[The temporomandibular joint compromise as a cause of acute and chronic headaches and other otoneurological symptoms]. / El compromiso articular temporomandibular como causa de cefaleas agudas y crónicas y otros síntomas otoneurológicos.

OBJECTIVES: The aim of this work is to introduce a new condition within temporomandibular disorders, temporomandibular joint compromise (TMJC), a mandibular movement limiting disorder of extra-articular traumatic cause, and evaluate the response rate and safety of treatment. The limiting cause of mandibular movement is the lack of space between the mandibular ramus and maxilla. The main symptoms of TMJC include headache, dizziness, and tinnitus. In many cases, the headache is previously diagnosed as a migraine. METHODS: Data were collected from 54 patients aged between 6 and 59 years that had a confirmed diagnosis of migraine according to the 3rd Edition of the International Headache Classification of the International Headache Society of 2018, and were treated for TMJC in a dental clinic. They also presented with other otolaryngological symptoms. A retrospective quasi-experimental study without a control group was carried out due to ethical considerations related to the harmless nature of the treatment. RESULTS: After treatment of TMJC, migraine symptoms disappeared in 52 patients (96.3%, P<.001), and persisted, although with clinical improvement, in 2 (3.7%). There was also an improvement in the other associated symptoms: dizziness disappeared in 23 out of 27 affected patients (85.21%, P<.001), and tinnitus disappeared in the 31 affected patients (100%, P<.001). No significant treatment-related side effects were observed. CONCLUSIONS: This study shows the high rate of response and safety of the treatment of TMJC.

Proceso de adaptación cultural del "Questionnaire for Assesing the Childbirth Experience (QACE)" / Spanish Cultural Adaptation of the Questionnaire for Assessing the Childbirth Experience (QACE)English

INTRODUCCIÓN: Las experiencias negativas durante el parto se han asociado con desempoderamiento de la mujer, depresión postparto, trastorno por estrés postraumático y bajas tasas de lactancia maternal, entre otros. El Questionnaire for Assessing the Childbirth Experience (QACE) es una herramienta de 23 ítems útil para identificar mujeres que han tenido una mala experiencia en su proceso de parto y evitar así futuras complicaciones en embarazos posteriores o en la relación de pareja. OBJETIVO: El objetivo general consiste en adaptar el Questionnaire for Assessing the Childbirth Experience (QACE) a la población española y obtener sus características psicométricas. METODOLOGÍA: El proceso de adaptación cultural ha consistido en la traducción y retro traducción al español, evaluación de la equivalencia conceptual por un comité de jueces, evaluación de la comprensibilidad y una entrevista cognitiva a un grupo de mujeres puérperas. Las características psicométricas se han obtenido mediante el análisis factorial, los test de Kaiser-Meyer-Olkin (KMO) y Bartlett y el alfa de Cronbach. RESULTADOS: Tras el proceso de adaptación transcultural, el grupo de expertos realizó las modificaciones necesarias para conseguir una mayor compresión del cuestionario en la población española, evitar malentendidos y palabras ofensivas en la lengua de destino. Se necesitaron 138 participantes para obtener el análisis factorial. El KMO (0,838) y el test de Bartlett (p < 0,001) confirmaron la adecuación del análisis factorial y el grafico de sedimentación mostró 6 factores con un poder predictivo del 73,75% del total de la varianza. La consistencia interna se obtuvo mediante un alfa de Cronbach de 0,896. CONCLUSIONES: Los datos obtenidos en este estudio demuestran que la versión española del QACE es una herramienta válida y fiable para medir la experiencia en el nacimiento en la población española

BACKGROUND: Negative experiences during delivery are associated with women disempowerment, postpartum depression, post-traumatic stress disorder, and low breastfeeding rates. The Questionnaire for Assessing the Childbirth Experience (QACE) is a 23-item screening tool useful for discovering women with a negative experience in their birth process and avoids future complications in following pregnancies or couple's relationships. OBJECTIVE: The general objective is to adapt the Questionnaire for Assessing the Childbirth Experience (QACE) to the Spanish population and to obtain its psychometric characteristics. METHODOLOGY: The cultural adaptation process consisted of forwarding translation and back translation into Spanish, conceptual equivalence evaluation by a committee of judges, comprehensibility evaluation and cognitive interview to a postpartum group. Psychometric characteristics were obtained throughout the factorial analysis, Kaiser-Meyer-Olkin (KMO) and Bartlett's test of sphericity and Cronbach alpha level. RESULTS: After complete the adaptation process, the committee of judges made several adjustments to achieve a better comprehension in the Spanish population, avoid misunderstandings or offensive words in the target language. 138 participants were needed to calculate factor analysis. The KMO (0.838) and Bartlett test (p < 0.001) confirmed the adequacy of factor analysis and the Scree plot showed 6 factors with the predictive power of 73.75% supported total variance. Internal consistency was assured using a Cronbach α of 0.896. CONCLUSIONS: Data from this study demonstrate that the Spanish version of QACE is a valid and reliable measure of childbirth experience in the Spanish population

Randomized control trial to assess the efficacy of metacognitive training compared with a psycho-educational group in people with a recent-onset psychosis.

BACKGROUND: Aims were to assess the efficacy of metacognitive training (MCT) in people with a recent onset of psychosis in terms of symptoms as a primary outcome and metacognitive variables as a secondary outcome. METHOD: A multicenter, randomized, controlled clinical trial was performed. A total of 126 patients were randomized to an MCT or a psycho-educational intervention with cognitive-behavioral elements. The sample was composed of people with a recent onset of psychosis, recruited from nine public centers in Spain. The treatment consisted of eight weekly sessions for both groups. Patients were assessed at three time-points: baseline, post-treatment, and at 6 months follow-up. The evaluator was blinded to the condition of the patient. Symptoms were assessed with the PANSS and metacognition was assessed with a battery of questionnaires of cognitive biases and social cognition. RESULTS: Both MCT and psycho-educational groups had improved symptoms post-treatment and at follow-up, with greater improvements in the MCT group. The MCT group was superior to the psycho-educational group on the Beck Cognitive Insight Scale (BCIS) total (p = 0.026) and self-certainty (p = 0.035) and dependence self-subscale of irrational beliefs, comparing baseline and post-treatment. Moreover, comparing baseline and follow-up, the MCT group was better than the psycho-educational group in self-reflectiveness on the BCIS (p = 0.047), total BCIS (p = 0.045), and intolerance to frustration (p = 0.014). Jumping to Conclusions (JTC) improved more in the MCT group than the psycho-educational group (p = 0.021). Regarding the comparison within each group, Theory of Mind (ToM), Personalizing Bias, and other subscales of irrational beliefs improved in the MCT group but not the psycho-educational group (p < 0.001-0.032). CONCLUSIONS: MCT could be an effective psychological intervention for people with recent onset of psychosis in order to improve cognitive insight, JTC, and tolerance to frustration. It seems that MCT could be useful to improve symptoms, ToM, and personalizing bias.

Evaluation of the Effectiveness of a Psychoeducational Intervention in Treatment-Naïve Patients with Antidepressant Medication in Primary Care: A Randomized Controlled Trial.

BACKGROUND: There is evidence supporting the effectiveness of psychoeducation (PE) in patients with symptoms of depression in primary care (PC), but very few studies have assessed this intervention in antidepressant-naïve patients. The aim of this study is to assess the effectiveness of a PE program in these patients, since the use of antidepressant (AD) medication may interfere with the effects of the intervention. METHODS: 106 participants were included, 50 from the PE program (12 weekly 1.5-hour sessions) and 56 from the control group (CG) that received the usual care. Patients were assessed at baseline and at 3, 6, and 9 months. The main outcome measures were the Beck Depression Inventory (BDI) and remission based on the BDI. The analysis was carried out on an intention-to-treat basis. RESULTS: The PE program group showed remission of symptoms of 40% (P = 0.001) posttreatment and 42% (P = 0.012) at 6 months. The analysis only showed significant differences in the BDI score posttreatment (P = 0.008; effect size Cohen's d' = 0.55). CONCLUSIONS: The PE intervention is an effective treatment in the depressive population not treated with AD medication. Before taking an AD, psychoeducational intervention should be considered.

Hipocinetismo: un problema de salud entre jóvenes ucevistas? / Hypokinetism: a problem of health among young ucevistas?

Se explora la evaluación del hipocinetismo como factor de riesgo para la salud. A tal fin fueron analizados los hábitos de actividad física y el nivel de riesgo cardiovascular, en 314 estudiantes no atletas de la Universidad Central de Venezuela con edades entre 17 y 29 a¤os, mediante la aplicación del Cuestionario Internacional de Actividad Física-IPAQ (2004) y un cuestionario de Hoeger y Hoeger (2002) para la estimación del riesgo cardiovascular. Los resultados indicaron que globalmente 31,53 por ciento de los sujetos tenían un nivel de actividad física que se relaciona con hipocinetismo. Se evidenció que las jóvenes estudiadas mostraron mayores niveles de riesgo cardiovascular. Se identificaron asociaciones entre las variables género y la categoría de riesgo cardiovascular, asícomo entre esta última y los niveles de actividad física, apuntando a que el hipocinetismo representa un factor de riesgo adicional en el desarrollo de enfermedades crónicas no transmisibles en los ucevistas evaluados.

Measurement of liver iron overload by magnetic induction using a planar gradiometer: preliminary human results.

The measurement of hepatic iron overload is of particular interest in cases of hereditary hemochromatosis or in patients subject to periodic blood transfusion. The measurement of plasma ferritin provides an indirect estimate but the usefulness of this method is limited by many common clinical conditions (inflammation, infection, etc). Liver biopsy provides the most quantitative direct measurement of iron content in the liver but the risk of the procedure limits its acceptability. This work studies the feasibility of a magnetic induction (MI) low-cost system to measure liver iron overload. The excitation magnetic field (B0, frequency: 28 kHz) was produced by a coil, the perturbation produced by the object (deltaB) was detected using a planar gradiometer. We measured ten patients and seven volunteers in supine and prone positions. Each subject was moved in a plane parallel to the gradiometer several times to estimate measurement repeatability. The real and imaginary parts of deltaB/B0 were measured. Plastic tanks filled with water, saline and ferric solutions were measured for calibration purposes. We used a finite element model to evaluate the experimental results. To estimate the iron content we used the ratio between the maximum values for real and imaginary parts of deltaB/B0 and the area formed by the Nyquist plot divided by the maximum imaginary part. Measurements in humans showed that the contribution of the permittivity is stronger than the contribution of the permeability produced by iron stores in the liver. Defined iron estimators show a limited correlation with expected iron content in patients (R < or = 0.56). A more precise control of geometry and position of the subjects and measurements at multiple frequencies would improve the method.

[Fiber in the treatment of obesity and its comorbidities]. / La fibra en el tratamiento de la obesidad y sus comorbilidades.

A considerable part of the health-care significance of obesity lies in its co-morbidity. Obesity is associated with high blood pressure, type 2 diabetes mellitus and dyslipidaemia, representing both individually and when taken together risk factors for cardiovascular disease, the main cause of death in industrialized countries. The influence of fibre consumption on body weight, the risk of type 2 diabetes and cardiovascular disease has been shown in important epidemiological surveys, but the mechanisms whereby fibre exercises this protective effect have not been definitively clarified. For the most part, the ability of fibre to slow down the process of absorption of nutrients by modifying the metabolic response to intake, its ability to increase the excretion of biliary acid and the metabolic effects of the short-chain fatty acids produced in the bacterial fermentation of fibre have all focussed the attention of the working hypotheses analyzed in the studies published in the last few years. This review is intended to identify the importance of fibre for the prevention and treatment of obesity and its comorbidities on the basis of the available evidence at present.

La fibra en el tratamiento de la obesidad y sus comorbilidades / Fiber in the treatment of obesity and its co-morbidities

Una parte importante de la trascendencia sanitaria de la obesidad radica en su comorbilidad. La hipertensión, la diabetes tipo II y la dislipemia se asocian a la obesidad, representando individualmente y en conjunto factores de riesgo para la enfermedad cardiovascular, principal causa de muerte de los países industrializados. La influencia del consumo de fibra sobre el peso corporal, el riesgo de diabetes tipo II, y de enfermedad cardiovascular ha sido mostrada en importantes estudios epidemiológicos, pero los mecanismos a través de los cuales la fibra ejerce este efecto protector no están definitivamente aclarados. La capacidad de la fibra para ralentizar los procesos de absorción de nutrientes modificando la respuesta metabólica a la ingesta, la capacidad para aumentar la excreción de ácidos biliares y los efectos metabólicos de los ácidos grasos de cadena corta producidos en la fermentación bacteriana de la fibra, centran mayoritariamente las hipótesis de trabajo de los estudios publicados en los últimos años. Esta revisión pretende situar la importancia de la fibra en la prevención y el tratamiento de la obesidad y sus comorbilidades sobre la base de las evidencias disponibles hasta el momento actual (AU)

A considerable part of the health-care significance of obesity lies in its co-morbidity. Obesity is associated with high blood pressure, type 2 diabetes mellitus and dyslipidaemia, representing both individually and when taken together risk factors for cardiovascular disease, the main cause of death in industrialized countries. The influence of fibre consumption on body weight, the risk of type 2 diabetes and cardiovascular disease has been shown in important epidemiological surveys, but the mechanisms whereby fibre exercises this protective effect have not been definitively clarified. For the most part, the ability of fibre to slow down the process of absorption of nutrients by modifying the metabolic response to intake, its ability to increase the excretion of biliary acid and the metabolic effects of the short-chain fatty acids produced in the bacterial fermentation of fibre have all focussed the attention of the working hypotheses analyzed in the studies published in the last few years. This review is intended to identify the importance of fibre for the prevention and treatment of obesity and its comorbidities on the basis of the available evidence at present (AU)

Sensitivity maps and system requirements for magnetic induction tomography using a planar gradiometer.

We evaluated analytically and experimentally the performance of a planar gradiometer as a sensing element in a system for magnetic induction tomography. A system using an excitation coil and a planar gradiometer was compared against a system with two coils. We constructed one excitation coil, two different sensing elements and a high-resolution phase detector. The first sensor was a PCB square spiral coil with seven turns. The second sensor was a PCB planar gradiometer with two opposite square spirals of seven turns, with a distance between centres of 8 cm. Theoretical sensitivity maps were derived from basic equations and compared with experimental data obtained at 150 kHz. The experimental sensitivity maps were obtained measuring the perturbation produced by a brass sphere of 12 mm in empty space. The advantage of using a gradiometer is that it can be adjusted to give a minimum signal for homogeneous objects, while increasing the sensitivity to local perturbations of the conductivity. Results show that a system using a planar gradiometer as detector has less demanding requirements for the electronic system than a system using simple coils.

Preservación del medio ambiente hídrico

Detalla aspectos sobre la calidad del agua, la contaminacion de la misma y tipo de contaminantes, complementando la informacion con ilustraciones. Manifiesta la relacion existente entre la cantidad y calidad del agua, analizando los parámetros involucrados en el balance ecológico: poblacion, urbanizacion, crecimiento económico y residuos químicos. Incluye pautas de manejo de la calidad del agua