PNL2. Importantly, the efficacy of PNL1 and PNL2 was finally confirmed in vivo in a transgenic mouse model. Conclusions: In conclusion, the novel multifunctional nanoliposomes tested in our study inhibit α-syn fibrillization, attenuate microglial activation, and silence SNCA gene. Our findings suggest the therapeutic potential of PNL1 and PNL2 for treating synucleinopathies.(AU)

Introducción: El objetivo de este estudio fue comparar el efecto de cinco tipos de nanoliposomas PEGlados (PNL) sobre la fibrilización de la α-sinucleína (α-syn), la atenuación de la activación microglial y el silencio del gen synuclein alpha (SNCA), que codifica α-syn. Métodos: Para evaluar la inhibición de la fibrilización α-syn, utilizamos un ensayo in vitro estándar basado en la fluorescencia de la tioflavina T (ThT). A continuación, para evaluar la atenuación de la activación microglial, se cuantificó la concentración de factor de necrosis tumoral alpha (TNF-a) e interleucina 6 (IL-6)mediante ensayo ELISA en células de microglía BV2 tratadas con 100 nM de α-syn de A53T y PNL. Para determinar el silenciamiento del SNCA, se utilizó reacción en cadena de la polimerasa (PCR) en tiempo real y análisis de Western blot. Finalmente, la eficacia de las PNL se confirmó en un modelo de ratón transgénico que expresa α-syn humana. Resultados: El ensayo ThT mostró que tanto PNL1 como PNL2 inhibieron significativamente la fibrilización de α-syn. La prueba enzyme-linked immunosorbent assay (ELISA) también mostró que la producción de TNF-a e IL-6 se atenuó significativamente cuando las células microgliales se trataron con PNL1 o PNL2. También encontramos que el gen SNCA, tanto a nivel de ARN mensajero (ARNm) como de proteína, se silenciaba significativamente cuando las células de microglía BV2 se trataban con PNL1 o PNL2. Es importante destacar que la eficacia de PNL1 y PNL2 finalmente se confirmó in vivo en un modelo de ratón transgénico.Conclusiones: Los nuevos nanoliposomas multifuncionales probados en nuestro estudio inhiben la fibrilización α-syn, atenúan la activación microglial y silencian el gen SNCA. Nuestros hallazgos sugieren el potencial terapéutico de PNL1 y PNL2 para el tratamiento de sinucleinopatías.(AU)

Novel multifunctional nanoliposomes inhibit α-synuclein fibrillization, attenuate microglial activation, and silence the expression of SNCA gene.

INTRODUCTION: The aim of this study was to compare the effect of five types of PEGlated nanoliposomes (PNLs) on α-synuclein (α-syn) fibrillization, attenuation of microglial activation, and silence of the SNCA gene, which encodes α-syn. METHODS: To evaluate the inhibition of α-syn fibrillization, we used standard in vitro assay based on Thioflavin T (ThT) fluorescence. Next, to evaluate the attenuation of microglial activation, the concentration of TNF-a and IL-6 was quantified by ELISA assay in BV2 microglia cells treated with 100nM A53T α-syn and PNLs. In order to determine the silencing of the SNCA, real-time PCR and Western blot analysis was used. Finally, the efficacy of PNLs was confirmed in a transgenic mouse model expressing human α-syn. RESULTS: ThT assay showed both PNL1 and PNL2 significantly inhibited a-syn fibrillization. ELISA test also showed the production of TNF-a and IL-6 was significantly attenuated when microglial cells treated with PNL1 or PNL2. We also found that SNCA gene, at both mRNA and protein levels, was significantly silenced when BV2 microglia cells were treated with PNL1 or PNL2. Importantly, the efficacy of PNL1 and PNL2 was finally confirmed in vivo in a transgenic mouse model. CONCLUSIONS: In conclusion, the novel multifunctional nanoliposomes tested in our study inhibit α-syn fibrillization, attenuate microglial activation, and silence SNCA gene. Our findings suggest the therapeutic potential of PNL1 and PNL2 for treating synucleinopathies.

Can platelet activation markers predict preeclampsia and/or its severity?

OBJECTIVE: This study aimed to evaluate the value of platelet activation markers in predicting preeclampsia and its severity. Preeclampsia is a serious pregnancy complication that affects 3-5% of pregnancies and can lead to significant morbidity and mortality for both the mother and the fetus. METHODS: The study included 99 patients diagnosed with preeclampsia and 60 healthy pregnant women as a control group. Platelet activation markers such as mean platelet volume (MPV), platelet distribution width (PDW), platelet count, and plateletcrit were evaluated along with other clinical parameters. RESULTS: The results of the study showed that platelet activation markers, particularly PDW and MPV, are valuable in the diagnosis and follow-up of preeclampsia. However, they are not sufficient to predict the severity of the disease. CONCLUSION: The study suggests that platelet activation markers could aid in predicting, diagnosing, and managing preeclampsia. However, further research is needed to determine the role of these markers in predicting the severity of the disease. The findings of this study could contribute to the development of more effective strategies for the prevention and management of preeclampsia, which could ultimately improve maternal and fetal outcomes.

OBJETIVO: El estudio tuvo como objetivo determinar el valor de los marcadores de activación plaquetaria en la predicción de la preeclampsia y su gravedad. MÉTODO: Se incluyeron 99 pacientes diagnosticadas con preeclampsia, incluyendo 36 casos graves, y un grupo control de 60 mujeres embarazadas sanas. Se evaluaron diversas variables, como el volumen plaquetario medio, el recuento de plaquetas, el hematocrito plaquetario y la amplitud de distribución plaquetaria. RESULTADOS: Los resultados mostraron que el volumen plaquetario medio y la amplitud de distribución plaquetaria son parámetros valiosos en el diagnóstico y seguimiento de la preeclampsia, aunque no son suficientes para predecir su gravedad. El análisis estadístico reveló que la edad, el volumen plaquetario medio, la amplitud de distribución plaquetaria, la semana de gestación y los puntajes de Apgar al primer y quinto minuto fueron significativamente diferentes en el grupo de preeclampsia en comparación con el grupo control. CONCLUSIONES: En conclusión, estos resultados sugieren que los marcadores de activación plaquetaria pueden ser útiles para el diagnóstico y seguimiento de la preeclampsia, y que el volumen plaquetario medio y la amplitud de distribución plaquetaria, por ser parámetros económicos y accesibles, podrían ayudar a predecir, diagnosticar y manejar esta complicación durante el embarazo.

Mapeo neuroanatómico de atención inhibitoria y memoria de trabajo con resonancia magnética funcional en niños sanos / Neuroanatomical mapping of inhibitory attention and working memory with functional magnetic resonance imaging in healthy children

Introducción: El objetivo es lograr una plantilla de mapeo de activación cerebral promedio en niños sanos usando la resonancia magnética funcional (RMf), con paradigmas específicos para activar funciones de atención inhibitoria y de memoria de trabajo. Sujetos y métodos: Se realizó una evaluación nutricional y neuropsicológica a 87 niños diestros. Cumplieron los criterios de inclusión 30 (15 niños y 15 niñas) entre 9 y 11 años, a quienes se estudió con RMf con realización de dos pruebas de atención inhibitoria (Go/No Go), con letras e imágenes de alimentos, un test de memoria de trabajo (Test de Atención Continua-Pares Idénticos) y obtención de volúmenes anatómicos. Los datos posteriormente se procesaron con el programa FSL-v5 con un umbral de p < 0,05 (cluster-wise). Las áreas cerebrales activadas se localizaron utilizando una plantilla cerebral estándar del Montreal Neurological Institute y el atlas cortical estructural de Harvard-Oxford. Resultados: En las pruebas de atención inhibitoria hay activación en áreas frontales de predominio derecho, cíngulo, parietales y occipitales, con preponderancia en áreas occipitales en la prueba con alimentos. En la prueba Test de Atención Continua-Pares Idénticos se obtuvo activación de predominio en áreas occipitales, frontales y parietales. Conclusiones: Se obtienen plantillas de mapeo de actividad cerebral en niños sanos con test de atención inhibitoria, de alimentos y de memoria de trabajo. Las áreas de activación corresponden mayoritariamente a las descritas en la bibliografía. Esto nos permite tener patrones basales de activación cerebral para estudiar patologías relacionadas con la atención inhibitoria, la impulsividad y la memoria de trabajo.(AU)

Introduction: The objective is to produce an average brain activation mapping template in healthy children using functional magnetic resonance imaging (fMRI), with specific paradigms for activating inhibitory attention and working memory functions. Subjects and methods: A nutritional and neuropsychological evaluation was performed on 87 right-handed children. The inclusion criteria were met by 30 children (15 boys and 15 girls) between 9 and 11 years old, who were studied with fMRI in two inhibitory attention tests (Go/No Go), with food cues, a working memory test (Continuous Performance Test Identical Pairs) and measurement of anatomical volumes. These data were subsequently processed with the FSL-v5 program, with a threshold of p < 0.05 (cluster-wise). The brain areas activated were located using a standard Montreal Neurological Institute brain template and the Harvard-Oxford structural cortical atlas. Results: The inhibitory attention tests showed activation frontal areas predominantly on the right, and the cingulate, parietal and occipital areas, with preponderance in occipital areas in the food cues test. In the Continuous Performance Test-Identical Pairs test, activation was obtained predominantly in the occipital, frontal and parietal areas. Conclusions: Brain activity mapping templates are obtained in healthy children with tests for inhibitory attention, food cues and working memory. The activation areas are mostly those reported in the literature. This provides baseline brain activation patterns for studying pathologies related to inhibitory attention, impulsivity and working memory.(AU)

Psychometric properties of the Reward Probability Index in a Colombian sample / Propiedades psicométricas del Índice de Probabilidad de Recompensa en una muestra Colombiana

Introduction: This study analysed the psychometric properties of the Reward Probability Index (RPI) in an online Colombian sample with 1129 participants. Method: To conduct a cross-validation study, the sample was randomly divided into two subsamples. An exploratory factor analysis was conducted with the first subsample yielding a two-factor structure. Then, the fit of this two-factor model was tested on the second subsample by conducting a confirmatory factor analysis. Results: This model obtained a good fit to the data and measurement invariance across gender was observed. The RPI also showed good internal consistency according to both Cronbach's alpha and McDonald's omega, scoring .88 in both cases. The RPI demonstrated convergent construct validity given its correlations with other related measures such as the Environmental Reward Observation Scale (r = .81), and the full version of the Behavioral Activation Scale for Depression (r = .71). Conclusions: The RPI showed good psychometric properties in this Colombian sample.

Introducción: Este artículo tuvo como objetivo analizar las propiedades psicométricas del Índice de Probabilidad de Recompensa (RPI) en una muestra colombiana en línea con 1129 participantes. Método: Para realizar un estudio de validación cruzada, la muestra se dividió aleatoriamente en dos submuestras. Se realizó un análisis factorial exploratorio con la primera submuestra que arrojó una estructura de dos factores. Luego, se probó el ajuste de este modelo de dos factores en la segunda submuestra mediante la realización de un análisis factorial confirmatorio. Resultados: Este modelo obtuvo un buen ajuste a los datos y se observó invarianza de medida entre sexos. El RPI también mostró buena consistencia interna según el alfa de Cronbach y el omega de McDonald (.88 en ambos casos) y validez de constructo convergente dadas las correlaciones con otras medidas relacionadas como la Escala de Observación de Recompensa Ambiental (r = .81), y la versión de la Escala de Activación Conductual para la Depresión (r = .71). Conclusiones: el RPI mostró buenas propiedades psicométricas en esta muestra colombiana.

El endotelio sano y su disfunción en el riesgo cardiovascular / Healthy Endothelium and its Dysfunction in Cardiovascular Risk

Resumen El endotelio es una monocapa formada por células aplanadas llamadas w, que revisten la parte más interna del corazón, los vasos sanguíneos y los linfáticos. Es considerado un órgano que tiene una función de barrera, pero además se encarga de regular la permeabilidad y tono vascular, hemostasia, inflamación y angiogénesis. Esta revisión se centra sobre todo en las generalidades del endotelio vascular sano y su disfunción. Se analizan los conceptos de activación y disfunción, en donde la activación se considera como un proceso autolimitado, indispensable para la hemostasia y la inflamación. La disfunción endotelial, en cambio, es un proceso patológico, de mayor duración y que se presenta cuando el endotelio ya no puede autorregularse y cambia a un fenotipo proinflamatorio y protrombótico permanente. Esta disfunción es el primer cambio que lleva a la ateroesclerosis y al aumento del riesgo cardiovascular, por esta razón se revisan los principales biomarcadores de disfunción endotelial y riesgo cardiovascular. A medida que se avance en el conocimiento básico del endotelio y su disfunción, será posible diseñar nuevas medidas preventivas o terapéuticas que puedan disminuir dicho riesgo.

Abstract The endothelium is a monolayer of flatten cells named endothelial cells that form the inner layer of the heart, blood, and lymphatic vessels. Its function is not just as a barrier, but it is a regulator of vascular permeability and tone, hemostasis, inflammation, and angiogenesis. This review is about the general aspects of vascular endothelium and endothelial dysfunction that leads to increased vascular risk. Activation and dysfunction are discussed, considering the endothelial activation as a self-limiting process, necessary to promote inflammation and hemostasis. Endothelial dysfunction is a pathological process in which the endothelium loses its ability for self-regulation and acquires a prothrombotic and proinflammation phenotype. Endothelial dysfunction is the initial step for atherosclerosis and increased cardiovascular risk, so the main biomarkers of endothelial dysfunction are reviewed. As basic knowledge about endothelium increases, preventive or therapeutic measures can be designed as treatment or prevention the risk of its dysfunction.

Implications of highly suppressive treatment HIV infection.

Treatment of HIV infection has modified the initially fatal infection into a typically chronic disease requiring lifelong treatment. However, there is no complete normalization of immune activation, signs of inflammation and prothrombotic state in treated patients. This condition is the result of many factors, but the main cause is thought to be the residual production of HIV-1 RNA and viral proteins by infected cells in cellular reservoirs. Persistence of immune activation/inflammation/prothrombotic state leads to the pathophysiology of "sterile inflammation" and so-called non-AIDS diseases, which manifest one to two decades earlier in those infected. Despite all the pitfalls and unwanted secondary manifestations of antiretroviral drugs, the treatment of HIV infection has managed to reverse the trajectory of a fatal pandemic and has made it possible to approach therapeutic modalities that were absolutely unimaginable just a few years ago. Solid organ transplantation is now a completely legitimate therapeutic method for patients living with HIV, and highly suppressive treatment even allows transplantation from an HIV-infected donor. The text below presents a brief overview of the basic pitfalls, but also of the successes, of the current highly suppressive treatment of HIV infection.

Impacto del prebriefing en las emociones en una sesión de simulación de alta fidelidad: estudio controlado aleatorizado / Impact of prebriefing on emotions in a high-fidelity simulation session: A randomized controlled study

Introducción La simulación médica está asociada a emociones intensas, que influyen en el comportamiento humano. Nuestro objetivo fue investigar el modo en que el prebriefing repercute en las emociones de los alumnos durante una sesión de simulación de alta fidelidad (SAF). Métodos Estudio controlado aleatorizado prospectivo. Se asignó aleatorizadamente a los participantes para recibir un prebriefing estandarizado (grupo PE) o no recibirlo (grupo NPE). Se utilizó en ambos grupos el debriefing tras el enfoque de «buen juicio», estructurado en fases de reacciones, comprensión y resumen. A fin de evaluar las emociones, utilizamos el modelo circunflejo de afecto aplicando la escala Affect grid antes del prebriefing, tras el desempeño del caso y tras el debriefing. También se evaluaron los tiempos de debriefing. Resultados Participaron 128 facultativos en el estudio (64 frente a 64). Tras el desempeño del caso, la experiencia de esta sesión de SAF reflejó emociones significativamente más agradables en comparación con el nivel basal, que se mantuvieron durante el debriefing (p<0,01), mientras que el nivel de alerta se incrementó tras el desempeño del caso y disminuyó tras el debriefing (p<0,01). No se encontraron diferencias estadísticamente significativas entre los grupos. En el grupo NPE, los tiempos totales del debriefing (p=0,003) y de la fase de comprensión (p=0,002) fueron significativamente más prolongados. Conclusiones La experiencia de esta sesión de SAF fue agradable y con elevado nivel de alerta, sin impacto emocional específico atribuible al prebriefing, lo que da lugar a un debriefing con un flujo más libre. (AU)

Introduction Medical simulation is associated with intense emotions which influence human behavior. We aim to investigate how prebriefing impacts on learnerś emotions during a high-fidelity simulation (HFS) session. Methods This is a prospective randomized controlled study. Participants were randomly allocated to receive a standardized prebriefing (SP group) versus not receiving it (NSP group). Debriefing following the «good judgment» approach, structured in reactions, understanding and summary phases, was used in both groups. In order to assess emotions, we used the circumplex model of affect applying the Affect Grid scale, which was performed prior to prebriefing, following case performance and following debriefing. Debriefing times were also assessed. Results A total of 128 physicians participate in the study (64 vs. 64). Following case performance, this HFS session was experienced with significantly more pleasant emotions compared to baseline, that were maintained during debriefing (P<0.01) while alertness increased after case performance diminishing after debriefing (P<0.01). There were no statistical significant differences between groups. In the NSP group, total debriefing (P=0.003) and understanding phase (P=0.002) times were significantly longer. Conclusions This HFS session was experienced as pleasant with high alertness with no specific emotional impact attributable to prebriefing. Prebriefing leads to a freer flowing debriefing. (AU)

Impact of prebriefing on emotions in a high-fidelity simulation session: A randomized controlled study.

INTRODUCTION: Medical simulation is associated with intense emotions which influence human behavior. We aim to investigate how prebriefing impacts on learners' emotions during a high-fidelity simulation (HFS) session. METHODS: This is a prospective randomized controlled study. Participants were randomly allocated to receive a standardized prebriefing (SP group) versus not receiving it (NSP group). Debriefing following the «good judgment¼ approach, structured in reactions, understanding and summary phases, was used in both groups. In order to assess emotions, we used the circumplex model of affect applying the Affect Grid scale, which was performed prior to prebriefing, following case performance and following debriefing. Debriefing times were also assessed. RESULTS: A total of 128 physicians participate in the study (64 vs. 64). Following case performance, this HFS session was experienced with significantly more pleasant emotions compared to baseline, that were maintained during debriefing (p < 0.01) while alertness increased after case performance diminishing after debriefing (p < 0.01). There were no statistical significant differences between groups. In the NSP group, total debriefing (p = 0.003) and understanding phase (p = 0.002) times were significantly longer. CONCLUSIONS: This HFS session was experienced as pleasant with high alertness with no specific emotional impact attributable to prebriefing. Prebriefing leads to a freer flowing debriefing.

Severe and life-threatening onset of systemic lupus erythematosus.

Macrophage activation syndrome (MAS) is a potentially life-threatening complication of rheumatic diseases. We report a unique case of a previously healthy 20-year-old female presenting with MAS as first presentation of systemic lupus erythematosus. Remission was achieved with hydroxychloroquine, intravenous methylprednisolone pulse followed by oral prednisolone and cyclosporine. However, the management of MAS is still challenging, and the mortality rate remains high.

Severe and life-threatening onset of systemic lupus erythematosus / Una presentación grave y potencialmente fatal de lupus eritematoso sistémico

Macrophage activation syndrome (MAS) is a potentially life-threatening complication of rheumatic diseases. We report a unique case of a previously healthy 20-year-old female presenting with MAS as first presentation of systemic lupus erythematosus. Remission was achieved with hydroxychloroquine, intravenous methylprednisolone pulse followed by oral prednisolone and cyclosporine. However, the management of MAS is still challenging, and the mortality rate remains high.(AU)

El síndrome de activación macrofágica (SAM) es una complicación potencialmente letal de algunas enfermedades reumáticas. Presentamos un caso único de una mujer de 20 años previamente sana que se presentó con SAM como primera manifestación de lupus eritematoso sistémico. Se logró una remisión completa con hidroxicloroquina, pulsos intravenosos de metilprednisolona seguido de prednisolona oral y ciclosporina. Sin embargo, el manejo del SAM sigue siendo un desafío y la tasa de mortalidad sigue siendo alta.(AU)

La activación psicofisiológica en situaciones de competición en jugadores de bádminton / A ativação psicofisiológica em situações de competição em jugadores de bádminton / The psychophysiological activation in competition situations in badminton players

Diversas investigaciones demuestran la importancia de la relación del nivel de activación con el rendimiento deportivo. El objetivo fue analizar el nivel de activación psicofisiológica de la acción de saque y su efecto en el rendimiento, durante situaciones simuladas de competición. Participaron 30 jugadores de bádminton (M= 23.7 años, DE= 7.52), divididos por nivel de rendimiento: alto nivel de habilidad (mujeres=5, hombres=10) y bajo nivel de habilidad (mujeres=4, hombres=11). Variable independiente: simulación de competición con menor y mayor exigencia. Variable dependiente: nivel de activación psicofisiológica, subjetiva y rendimiento. No hubo diferencias significativas en electromiografía y conductancia de la piel por las diferentes condiciones, pero si en la temperatura periférica y la activación subjetiva. El nivel de activación psicofisiológica tuvo un incremento por las acciones, pero no fue significativo. Además, que la simulación imaginando situaciones de partido, es posible que no fue suficiente para generar diferencias significativas por las condiciones. (AU)

Various investigations demonstrate the importance of the relationship between the level of activation and sports performance. The objective was to analyze the level of psychophysiological activation of the serve action and its effect on performance during simulated competition situations. Thirty badminton players participated (M= 23.7 years, SD = 7.52), divided by performance level: high skill level (women=5, men=10) and low skill level (women=4, men=11). Independent variable: competition simulation with lower and higher demand. Dependent variable: level of psychophysiological and subjective activation and performance. There were no significant differences in electromyography and skin conductance for the different conditions, but there were significant differences in peripheral temperature and subjective arousal. The level of psychophysiological activation had an increase due to the actions, but it was not significant. In addition, that the simulation imagining match situations, it is possible that it was not enough to generate significant differences due to the conditions. (AU)

Várias investigações demonstram a importância da relação entre o nível de ativação e o desempenho esportivo. O objetivo foi analisar o nível de ativação psicofisiológica da ação de saque e seu efeito no desempenho durante situações simuladas de competição. Participaram 30 jogadores de badminton (M= 23,7 anos, DP = 7,52), divididos por nível de desempenho: alto nível de habilidade (mulheres=5, homens=10) e baixo nível de habilidade (mulheres=4, homens=11). Variável independente: simulação de competição com menor e maior demanda. Variável dependente: nível de ativação e desempenho psicofisiológico e subjetivo. Não houve diferenças significativas na eletromiografia e condutância da pele para as diferentes condições, mas houve diferenças significativas na temperatura periférica e excitação subjetiva. O nível de ativação psicofisiológica teve aumento devido às ações, mas não foi significativo. Além disso, que a simulação imaginando situações iguais, é possível que não tenha sido suficiente para gerar diferenças significativas devido às condições. (AU)

Eficacia de las terapias online de activación conductual y cognitivo conductual para el tratamiento de la depresión en mujeres mexicanas víctimas de violencia / Efficacy of online behavioral activation and cognitive-behavioral therapies for the treatment of depression in Mexican women victims of violence

Antecedentes: La violencia contra la mujer (VCM) y la pandemia por COVID-19 son problemáticas que han afectado la salud mental de las mujeres, con secuelas como la depresión. Objetivo: Comparar la eficacia del tratamiento breve de activación conductual (BATD) y la terapia cognitiva conductual (TCC) con adaptaciones culturales administradas online (telesalud) para la depresión en víctimas de VCM durante la COVID-19 en México. Método: Se realizó un ensayo clínico aleatorizado con 20 mujeres mexicanas de 18-60 años con depresión que experimentaron VCM en los últimos seis meses durante la COVID-19. Las participantes fueron asignadas de manera aleatorizada 1:1 a los grupos BATD y TCC. Para el análisis de datos se aplicaron las pruebas Friedman y U de Mann-Whitney, y se estimó el Índice de Cambio Confiable. Resultados: Se encontró una disminución en síntomas depresivos (p < .001) e incremento en los niveles de activación (p < .001) a favor del grupo BATD, al término de la intervención y en el seguimiento en contraste con la TCC. Conclusiones: La BATD mostró ser eficaz en crisis de emergencia sanitaria en contextos de VCM. Aunar evidencia de intervenciones eficientes para esta población contribuye a mitigar las afecciones de salud mental.

Background: Violence against women (VAW) and the COVID-19 pandemic are issues that have affected women's mental health, with sequela such as depression. Objective: To compare the efficacy of brief behavioral activation therapy (BATD) and cognitive behavioral therapy (CBT) with cultural adaptations administered online by telehealth for depression in victims of VAW during COVID-19 in Mexico. Method: A randomized clinical trial was conducted with 20 Mexican women aged 18-60 years with depression who experienced VAW in the last six months during COVID-19. Participants were randomized 1:1 to the BATD and CBT groups. For data analysis, Friedman and Mann-Whitney U tests were applied, and the Reliable Change Index was estimated. Results: A decrease in depressive symptoms (p < .001) and an increase in activation levels (p < .001) were found in favor of the BATD group at the end of the intervention and at follow-up, in contrast to CBT. Conclusions: BATD was shown to be effective in health emergency crises in VAW contexts. Gathering evidence of efficient interventions for this population contributes to mitigating mental health conditions.

How do Para swimmers respond physiologically and cognitively when watching their performance at the Paralympic Games? A Case Study / ¿Cómo los nadadores paralímpicos responden fisiológicamente y cognitivamente cuando ven seu desempenho nos Jogos Paralímpicos? Um estudio de caso / Como nadadores paralímpicos respondem fisiologicamente e cognitivamente ao assistirem seu desempenho nos Jogos Paralímpicos? Um estudo de caso

El objetivo de esta investigación fue analizar la respuesta de activación cognitiva y fisiológica de nadadores paralímpicos (n= 12) al ver la grabación de su prueba en los Juegos Paralímpicos. El diseño metodológico del estudio fue transversal y se llevó a cabo en dos etapas. El video contenía tres momentos: línea de base (LB), video neutral (VN) y video de los Juegos Paralímpicos (VJUEGOS). Durante las pruebas, se analizaron la variabilidad de la frecuencia cardíaca (VFC) y la actividad electrodérmica (EDA) para evaluar la activación fisiológica. También se recolectaron datos de activación cognitiva (Inventario de Ansiedad Estado). Se observó una reducción significativa en el tiempo medio de ritmo cardiaco y un aumento en los datos de conductancia con relación a VNxVJOGOS. No hubo diferencias significativas en las activaciones cognitivas. Si bien se puede explorar el uso de videos, debe tenerse en cuenta que el contenido puede causar respuestas positivas o negativas al rendimiento. (AU)

The aim of this study was to analyse the cognitive and physiological activation response of Paralympic swimmers (n= 12) when watching the recording of their events at the 2016 Paralympic games. The methodological design of the study was cross-sectional and carried out in two stages. The video contained three moments: baseline (BL), neutral video (NV) and Paralympic Games video (GAMESV). During the tests, Heart Rate Variability (HRV) and Electrodermal Activity (EDA) were analysed as a way to evaluate physiological activation. Before and after the video, cognitive activation data (State-Trait Anxiety Inventory) was collected. It was observed a significant reduction in the meantime of heartbeats and an increased conductance data in relation to NV×GAMESV, demonstrating physiological activation. However, no significant differences in cognitive activations were observed. While the use of videos in the psychological and sporting scope may be explored, certain weightings should be considered, knowing that their content may elicit positive or negative responses to performance. (AU)

O objetivo desse estudo foi analisar a resposta de ativação cognitiva e fisiológica de nadadores paralímpicos (n= 12) ao assistirem à gravação da sua prova nos Jogos Paralímpicos. O desenho metodológico do estudo foi caracterizado como transversal e realizado em duas etapas. O vídeo conteve três momentos: linha de base (LB), vídeo neutro (VN) e vídeo dos Jogos Paralímpicos (VJOGOS). Durante os testes foram analisados a Variabilidade da Frequência Cardíaca (VFC) e Atividade Eletrodérmica (EDA) como forma de avaliar a ativação fisiológica. Também foram coletados os dados de ativação cognitiva (Inventário de Ansiedade-Estado). Foi observada redução significativa da média detempo dos batimentos cardíacos e aumento dos dados de condutância em relação a VNxVJOGOS. No entanto, não foram observadas diferenças significativas nas ativações cognitivas. Ao mesmo tempo que o uso de vídeos pode ser explorado, devidas ponderações devemser consideradas sabendo que seu conteúdo pode eliciar repostas positivas ou negativas ao desempenho. (AU)

Patients and Therapists Reports of Psychotherapy Outcomes: Similarities and Differences / Informes de Pacientes y Terapeutas Sobre el Resultado de la Psicoterapia: Similitudes y Diferencias

Background: Discrepancies between therapists’ and patients’ measures regarding therapeutic results indicate the need to analyze which symptoms and processes are being taken into consideration when reporting clinical change. This study analyzes the concordance between patient and therapist, at pre- and post-treatment, when reporting about anxiety, depression, Experiential Avoidance (EA), Cognitive Fusion (CF) and Activation (A). Method: Convergence was examined between information obtained by means of standardized measures and visual analogical scales (VAS) in 94 patients with anxiety and/or depression who participated in a controlled clinical study (TRANSACTIVA study). Results: Statistically significant correlation (p < .05) was found between all the measures of anxiety and depression, regardless of the source, timepoint, and measures procedure at 95% confidence. In the VAS, patient and therapist agreed (p < .05) in their evaluation of specific symptoms. For EA, CF and A, the therapists’ measures demonstrated stronger correlations than those of the patients, although, in each condition, all the patients’ measures correlated with each other (p < .05). Conclusions: Suitable agreement was found between therapist and patient when reporting clinical change. One-item VAS appeared to b suitable for identifying anxiety, depression and the transdiagnostic patterns of EA, CF and A.(AU)

Antecedentes: Las discrepancias entre terapeutas y pacientes sobre los resultados terapéuticos indican la necesidad de analizar qué síntomas y procesos se tienen en cuenta al evaluar el cambio clínico. Se analizó la correspondencia entre paciente y terapeuta, en pre y post tratamiento, al informar sobre ansiedad, depresión, Evitación Experiencial (EA), Fusión Cognitiva (FC) y Activación (A). Método: Se examinó la convergencia entre la información obtenida mediante cuestionarios estandarizados y escalas analógicas visuales (EVA) en 94 pacientes con ansiedad y/o depresión que participaron en un estudio clínico controlado (estudio TRANSACTIVA). Resultados: Se encontró correlación significativa (p < .05) entre todas las medidas de ansiedad y depresión, independientemente de la fuente, momento y procedimiento de medida al 95% de confianza. En la EVA, paciente y terapeuta coincidieron (p < .05) al valorar síntomas específicos. Respecto a EA, CF y A, las medidas del terapeuta mostraron correlaciones más altas y significativas que las del paciente, aunque, en cada condición, todas las medidas del paciente se correlacionaron entre sí (p < .05). Conclusiones: Se observó adecuada correspondencia entre terapeuta y paciente al informar sobre el cambio clínico. La EVA de un ítem parece adecuada para identificar ansiedad, depresión y patrones transdiagnósticos de EA, CF y A. (AU)

A 5-Year Open-Label Follow-up of a Randomized Double-Blind Placebo-Controlled Trial of Intralymphatic Immunotherapy for Birch and Grass Allergy Reveals Long-term Beneficial Effects

Background: Intralymphatic immunotherapy (ILIT) is a novel, faster alternative to conventional allergen immunotherapy (AIT). Few previous studies have evaluated its long-term effects. The objective of the present study was to complete a 5-year follow-up of a randomized double-blind placebo-controlled trial of ILIT for a combination of birch and grass allergens. Methods: Fifty-eight patients with allergic rhinitis were treated with either placebo or a combination of ALK Alutard Birch and Grass 1000 SQ-U administered in 3 intralymphatic injections at 1-month intervals. A year after the vaccination, the symptoms induced by nasal provocation were significantly reduced. After 5-6 years, 20 out of 26 actively treated patients were followed up with a nasal provocation test (NPT) and seasonal registration of the combined symptom and medications score (CSMS), IgE and IgG4 levels in blood, and immunological markers in blood and lymph nodes and compared with 13 unvaccinated controls. Results: The reduction in the NPT response with ILIT at year 1 could not be convincingly reproduced at year 5. The new CSMS scores were markedly lower among the previously treated patients than among the control group. Furthermore, grass-specific IgG4 was increased, grass-specific IgE decreased, FcεR1 on basophils was reduced, and the fraction of memory T-cells in lymph nodes increased. Conclusion: The combination of seasonal clinical data and immunological parameters supports the notion of a long-lasting effect of ILIT. These data support the concept of ILIT as a good alternative to traditional AIT in pollen-induced allergic rhinitis (AU)

Antecedentes: La inmunoterapia intralinfática (ILIT) se ha propuesto como una alternativa novedosa y rápida frente a la inmunoterapia convencional con alérgenos (AIT). Muy pocos estudios han evaluado sus efectos a largo plazo. El objetivo del estudio fue completar un seguimiento de 5 años de un ensayo aleatorizado, doble ciego, controlado con placebo, previamente realizado, de ILIT con una combinación de alérgenos de abedul y gramíneas. Métodos: 58 pacientes con rinitis alérgica fueron tratados con placebo o una combinación de ALK Alutard Birch and Grass 1000 SQ-U, mediante tres inyecciones intralinfáticas administradas con intervalos de un mes. Un año después de la vacunación, los síntomas inducidos por provocación nasal se redujeron significativamente. Entre 5 y 6 años más tarde, 20 de los 26 pacientes tratados activamente fueron evaluados mediante nueva prueba de provocación nasal (NPT), registro estacional de la puntuación combinada de síntomas y consumo de medicamentos (CSMS), niveles de IgE e IgG4 en sangre y marcadores inmunológicos en sangre y ganglios linfáticos y en comparación con los observados en los 13 controles no vacunados. Resultados: La reducción inducida por ILIT en la respuesta de NPT observada en el primer año no se reprodujo de manera significativa en el quinto año. Las nuevas puntuaciones de CSMS fueron notablemente más bajas entre los pacientes previamente tratados que en el grupo de control. Además, aumentó la IgG4 específica frente gramíneas, disminuyó la IgE específica frente a gramíneas, se redujo la expresión del FcεR1 en los basófilos y aumentó la cantidad de células T de memoria en los ganglios linfáticos. Conclusión: La combinación de datos clínicos y parámetros inmunológicos respalda la noción de un efecto duradero de ILIT. Estos datos respaldan el concepto de ILIT como una buena alternativa a la AIT tradicional en la rinitis alérgica inducida por polen (AU)