Approach to COVID-19 pandemic management in Madrid. Chronic of a year.

After more than a year of pandemic, the international medical community has changed the perception of fear to one of respect for SARS-COV-2. This has been the consequence of the integral study of all the dimensions of the disease, from viral recombinant capacity to transmissibility, diagnosis, care and prevention. This document summarizes the main strategic lines of study and approach to the pandemic in Madrid.

Physical activity questionnaires for Spanish children and adolescents: a systematic review / Cuestionarios de actividad física para niños y adolescentes españoles: una revisión sistemática.

Questionnaires aimed at assessing the prevalence of physical activity are tools frequently used by health professionals. It is important to provide them with information about the characteristics and quality of these questionnaires. This systematic review aimed to identify and analyse the characteristics and psychometric properties of this type of questionnaires when administered to Spanish children and adolescents. A total of 14 questionnaires were found. Accurate validity values were obtained in two of them. Only two questionnaires obtained a score >5 in the "Qualitative Attributes and Measurement Properties of Physical Activity Questionnaires" checklist. Among the available questionnaires, the APALQ (9-18 years) and the ENERGY (12-14 years) seem to be the most accurate tools for assessing physical activity prevalence in Spanish children and adolescents, albeit with limitations that should be taken into account.

Cuestionarios de actividad física para niños y adolescentes españoles: una revisión sistemática / Physical activity questionnaires for Spanish children and adolescents: a systematic review

Los cuestionarios de valoración de la prevalencia de actividad física son herramientas muy empleadas por los profesionales de la salud. Es importante poner en su conocimiento la calidad y características de los mismos. Esta revisión sistemática tuvo como objetivo identificar y analizar las características y propiedades psicométricas de este tipo de cuestionarios cuando han sido aplicados a niños y adolescentes españoles. Se encontraron un total de 14 cuestionarios, obteniéndose valores de validez adecuados en dos de ellos. Solo dos cuestionarios obtuvieron una puntuación mayor que 5 sobre 10 en la evaluación de la calidad de sus propiedades de medida de acuerdo con la lista de comprobación Qualitative Atributes and Measurement Properties of Physical Activity Questionnaires. Los cuestionarios APALQ (9-18 años) y ENERGY (12-14 años), parecen ser, con sus limitaciones, los más adecuados de entre los disponibles para valorar la actividad física en niños y adolescentes españoles, contando ambos con limitaciones a considerar (AU)

Questionnaires aimed at assessing the prevalence of physical activity are tools frequently used by health professionals. It is important to provide them with information about the characteristics and quality of these questionnaires. This systematic review aimed to identify and analyse the characteristics and psychometric properties of this type of questionnaires when administered to Spanish children and adolescents. A total of 14 questionnaires were found. Accurate validity values were obtained in two of them. Only two questionnaires obtained a score >5 in the 'Qualitative Attributes and Measurement Properties of Physical Activity Questionnaires' checklist. Among the available questionnaires, the APALQ (9-18 years) and the ENERGY (12-14 years) seem to be the most accurate tools for assessing physical activity prevalence in Spanish children and adolescents, albeit with limitations that should be taken into account (AU)

The chemokine CCL5 induces CCR1-mediated hyperalgesia in mice inoculated with NCTC 2472 tumoral cells.

Although the expression of the chemokine receptor CCR1 has been demonstrated in several structures related to nociception, supporting the nociceptive role of chemokines able to activate it, the involvement of CCR1 in neoplastic pain has not been previously assessed. We have assayed the effects of a CCR1 antagonist, J113863, in two murine models of neoplastic hyperalgesia based on the intratibial injection of either NCTC 2472 fibrosarcoma cells, able to induce osteolytic bone injury, or B16-F10 melanoma cells, associated to mixed osteolytic/osteoblastic bone pathological features. The systemic administration of J113863 inhibited thermal and mechanical hyperalgesia but not mechanical allodynia in mice inoculated with NCTC 2472 cells. Moreover, in these mice, thermal hyperalgesia was counteracted following the peritumoral (10-30µg) but not spinal (3-5µg) administration of J113863. In contrast, hyperalgesia and allodynia measured in mice inoculated with B16-F10 cells remained unaffected after the administration of J113863. The inoculation of tumoral cells did not modify the levels of CCL3 at tumor or spinal cord. In contrast, although the concentration of CCL5 remained unmodified in mice inoculated with B16-F10 cells, increased levels of this chemokine were measured in tumor-bearing limbs, but not the spinal cord, of mice inoculated with NCTC 2472 cells. Increased levels of CCL5 were also found following the incubation of NCTC 2472, but not B16-F10, cells in the corresponding culture medium. The intraplantar injection of CCL5 (0.5ng) to naïve mice evoked thermal hyperalgesia prevented by the coadministration of J113863 or the CCR5 antagonist, d-Ala-peptide T-amide (DAPTA), demonstrating that CCL5 can induce thermal hyperalgesia in mice through the activation of CCR1 or CCR5. However, contrasting with the inhibitory effect evoked by J113863, the systemic administration of DAPTA did not prevent tumoral hyperalgesia. Finally, the peritumoral administration of an anti-CCL5 antibody completely inhibited thermal hyperalgesia evoked by the inoculation of NCTC 2472 cells.

The ambrosanolide cumanin inhibits macrophage nitric oxide synthesis: some structural considerations.

Since its role in inflammatory diseases was recognized, nitric oxide (NO) has become an important mediator to evaluate anti-inflammatory agents. Sesquiterpene lactones, which occur in several medicinal plants, inhibit the NO production in macrophage-like cells. This action is probably due to a 1,4 addition reaction between its alpha,beta-unsaturated carbonyl group with sulfhydryl (SH)-containing compounds. For this reason it is believed that these compounds are cytotoxic, which restricts their therapeutic use. In this contribution, the ability of the ambrosanolide-type sesquiterpene lactone cumanin (from the Asteraceae Ambrosia psilostachya) to inhibit NO biosynthesis was evaluated in lipopolisaccharide-induced peritoneal murine macrophages and its cytotoxicity was assessed in the MTT assay. Cumanin showed a potent inhibitory effect in NO production (IC(50) = 9.38+/-0.38 microM) with low cytotoxicity. The 1,4-addition reaction of thiols was slow, which does not explain the inhibition of NO production but does explain the low cytotoxicity of cumanin with respect to other lactones.

[Associated EMG responses in Alzheimer's disease and in healthy subjects]. / Respuestas electromiográficas asociadas en la enfermedad de Alzheimer y en sujetos sanos.

INTRODUCTION AND AIMS: Recently, the appearance of associated EMG responses in patients with probable Alzheimer s disease (AD) have been reported during the performance of cue stimuli recognition tasks using an oddball model. We present our work with AD patients and on the possibility of obtaining these responses in normal subjects by modifying the conditions under which the exploration is carried out. PATIENTS AND METHODS: We review 38 cases of probable AD, mild and moderate in intensity, in which we explored reaction time by bilateral EMG recording in the extensor muscles of the hand. The same exploration was performed in 20 healthy subjects in basal conditions and again while a simple mathematical task was being performed. RESULTS: In two of the 38 cases, both of moderate intensity, we observed associated EMG responses. On varying the conditions of exploration, 12 of the 20 normal subjects presented associated EMG responses. CONCLUSION: Associated EMG responses are a neurophysiological phenomenon that can be observed in some patients with AD. In normal subjects, it is possible to trigger the appearance of associated EMG responses by reducing their capacity to concentrate on the task to be performed. During the performance of unilateral motor tasks, inhibition pathways are activated physiologically to prevent the mirror contraction of contralateral muscles, which can be affected by the lowered capacity to pay attention.

Respuestas electromiográficas asociadas en la enfermedad de Alzheimer y en sujetos sanos / Associated emg responses in Alzheimer's disease and in healthy subjects

Introducción y objetivos. Recientemente, se ha descrito la aparición de respuestas EMG asociadas en los pacientes con probable enfermedad de Alzheimer (EA), durante la realización de tareas de reconocimiento de estímulos señal, de acuerdo con un modelo oddball. Exponemos nuestra experiencia al respecto en pacientes con EA, así como la posibilidad de obtener estas respuestas en sujetos normales, con la modificación de las condiciones de exploración. Pacientes y métodos. Revisamos 38 casos de probable EA, de leve y moderada intensidad, en los que se exploró el tiempo de respuesta, con registro EMG bilateral de músculos extensores de la mano. Se realizó la misma exploración en 20 sujetos sanos en condiciones basales, y, a continuación, mientras realizaban una tarea matemática sencilla. Resultados. En dos de los 38 casos de EA, ambos de moderada intensidad, hemos observado respuestas EMG asociadas. De los 20 sujetos normales, al variar las condiciones de exploración, obtenemos respuestas EMG asociadas en 12 casos. Conclusión. Las respuestas EMG asociadas son un fenómeno neurofisiológico que podemos observar en algunos pacientes con EA. En sujetos normales, al reducir la capacidad de concentración sobre la tarea realizada, podemos provocar la aparición de respuestas EMG asociadas. Durante la realización de tareas motoras unilaterales, se activan fisiológicamente vías de inhibición para evitar contracciones especulares de músculos contralaterales, que pueden afectarse por la disminución de la capacidad de atención (AU)

[Neurophysiological study and use of P300 evoked potentials for investigation in the diagnosis and of follow-up of patients with Alzheimer s disease]. / Estudio neurofisiológico y potenciales evocados P300 en el diagnóstico y seguimiento de pacientes con enfermedad de Alzheimer.

INTRODUCTION AND OBJECTIVES: At the present time the diagnosis of Alzheimer's disease (EA) is based on clinical evaluation of the symptoms and various complementary investigations mainly directed towards ruling out secondary dementias. However, definite diagnosis can only be made on cerebral biopsy. We wished to evaluate the efficacy of different neurophysiological investigations used in the diagnosis and follow-up of EA. PATIENTS AND METHODS: After drawing up a table of normal values, we selected a samples of 33 patients with suspected EA. Following assessment clinical, neuropsychological (Mini-Mental State Examination- MMSE-) and neurophysiological (electroencephalography-EEG-, P300 potentials, reaction time and rate of error)-, the patients were classified as having probable EA, possible EA or other dementia according to the criteria of NINCDS-ADRDA. Statistical analysis was done on the series of cases studied. RESULTS: In our experience, the most interesting findings were obtained from the EEG, MMSE and latency of the P300 evoked potentials. The most useful neurophysiological parameters for help in diagnosis of EA was the P300 latency, with a sensitivity of 77% and a specificity of 83%. The MMSE seems to show the degree of cognitive deterioration better, whilst the P300 latency seems to behave as a marker of a characteristic feature of the disorder. CONCLUSION: The P300 latency is very useful in diagnosis, since it is found to be altered in cases with EA at an early stage, with very little cognitive degeneration and even with a score of 30 on the MMSE.

Estudio neurofisiológico y potenciales evocados P300en el diagnóstico y seguimientode pacientes con enfermedad de Alzheimer / Neurophysiological study and use of P300 potentials for investigation in the diagnosis and follow-up of patients with Alzheimer´s disease

Introducción y objetivos. Actualmente basamos el diagnóstico de la enfermedad de Alzheimer (EA) en la evaluación clínica de los síntomas y en diversas exploraciones complementarias orientadas en su mayoría a descartar demencias secundarias, si bien el diagnóstico de certeza sólo es posible realizarlo por biopsia cerebral. Pretendemos evaluar la eficacia de diversas exploraciones neurofisiológicas en el diagnóstico y seguimiento de la EA. Pacientes y métodos. Después de confeccionar tablas de valores normales, seleccionamos una muestra de 33 pacientes con sospecha de EA. Tras la evaluación clínica, neuropsicológica (miniexamen cognitivo o Mini-Mental State Examination -MMSE-) y neurofisiológica (electroencefalografía -EEG-, potenciales P300, tiempo de reacción y tasa de errores), se clasifica al paciente según EA probable, EA posible y otras demencias, según criterios del NINCDS-ADRDA. Se realiza un análisis estadístico y de la casuística obtenida. Resultados. Los hallazgos de mayor interés se han obtenido, según nuestra experiencia, del EEG, del MMSE y de la latencia de los potenciales evocados P300. El parámetro neurofisiológico que se ha mostrado más eficaz en la ayuda al diagnóstico de la EA ha sido la latencia P300, con una sensibilidad del 77 por ciento y una especificidad del 83 por ciento. El MMSE parece representar mejor el grado de deterioro cognitivo, mientras que la latencia P300 parece comportarse como un marcador de rasgo. Conclusión. La latencia P300 es de enorme valor diagnóstico, ya que se observa alterada en casos correspondientes a fases incipientes de la EA, con muy leve deterioro cognitivo, incluso con puntuación de 30 en el MMSE (AU)

[Electromyographic diagnosis of 772 patients in the Móstoles Hospital]. / Diagnósticos electromiográficos de 772 pacientes en el Hospital de Móstoles.

INTRODUCTION AND OBJECTIVE: There are few references in the literature to demographic data of the disorders most frequently studied by electromyography. Our objective was to obtain a demographic description of the patients usually sent to us for electromyographic studies. MATERIAL AND METHODS: Descriptive and analytical assessment was done of 914 electromyographic diagnoses seen in a sample of 722 patients sent to Mostoles Hospital, referral centre of Health District VIII of the Community of Madrid with an estimated population of 407,836 inhabitants, for conventional electroneurographic and electromyographic studies between May 1995 and February 1996. We recorded data regarding electromyographic diagnosis, localization, intensity, whether the study was for diagnostic purposes or follow-up, medical centre referring the patient, medical speciality sending the patient, clinical impression, age and sex. RESULTS: The commonest pathology seen was carpal trapping of the median nerve, both in men and in women (three times more frequent in women). There was an estimated incidence of 136 cases per year per 100,000 women and 36 cases per year per 100,000 men (most frequent in patients aged 20-70, with a maximum frequency in those in their fifties). There was marked right sided predominance. The commonest pathology in men was polyneuropathy, with an estimated incidence of 80 cases per 100,000 men and 72 cases per 100,000 women. This was the commonest diagnosis in the patients aged over 70. Mononeuropathy of the legs was most commonly seen in men and in the first twenty years of life.

A comparative study of the analgesic and anti-inflammatory activities of pectolinarin isolated from Cirsium subcoriaceum and linarin isolated from Buddleia cordata.

The dried aqueous extract of aerial parts of Cirsium subcoriaceum (Asteraceae) and its major flavonoid glycoside, pectolinarin, have been evaluated for analgesic and anti-inflammatory effects in mice and rats, respectively. Both the extract and pectolinarin exerted significant and dose-dependent analgesic and anti-inflammatory activities. Also, the anti-inflammatory activities of an aqueous extract of Buddleia cordata and its principal glycoside linarin were evaluated. The results of pharmacological testing proved that linarin is a better anti-inflammatory agent than pectolinarin and indomethacin. On the other hand, pectolinarin exerted a better analgesic effect than linarin.

[Perforation of the gallbladder during pregnancy. Report of a case]. / Perforación de vesícula biliar durante el embarazo. Informe de un caso.

The case of a 20 year old primigesta with a 30 weeks pregnancy, who was admitted to Emergency Service, with acute abdomen by cholecystitis, is presented. At laparotomy, a vesicular wall perforation, was found, partially sealed with epiplon and free biliary fluid in peritoneal cavity. Cholecystectomy was performed; and cesarean section 24 hours after. Therapeutic options in these patients, are analyzed, and surgical treatment risks, during gestation, and otherwise.

Gastroprotection induced by silymarin, the hepatoprotective principle of Silybum marianum in ischemia-reperfusion mucosal injury: role of neutrophils.

Investigations were carried out to determine the antiulcer effects of silymarin, the hepatoprotective principle of Silybum marianum L. Gaertn., in gastric injury induced by ischemia-reperfusion and its effects on mucosal myeloperoxidase activity, an index of polymorphonuclear leukocyte infiltration, after injury in rats. These results were compared with those from rats that received allopurinol, an inhibitor of xanthine oxidase and with those from rats made neutropenic by prior administration of dexamethasone and methotrexate. Pretreatment with silymarin prevented post-ischemic mucosal injury. The mean ulcer indexes (U.I.) of rats treated with 25, 50 mg, and 100 mg silymarin/kg body weight (4.79 +/- 0.75, 4.50 +/- 0.81, and 3.63 +/- 0.74, respectively) were significantly lower (p < 0.05, 0.05, and p < 0.005) than that of control rats. Allopurinol was considerably more potent in reducing the U.I. than silymarin, with a calculated U.I. of 2.33 +/- 0.45, p < 0.001. These protective effects were specifically related to a reduction in the number of neutrophils in the gastric mucosa. Reduction in the numbers of circulating neutrophils by treating rats with methotrexate (MPO level of 7.2 x 10(-2) +/- 0.56 x 10(-2)U/mg wt) and dexamethasone (MPO level of 6.97 x 10(-2) +/- 0.68 x 10(-2)U/mg wt) also resulted in a significant reduction in the susceptibility to gastric damage induced by ischemia-reperfusion. These results suggest that neutrophils play an important role in the gastric mucosal dysfunction associated with ischemia-reperfusion. These findings also indicate that the inhibitory effects of silymarin on neutrophil function may contribute significantly to its gastroprotective actions.

[Abdominal pregnancy with fetal survival. A report of 2 cases]. / Embarazo abdominal con supervivencia fetal. Presentación de dos casos.

The objective of this paper is to present two cases of abdominal pregnancy, secondary, with fetal survival, studied at Hospital General de Zona No. 1, IMSS, at Villahermosa, Tabasco. Both patients were referred to our Unit for cesarean section by pelvic presentation. A review was done of: classification, clinical picture, operative findings, medical and surgical treatment, hemorrhagic complications, fetal findings and specific diagnostic methods. It was concluded that one should know about this condition, in order to offer a therapeutic option to the patients.