Search

Objectives. To estimate the incidence and prevalence of multiple sclerosis (MS) in Malmö municipality in southwestern Sweden. Materials and Methods. Multiple sources were used in the case identification process. Case ascertainment was assessed by medical chart review including examinations such as magnetic resonance imaging, cerebrospinal fluid analyses, and relevant laboratory tests. Cases were classified according to the 2010 McDonald’s diagnostic criteria. Onset-adjusted prevalence and a definition of onset symptoms were applied. Results. The crude incidence of MS in 2001-2010 in Malmö municipality was 5.3/100,000 (95% confidence interval (CI): 4.5 to 6.2). There was a relapsing onset in 90.5% of cases. The female to male ratio was 1.8. The onset-adjusted prevalence for Dec 2010 was 133/100,000 (95% CI, 120 to 146) with a female to male ratio of 2.1. Conclusions. This is the first population-based epidemiological study in Skåne, the most southwestern part of Sweden showing a high incidence and prevalence. We found a lower incidence than expected according to previous nationwide figures, probably due to methodological differences between the studies. Our findings support the presence of a north-south gradient of MS prevalence in Sweden.

Background: Arterial catheterisation is a common procedure in intensive care units (ICUs), typically performed using the palpation technique. Ultrasound (US)-guided catheterisation remains underutilised, particularly when performed by nonphysician operators., Objective: The objective of this study was to assess the effectiveness of US-guided arterial catheterisation performed by nurses in critically ill patients., Methods: This prospective cohort study took place in a medical ICU at a tertiary university hospital, comparing outcomes before and after a training program. Critically ill patients requiring arterial catheterisation were included. The study examined the performance and complications associated with two catheterisation techniques used by critical care nurses: palpation (PP) and US-guided. Nurses inexperienced with the US technique completed a brief training program consisting of two 3-h workshops followed by supervised clinical practice before performing the procedure. Collected data included the first-attempt success rate (primary endpoint), overall success rate, procedure time, the number of attempts, the number of cannulas used, complication rate, and catheter durability., Results: The study included 175 patients, with 89 in the PP group and 86 in the US group. Baseline characteristics were similar between groups. The first-attempt success rate was 50% in the PP group and 58% in the US group (p = 0.39, 95% confidence interval -23.4% to +8.3%). No significant differences were observed between groups in terms of failed attempts (21.3% vs. 14%, p = 0.28), procedure time (284 s vs 350 s, p = 0.44), or rates of immediate (haematoma) and late (catheter infection or dysfunction) complications. Catheter durability was also comparable. Although radial artery cannulation was preferred in both groups, femoral and brachial access were more frequently used in the US group (12.9% and 2.9% vs. 17.6% and 14.9%, respectively, p = 0.02)., Conclusions: Arterial catheterisation using US guidance, performed by nurses with limited prior experience after a brief training course, demonstrated similar performance and complications rates compared to the traditional PP technique in a medical ICU setting., (Copyright © 2024 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

This research aimed to investigate whether the mental space-time association of temporal concepts could be modulated by the availability of cognitive resources (in terms of working memory and inhibitory control capacities) and to explore whether access to this association could be an automatic process. To achieve this, two experiments were carried out. In Experiment 1, participants had to classify words with future and past meanings. The working memory load (high vs. low) was manipulated and the participants were grouped into quartiles according to their visuospatial working memory capacity (WMC). Temporal concepts were displayed subliminally (immediate masking) and supraliminally (delayed masking). The ANOVA showed a performance pattern consistent with the left-past right-future conceptual scheme, regardless of both the type of masking and the working memory load, except in high WMC participants, in which, interestingly, the space-time association effect was absent. In Experiment 2, participants were asked to respond to the colour of the font of the temporal words, and their attentional control capacity was assessed. The results indicated a timeline effect that was irrespective of the WM load and the type of perceptual processing, but not of the WM capacity or the inhibitory abilities. These findings partially endorse the automatic and implicit access to the mental space-time association and suggest the involvement of the availability of cognitive resources. Individual WMC differences appear to modulate the automatic nature of the effect rather than the processing conditions themselves., (© 2024. The Author(s).)

Introduction: Coordination and balance are progressive motor skills that guide physical therapists in recognizing abnormal patterns during childish neurodevelopment. We aim to compare the efficacy of craniosacral therapy (CST) together with balance and coordination therapy (BCT) vs traditional BCT during neurodevelopment., Methods: Longitudinal, observational, and descriptive study with 111 apparently healthy children divided into 4 groups: craniosacral-balance and coordination therapy placebo (CS-BCTp), craniosacral-balance and coordination therapy (CS-BCT), balance and coordination therapy placebo (BCTp), and balance and coordination therapy (BCT)., Results: Significant changes have been observed with the CS-BCT from the fourth session. Balance and coordination therapy is less effective. There are differences in the Battelle Scale at the beginning and after the 7 therapy sessions in the CS-BCT group., Conclusions: The study shows that CST together with balance and coordination exercises can be a more effective and faster treatment to improve these motor skills, correcting and improving alterations during child neurodevelopment., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background and Aim: Patients with chronic kidney disease (CKD) and hepatitis C infection can be safely and effectively treated with direct-acting antivirals (DAAs). However, there is scarce data on the long-term impact of hepatitis C cure on CKD. The aim of this study was to assess the long-term mortality, morbidity and hepatic/renal function outcomes in a cohort of HCV-infected individuals with CKD treated with DAAs., Methods: 135 HCV patients with CKD stage 3b-5 who received ombitasvir/paritaprevir/ritonavir±dasabuvir in a multicenter study were evaluated for long-term hepatic and renal outcomes and their associated mortality., Results: 125 patients achieved SVR and 66 were included. Prior to SVR, 53 were under renal replacement therapy (RRT) and 25 (37.8%) had liver cirrhosis. After a follow-up of 4.5 years, 25 (38%) required kidney transplantation but none combined liver-kidney. No changes in renal function were observed among the 51 patients who did not receive renal transplant although eGFR values improved in those with baseline CKD stage 3b-4. Three (5.6%) subjects were weaned from RRT. Eighteen (27.3%) patients died, mostly from cardiovascular events; 2 developed liver decompensation and 1 hepatocellular carcinoma. No HCV reinfection was observed., Conclusions: Long-term mortality remained high among end-stage CKD patients despite HCV cure. Overall, no improvement in renal function was observed and a high proportion of patients required kidney transplantation. However, in CKD stage 3b-4 HCV cure may play a positive role in renal function., (Copyright © 2022 Elsevier España, S.L.U. All rights reserved.)

Introduction: SARS-COV-2 pneumonia is a highly contagious respiratory disease that causes respiratory, physical and psychological dysfunctions. We present the results of patient assessment when they were discharged from the ICU., Material and Method: Cohort study of patients affected by SARS-COV-2 pneumonia admitted to the intensive care unit from 01/10/2020 to 31/07/2021. We collect sociodemographic data, personal history, ICU and hospital stay, Barthel, FAC and mMRC (pre-admission/initial assessment/discharge), development of osteomuscular and/or neurological pathology and need for rehabilitation treatment., Results: A total of 341 patients were evaluated, of which 224 met criteria. The average age was 63 years (68.75% men). Mean ICU/hospital stay were 27/44 days. They were assessed by physiatry, after that, we provide a guide developed by physiatry, solving doubts about the disease and setting exercises of intensity and progressive difficulty, to be carried out during the admission and at home. Neurological pathology was present at 42.86% patients, of whom a 83.33% were peripheral nervous system disease. The total of the sample needed respiratory physiotherapy and a 72.32% motor physiotherapy., Conclusions: In our study, a high number of patients have needed rehabilitation treatment in order to get functional recovery, highlighting the development of post-COVID neurological pathology. SARS-COV-2 generates other complications, not only respiratory, subsidiary to be assessed and treated by rehabilitation services for a comprehensive recovery that minimizes sequelae., (Copyright © 2022 Sociedad Española de Rehabilitación y Medicina Física. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: The ORBE II study aimed to describe the characteristics and clinical outcomes of adult patients with severe eosinophilic asthma (SEA) treated with benralizumab in a real-world setting in Spain., Methods: ORBE II (NCT04648839) was an observational, retrospective cohort study in adult SEA patients who had been prescribed benralizumab. Demographic and clinical data of 204 SEA patients were collected 12 months prior to benralizumab initiation (baseline) and at follow-up. Exacerbation rate, asthma symptoms, maintenance oral corticosteroid (OCS) use and lung function were evaluated, among other variables., Results: A total of 204 SEA patients were evaluated. Mean (standard deviation, SD) age of the study population was 56.4 (12.4) years, 62.3% were women and mean (SD) duration of asthma was 15.1 (12.7) years. Median (Q1-Q3) follow-up duration was 19.5 (14.2-24.2) months. At baseline, 72.6% of the overall population (OP) presented blood eosinophil counts ≥ 300 cells/µL; 36.8% had comorbid chronic rhinosinusitis with nasal polyps (CRSwNP); 84.8% reported at least one severe exacerbation, and 29.1% were OCS-dependent. At 1 year of follow-up, patients receiving benralizumab treatment had a 85.6% mean reduction in exacerbations from baseline, and 81.4% of patients achieved zero exacerbations. We also found a clinically relevant mean (SD) increase in pre-bronchodilator (BD) FEV 1 of 331 (413) mL, with 66.7% of patients achieving a pre-BD FEV 1 increase ≥ 100 mL, and 46.3% of patients achieving a pre-BD FEV 1  ≥ 80% of predicted. Regarding symptom control, 73.8% of the OP obtained an ACT score ≥ 20 points. After 1 year of follow-up, mean reduction in the daily OCS dose was 70.5%, and complete OCS withdrawal was achieved by 52.8% of the OCS-dependent patients. Almost half (43.7%) of the OP on benralizumab met all four criteria for clinical remission. Patients with concomitant CRSwNP obtained similar or enhanced outcomes., Conclusions: These data support the real-world benefits of benralizumab in SEA patients, and particularly in those with concomitant CRSwNP., Trial Registration: NCT04648839., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: In healthy children, the frequency of the anomalous persistence of primitive reflexes (PRs) and craniosacral blocks (CBs) is unknown, as well as their impact on neurodevelopment, behaviour disorders and related consequences. We aim to know the prevalence of anomalous PRs and CBs in apparently healthy children and their relationships with behavior and neurodevelopment anomalies., Methods: Participants ( n = 120) were evaluated via a physical examination to detect PRs and CBs and an ad hoc parent survey to collect perinatal events, and children's behavioral assessments were conducted by teachers using the Battelle score., Results: PRs were present in 89.5%. Moro (70.8%), cervical asymmetric (78.3%) and cervical symmetric PRs (67.5%) were the most frequently observed PRs. CBs were found in 83.2%, and the most frequent CBs were dura mater (77.5%) and sphenoid bone (70%) blocks. Moro, cervical asymmetric and cervical symmetric active primitive reflexes were significantly associated with cranial blocks of dura mater, parietal zones and sphenoid bone sway. Gestational disorders or perinatal complications were associated with a higher frequency of PRs and CBs. The presence of PRs and CBs was associated with abnormal Battelle scores and neurobehavioral problems., Conclusion: The presence of PRs and CBs in children without diagnosed diseases is frequent and related to disturbances in childhood neurodevelopment.

There is a great deal of research describing the close association that exists between numerical and spatial representations, illustrating the SNARC (Spatial-Numerical Association of Response Code) effect. This effect signals the spatial mental representation of small numbers to the left and larger numbers to the right, coinciding with the direction of reading and writing. Subsequent research has found a similar spatial representation for other stimuli (e.g., size of objects and animals, and words associated with time). Some of these spatially represented stimuli are social in nature, even suggesting a spatial mental organization of stimuli based on gender (e.g., the upper part of a vertical axis for males and the lower part for females). The aim of the present study was threefold (1) to replicate and extend results on the existence of a mental gender line (as a function of response hand: female-left hand and male-right hand) when responding simply to gender of stimuli; (2) to explore the influence of inhibitory control; and, (3) to determine whether gender-space associations depend on the explicit or implicit nature of a gender task. Three experiments were designed to pursue these objectives. In Experiment 1, female, male and neutral faces and names were displayed, and the participants were asked to identify their gender. Experiment 2, which also included a Stroop task, followed the same procedure as Experiment 1, but displayed objects that could be designated as female or male and others not related to any gender. Finally, in Experiment 3, in which participants were asked to respond to the direction of an arrow, object gender was not relevant to the task. Consistent with previous research and confirming our hypotheses, the results showed a spatial mental representation of the stimuli based on gender in all three experiments, regardless of whether the stimulus was consciously perceived. Moreover, inhibitory ability showed a relationship with the gender-space line effect. The contributions and implications of this study are discussed, as are possible limitations and future lines of research., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Calvente, Noguera, Álvarez, Fernández and Carmona.)

Virgin olive oil (VOO) production generates large amounts of a harmful by-product, olive mill waste (OMW) or alpeorujo, which has a strong environmental impact and that must be recycled to adapt VOO production to a circular economy model. Here, the valorization of OMW was studied by considering three consecutive stages: Stage 1 involves the generation of OMW; Stage 2 the recovery of bioactive phenolic compounds from the fresh OMW using natural deep eutectic solvents (NADESs), generating a valuable phenolic extract and a new by-product, a dephenolized OMW named "alpeoNADES"; and Stage 3 involves vermicomposting alpeoNADES with Eisenia fetida earthworms. Six NADES were formulated and tested, selecting a NADES composed of citric acid and fructose (CF) derived from food grade and biodegradable substances. CF was the most effective solvent to obtain phenolic extracts for nutraceutical and agronomical purposes, extracting 3988.74 mg/kg of polyphenols from fresh OMW. This alpeoNADES is a non-palatable substrate for E. fetida earthworms, as the residual CF gives it an acidic pH (pH 2). Its palatability was improved by mixing it with horse manure and straw for vermicomposting, in a 1:1 and 3:1 dry weight ratio. When these substrates were precomposted for 3 weeks they reached pH 5.5-6 and they could then be vermicomposted for 23 weeks (using OMW as a control). The best substrate for vermicomposting was determined by the worm biomass, growth rate, carbon to nitrogen (C:N) ratio, and N and P content. AlpeoNADES and manure 3:1 produced the highest quality vermicompost in the shortest time, generating a product that complied with European standards for organic fertilizers. Hence, alpeoNADES was recycled to a low-cost, organic balanced fertilizer in Stage 3, enabling the olive oil industry to transition to sustainable production through this integrated circular economy design., Competing Interests: Declaration of competing interest The authors have no known competing financial interests to declare or personal relationships that could have influenced the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

The aim of this study was to evaluate the efficacy of mesenchymal stem cells (MSCs) in the regeneration of periodontal bone defects in animal models. A systematic review and meta-analysis were conducted following the PRISMA guidelines, and the study was recorded in PROSPERO under reference number CDR42021247462. The PICO question was: is periodontal regeneration (cementum, periodontal ligament and alveolar bone) with MSCs more effective than other techniques? Three groups were considered: Group 1: MSCs alone or mixed with regenerative materials. Group 2: only regenerative materials. Group 3: no regenerative material nor MSCs. The search was conducted using MeSH with a total of 18 articles for qualitative analysis and 5 for quantitative analysis. For the meta-analysis, a modification of the effect size algorithm was developed, which considered a comparison of means between treatments using the Student's t sample distribution. When comparing the effect size between Group 1 and Group 2, the effect size for the new cementum was 2.83 mm with an estimated confidence interval of 95% (CI 95%) between 0.48 and 5.17 mm. When considering the fit to a random-effects model, the combined variance (τ 2 ) was 6.1573 mm, with a standard deviation (SD) of 5.6008 mm and a percentage of total heterogeneity I 2 of 92.33% (p < 0.0001). For new bone, the effect size was 0.88 mm, CI 95% - 0.25 to 2.01 mm, τ 2  = 1.3108 mm (SD = 1.2021 mm) and I 2  = 80.46%, p = 0.0004). With regard to the new periodontal ligament, it was not possible for the meta-analysis to be performed. MSCs have a greater capacity for tissue regeneration in root cementum than in alveolar bone compared to other regenerative materials., (© 2022. The Author(s).)

Deciphering the human spatial cognition system involves the development of simple tasks to assess how our brain works with shapes and forms. Prior studies in the mental rotation field disclosed a clockwise rotation bias on how basic stimuli are perceived and processed. However, there is a lack of a substantial scientific background for complex stimuli and how factors like sex or aging could influence them. Regarding the latter point, it is well known that our spatial skills tend to decline as we grow older. Hence, the hippocampal system is especially sensitive to aging. These neural changes underlie difficulties for the elderly in landmark orientation or mental rotation tasks. Thus, our study aimed to check whether the effect of clockwise and anticlockwise rotations in the spatial recognition of complex environments could be modulated by aging. To do so, 40 young adults and 40 old adults performed the ASMRT, a virtual spatial memory recognition test. Results showed that young adults outperformed old adults in all difficulty conditions (i.e., encoding one or three boxes positions). In addition, old adults were affected more than young adults by rotation direction, showing better performance in clockwise rotations. In conclusion, our study provides evidence that aging is particularly affected by the direction of rotation. We suggest that clockwise bias could be linked with the cognitive decline associated with aging. Future studies could address this with brain imaging measures., (© 2022. The Author(s).)

Limited data exists on SARS-CoV-2 sustained-response to vaccine in patients with rheumatic diseases. This study aims to evaluate neutralizing antibodies (nAB) induced by SARS-CoV-2 vaccine after 3 to 6 months from administration in Systemic Lupus Erythematosus (SLE) patients, as a surrogate of sustained-immunological response. This cross-sectional study compared nAB titre of 39 SLE patients and 37 Healthy individuals with no previous SARS-CoV-2 infection, who had all received a complete regimen of a mRNA SARS-CoV-2 vaccine within the last 3 to 6 months. We included four lines of SLE treatment including Not-treated, Hydroxychloroquine, immunosuppressive drugs and biological therapy. Glucocorticoids were allowed in all groups. Healthy and Not-treated individuals showed the highest levels of nAB. Treated patients presented lower nAB titres compared to Healthy: a 73% decrease for First-Line patients, 56% for Second-Line treatment and 72% for Third-Line. A multivariate analysis pointed to Glucocorticoids as the most associated factor with declining nAB levels (75% decrease) in treated SLE. Furthermore, a significant reduction in nAB titres was observed for Rituximab-users compared to Healthy subjects (89% decrease). Medium-term response of SLE patients to SARS-CoV-2 mRNA vaccines is negatively impacted in Glucocorticoids and Rituximab users. These findings might help to inform recommendations in vaccination protocols for SLE patients., (© 2022. The Author(s).)

Introduction: Despite the direct-acting antiviral therapy has dramatically decreased the likelihood of having liver-related complications and extrahepatic outcomes, the risk of developing hepatocellular carcinoma (HCC) is not totally eliminated after sustained virological response (SVR). We aimed to develop an easy-to-apply strategy to be adopted in clinical practice for accurately classifying the HCC risk in hepatitis C virus patients after SVR., Methods: Prospective and multicenter study enrolling hepatitis C virus patients with advanced fibrosis (transient elastography [TE] > 10 kPa) or cirrhosis by ultrasound showing SVR. They were followed up until HCC, liver transplantation, death, or until October 2020, which occurred first, with a minimum follow-up period of 6 months after SVR (follow-up: 49 [interquartile range 28-59] months)., Results: Patients with cirrhosis by ultrasound represented 58% (611/1,054) of the overall cohort. During the study, HCC occurrence was 5.3% (56/1,054). Multivariate analyses revealed that Fibrosis-4 (FIB-4) > 3.25 (hazard ratio [HR] 2.26 [1.08-4.73]; P = 0.030), TE (HR 1.02 [1.00-1.04]; P = 0.045) and cirrhosis by ultrasound (HR 3.15 [1.36-7.27]; P = 0.007) predicted HCC occurrence. Baseline HCC screening criteria (TE > 10 kPa or cirrhosis) identified patients at higher risk of HCC occurrence in presence of FIB-4 > 3.25 (8.8%; 44/498) vs FIB-4 < 3.25 (2.4%; 12/506), while those with only FIB > 3.25 had no HCC (0%; 0/50) (logRank 22.129; P = 0.0001). A combination of baseline FIB-4 > 3.25 and HCC screening criteria had an annual incidence >1.5 cases per 100 person-years, while the rest of the groups remained <1 case. Patients who maintained post-treatment FIB-4 > 3.25 and HCC screening criteria remained at the highest risk of HCC occurrence (13.7% [21/153] vs 4.9% [9/184]; logRank 7.396, P = 0.007)., Discussion: We demonstrated that a two-step strategy combining FIB-4, TE, and ultrasound could help stratify HCC incidence risk after SVR., (Copyright © 2021 by The American College of Gastroenterology.)

Introduction: Laparoscopic Roux-en-Y gastric bypass surgical technique systematization makes it a very safe technique that it is not exempt from intraoperative complications. One of the key aspects for performing a safe procedure is combining technical expertise with nontechnical skills, such as communication and teamwork. Materials and Methods: We describe a case that highlights the importance of surgical team interaction to avoid intraoperative complications during bariatric surgery, as an incidental stapling of the nasogastric tube. Results: This clinical case highlights the importance of effective teamwork and a culture of safety during complex laparoscopic surgical procedures. Conclusions: The lack of effective surgical team communication during a laparoscopic Roux-en-Y gastric bypass can be a cause of severe surgical complications that requires experience of the surgical team for its resolution.

Schizotypy can be defined as a combination of traits qualitatively similar to those found in schizophrenia, but milder in their expression, that can be found in clinical and non-clinical populations. In this research, we explore, to our knowledge, for the first time, whether schizotypal personality traits may affect the acquisition of conditioned fear by social means only. Apart from being an essential capacity to ensure learning in safe environments, social fear learning shares important characteristics with direct fear acquisition, which also makes it a great candidate for developing successful extinction procedures. Undergraduate students (n = 72) performed a task of social fear learning. In this task, participants watched a video of a person that simulated to receive electric shocks (unconditioned stimulus; US) paired with a coloured square (conditioned stimulus plus; CS+), while another coloured square was never paired (conditioned stimulus minus; CS-) with the shock. After that, they were presented with a similar sequence of coloured screens. Their Skin Conductance Responses (SCRs) were registered during the whole process. Once they finished, they completed the Schizotypal Personality Questionnaire (SPQ). Our results revealed that participants with a low score in the Cognitive-Perceptual factor of the SPQ exhibited higher SCRs when they saw the US than when they saw the CS- (all ps < 0.01) during the learning phase. Nevertheless, those with higher scores did not present any difference in their SCRs toward both stimuli (all ps > 0.05), a pattern that has been similarly found in schizophrenia. During the final trials of the test phase, participants with the highest scores in the Disorganized factor were the only ones that maintained a higher SCR towards the CS+ than towards the CS- (p = 0.006), which could be associated with an impairment in their extinction processes., (© 2021. The Author(s).)

In the present study, event-related potentials (ERPs) were registered during a semantic negative priming (NP) task in participants with higher and lower working memory capacity (WMC). On each trial participants had to actively ignore a briefly presented single prime word, which was followed either immediately or after a delay by a mask. Thereafter, either a semantically related or an unrelated target word was presented, to which participants made a semantic categorization judgment. The ignored prime produced a behavioral semantic NP in delayed (but not in immediate) masking trials, and only for participants with a higher-WMC. Both masking type and WMC also modulated ERP priming effects. When the ignored prime was immediately followed by a mask (which impeded its conscious identification) a reliable N400 modulation was found irrespective of participants' WMC. However, when the mask onset following the prime was delayed (thus allowing its conscious identification), an attenuation of a late positive ERP (LPC) was observed in related compared to unrelated trials, but only in the higher-WMC group showing reliable behavioral NP. The present findings demonstrate for the first time that individual differences in WMC modulate both behavioral measures and electrophysiological correlates of semantic NP., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Megías, Ortells, Carmona, Noguera and Kiefer.)