Neurotization of femoral nerve using the anterior branch of the obturator nerve

Nerve transfer is nowadays a standard procedure for motor reinnervation. There is a vast number of articles in the literature which describe different techniques of neurotization performed after brachial plexus injuries. Although lower limb nerve transfers have also been studied, the number of articles are much limited. The sacrifice of a donor nerve to reinnervate a disrupted one causes morbidity of whichever structures that healthy nerve innervated before the transfer. New studies are focused on isolating branches or fascicles of the main donor trunk that can also be useful for rein-nervation in order to limit donor site motor dysfuntion. Femoral nerve injury due to trauma or surgery cause loss of function of the iliopsoas and quadriceps muscles, which impairs normal gait. In this article we present two clinical cases of femoral nerve injury that were successfully treated with the anterior branch of the obturator nerve

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Spanish Adaptation and Validation of the Transplant Effects Questionnaire (TxEQ-Spanish) in Liver Transplant Recipients and Its Relationship to Posttraumatic Growth and Quality of Life.

The valid assessment of the impact of transplantation on psychological well-being is highly relevant to optimize treatment. However, to date there is no standardized instrument available in Spain. The Transplant Effects Questionnaire (TxEQ) evaluates the specific problems associated with organ transplantation, such as worry about transplant, guilt regarding the donor, disclosure of having undergone transplantation, adherence to medical treatment and responsibility toward the donor, family, friends, or medical staff. Against this backdrop the English original version of the TxEQ was translated into Spanish and validated in a sample of 240 liver transplant recipients. Participants also filled in the Posttraumatic Growth Inventory (PTGI), and the 12-Item Short Form Health Survey (SF-12v.2). Confirmatory factor analysis of the TxEQ-Spanish revealed a five-factor structure equivalent to the English original version, and satisfactory internal consistency (Cronbach's alpha: worry α = 0.82, guilt α = 0.77, disclosure α = 0.91, adherence α = 0.82, responsibility α = 0.83). Results showed that better mental quality of life was associated with higher adherence and disclosure, as well as less worry and guilt. Higher posttraumatic growth was significantly associated with worry, guilt, and responsibility. Interestingly, the most powerful predictor of posttraumatic growth was worry. Analysis of variance showed an interaction effect of PTG and mental quality of life on adherence, with medium PTG being associated with significantly stronger adherence in participants with better mental quality of life. In conclusion our study could successfully adapt and validate the Spanish version of the TxEQ in a large sample of liver transplant recipients. Our findings show a complex relationship between emotional reactions to transplantation, mental quality of life, and posttraumatic growth, which give further insight into inner processes supporting psychological well-being and adherence after liver transplantation.

Functionally defective high-density lipoproteins are related to heightened T-cell activation in vertically HIV-infected adolescents.

We assessed high-density lipoprotein (HDL) anti-inflammatory properties in a cohort of vertically HIV-infected adolescents. We hypothesized that proatherogenic mechanisms related to inflammation and immune activation during HIV infection may impair HDL functionality and impact on the atherosclerotic burden. Compared with healthy controls, HDL from HIV-infected adolescents presented impaired functionality, as determined by its ability to inhibit monocyte chemotaxis in vitro, which correlated with detectable viral loads (P = 0.044), lower CD4 nadir (P = 0.043), increased levels of CD4 T-cell activation (P = 0.018), higher C-reactive protein (P = 0.009), and a tendency toward thicker carotid intima-media thickness (P = 0.071).

Prospective study of renal function in HIV-infected pediatric patients receiving tenofovir-containing HAART regimens.

AIM: to describe the impact of tenofovir disoproxil fumarate (TDF) use on renal function in HIV-infected pediatric patients. DESIGN: it is a prospective, multicenter study. The setting consisted of five third-level pediatric hospitals in Spain. The study was conducted on patients aged 18 years and younger who had received TDF for at least 6 months. The intervention was based on the study of renal function parameters by urine and serum analyses. The main outcome measures were renal function results following at least 6 months of TDF therapy. RESULTS: forty patients were included (32 were white and 26 were diagnosed with AIDS). Median (range) duration of TDF treatment was 77 months (16-143). There were no significant changes in the estimated creatinine clearance. Urine osmolality was abnormal in eight of 37 patients, a decrease in tubular phosphate absorption was documented in 28 of 38 patients, and 33 of 37 patients had proteinuria. A statistically significant decrease in serum phosphate and potassium concentrations was observed during treatment (P = 0.005 and P = 0.003, respectively), as well as a significant relationship between final phosphate concentration and tubular phosphate absorption (P = 0.010). A negative correlation was found between phosphate concentration and time on TDF. CONCLUSIONS: TDF use showed a significant association with renal tubular dysfunction in HIV-infected pediatric patients. Periodic assessment of tubular function may be advisable in the follow-up of this population.

Condiciones de trabajo, burnout y síntomas de estrés en la universidad: validación de un modelo estructural sobre el efecto mediador de la competencia personal percibida / Work conditions, burnout and stress symptoms at university: testing a structural model on the mediating effect of personal perceived competent

En este estudio se ha puesto a prueba un modelo estructural sobre el papel mediador de la competencia personal percibida en la aparición del síndrome del desgaste profesional (burnout) y de los síntomas de estrés ante condiciones de trabajo estresantes, en una muestra de 315 trabajadores de la Universidad de Sevilla (193 docentes y 122 no docentes). Los instrumentos de evaluación fueron: un cuestionario de datos sociodemográficos, el “Inventario de burnout de Maslach”, la “Escala laboral de estrés” y la “Escala Magallanes de estrés”. Para el análisis de datos se utilizaron matrices de correlaciones bivariadas y el cálculo de ecuaciones estructurales. Los modelos estimados, para cada colectivo, se ajustaron de forma satisfactoria, constatándose el efecto mediador de la competencia percibida sobre las dimensiones despersonalización y realización personal y la sintomatología de estrés. No se confirmó su efecto mediador sobre la dimensión cansancio emocional, que actuó también como variable mediadora. Además, se concluye que en el modelo estimado para los docentes adquieren más fuerza los componentes cognitivo-aptitudinales y, en el del personal no docente los de carácter emocional (AU)

The present study has tested on a sample of 315 employees of the University of Seville (193 faculty and 122 non-faculty) a structural model of the mediating role of personal perceived competence in the appearance of burnout syndrome and stress symptoms under stressful work conditions. The evaluating instruments used were: a sociodemographic questionnaire, the Maslach Burnout Inventory, the Occupational Stress Scale and the Magallanes Stress Scale. Bivariate correlation matrixes and structural equation modeling were used to analyze the data. The estimated models for each group were satisfactorily adjusted, thus ascertaining the mediating effect of perceived competence over the dimensions of the syndromes depersonalization and personal accomplishment, and stress symptoms. Its mediating effect was not confirmed for the emotional exhaustion dimension, which acted as mediating variable. Furthermore, it was determined that cognitive-aptitudinal components acquire more strength in the estimated model used for faculty whereas for non-faculty, those of emotional characteristics do