Search

Objectives: To analyse the effectiveness of a physical exercise programme guided by a mobile health technology system (COVIDReApp) for patients with post-acute COVID-19 syndrome. This syndrome is a multisystem disease that occurs in people with a history of COVID-19 between 1 and 3 months after the onset of the disease. This study will assess the impact of the intervention on fatigue, post-exertional dyspnoea, quality of life, pain severity, physical fitness, anxiety, depression and cognitive function. We also aim to analyse whether there are associations between the variables studied and the evolution of these associations during follow-up., Design: A single-blind randomised controlled trial., Methods: One hundred patients diagnosed with post-acute COVID-19 will be enrolled and randomly assigned to two groups. The experimental group will perform the intervention through a physical exercise programme guided by the COVIDReApp system, whereas the control group will perform the programme in paper format. Study outcomes will be collected at baseline and at 4, 12 and 24 weeks. Student's t -tests or Mann-Whitney U -tests will be used to analyse differences between groups, mixed ANOVA for differences over time and longitudinal structural equations for associations between variables at follow-up., Discussion: This study is based on current evidence regarding exercise prescription recommendations for patients with post-acute COVID-19 syndrome. Our intervention is supported by a solid theoretical framework; however, challenges include tailoring the physical exercise programme to everyone's predominant symptoms and ensuring adherence to the programme., Trial Registration Number: NCT05725538., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© The Author(s) 2024.)

Objective: To determine the prevalence and related factors of diagnosed osteoarthrosis (DO) and undiagnosed osteoarthrosis (UO) in the general Spanish adult population., Setting: Cross-sectional study with data from the Spanish National Health Survey 2017., Participants: N=23,089 adults. Three groups of people were defined: DO, UO, and no osteoarthrosis (NO)., Main Measurements: Sociodemographic information, lifestyle (tobacco, alcohol, physical activity, body mass index) and health factors (intensity of pain, pain drug consumption, mental health, self-perceived health status, pain involvement in daily living) were collected. Descriptive and bivariate analyses were performed, and a multinomial logistic regression model for the factors associated with each group., Results: The prevalence of DO was 22.4% (95%CI=21.8;22.9) and 0.9% (95%CI=0.8;1) of UO. With respect to NO, risk factors for DO and UO included higher pain levels and pain drug consumption. Better self-perceived health status was inversely related with both. More pain involvement in daily living was associated with increased risk of DO, but reduced risk of UO., Conclusions: The prevalence of DO and UO was similar to that reported in Europe, but slightly higher than in low/middle-income countries. It was more prevalent in females, older people, people with worse perceived health status and worse mental health. Higher pain levels and pain drug consumption were risk factors for DO and UO. Better self-perceived health status was protective. Pain involvement in daily living was a risk factor for DO, but protective for UO. Different public health strategies should be considered in view of this., (Copyright © 2024 The Authors. Publicado por Elsevier España S.L.U. All rights reserved.)

Background: The clinical debut of schizophrenia is frequently a first episode of psychosis (FEP). As such, there is considerable interest in identifying associations between biological markers and clinical or cognitive characteristics that help predict the progression and outcome of FEP patients. Previous studies showed that high prolactin, low oxytocin, and high homocysteine are factors associated with FEP 6 months after diagnosis, at which point plasma levels were correlated with some clinical and cognitive characteristics., Methods: We reexamined 75 patients at 12 months after diagnosis to measure the evolution of these molecules and assess their association with clinical features., Results: At follow-up, FEP patients had lower prolactin levels than at baseline, and patients treated with risperidone or paliperidone had higher prolactin levels than patients who received other antipsychotic agents. By contrast, no changes in oxytocin and homocysteine plasma levels were observed between the baseline and follow-up. In terms of clinical features, we found that plasma prolactin and homocysteine levels were correlated with the severity of the psychotic symptoms in male FEP patients, suggesting that they might be factors associated with psychotic symptomatology but only in men. Together with oxytocin, these molecules may also be related to sustained attention, verbal ability, and working memory cognitive domains in FEP patients., Conclusion: This study suggests that focusing on prolactin, oxytocin, and homocysteine at a FEP may help select adequate pharmacological treatments and develop new tools to improve the outcome of these patients, where sex should also be borne in mind., (© The Author(s) 2023. Published by Oxford University Press on behalf of CINP.)

Background: Opioid drug prescription (ODP) and opioid-related mortality (ORM) have increased in Spain. However, their relationship is complex, as ORM is registered without considering the type of opioid (legal or illegal)., Objective: This ecological study aimed to examine the correlation between ODP and ORM in Spain and discuss their usefulness as a surveillance tool., Methods: This was an ecological descriptive study using retrospective annual data (2000-2019) from the Spanish general population. Data were collected from people of all ages. Information on ODP was obtained from the Spanish Medicines Agency in daily doses per 1000 inhabitants per day (DHD) for total ODP, total ODP excluding those with better safety protocols (codeine and tramadol), and each opioid drug separately. Rates of ORM (per 1,000,000 inhabitants) were calculated based on deaths registered (International Classification of Diseases, 10th Revision codes) as opioid poisoning by the National Statistics Institute, derived from the drug data recorded by medical examiners in death certificates. Opioid-related deaths were considered to be those that indicated opioid consumption (accidental, infringed, or self-inflicted) as the main cause of death: death due to accidental poisoning (X40-X44), intentional self-inflicted poisoning (X60-X64), drug-induced aggression (X85), and poisoning of undetermined intention (Y10-Y14). A descriptive analysis was carried out, and correlations between the annual rates of ORM and DHD of the prescribed opioid drugs globally, excluding medications of the least potential risk of overdose and lowest treatment tier, were analyzed using Pearson linear correlation coefficient. Their temporal evolution was analyzed using cross-correlations with 24 lags and the cross-correlation function. The analyses were carried out using Stata and StatGraphics Centurion 19., Results: The rate of ORM (2000-2019) ranged between 14 and 23 deaths per 1,000,000 inhabitants, with a minimum in 2006 and an increasing trend starting in 2010. The ODP ranged between 1.51 to 19.94 DHD. The rates of ORM were directly correlated with the DHD of total ODP (r=0.597; P=.006), total ODP without codeine and tramadol (r=0.934; P<.001), and every prescribed opioid except buprenorphine (P=.47). In the time analysis, correlations between DHD and ORM were observed in the same year, although not statistically significant (all P≥.05)., Conclusions: There is a correlation between greater availability of prescribed opioid drugs and an increase in opioid-related deaths. The correlation between ODP and ORM may be a useful tool in monitoring legal opiates and possible disturbances in the illegal market. The role of tramadol (an easily prescribed opioid) is important in this correlation, as is that of fentanyl (the strongest opioid). Measures stronger than recommendations need to be taken to reduce off-label prescribing. This study shows that not only is opioid use directly related to the prescribing of opioid drugs above what is desirable but also an increase in deaths., (©Alejandro Salazar, Soledad Moreno-Pulido, Pablo Prego-Meleiro, Jesús Henares-Montiel, José Pulido, Marta Donat, Gabriel Sotres-Fernandez, Luis Sordo. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 28.06.2023.)

Objective: The purpose of this study was to evaluate the impact of COVID-19 pandemic public health restrictions on our drip and ship mechanical thrombectomy program in Santiago Chile., Materials and Methods: This was a retrospective analysis of a prospectively collected database comparing two cohorts, one during a two-year period before COVID-19 and the second during the two years of the pandemic at our metropolitan stroke program., Results: A total of 100 patients were included in the pre COVID-19 cohort (cohort 1) and 121 in the COVID-19 cohort (cohort 2). There was a significant difference between cohorts, with older patients, different occlusion sites and higher door to arterial puncture time during the COVID-19 period. A non-significant trend for worse 90-day outcomes and higher mortality was present in cohort 2. There were no statistical differences in safety treatment parameters., Conclusions: COVID-19 pandemic has had a measurable impact on our mechanical thrombectomy program. Results showed similarities to other reported Latin American series, where less robust health systems could adapt less efficiently compared to developed countries. After two years of public health restrictions, there were changes in the treatment population characteristics, delay in some internal management metrics and a non-significant trend to worse 90-day outcomes and higher mortality., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Chronic pain (CP) is 1 of the leading causes of disability worldwide and represents a significant burden on individual, social, and economic aspects. Potential tools, such as mobile health (mHealth) systems, are emerging for the self-management of patients with CP., Objective: A systematic review was conducted to analyze the effects of mHealth interventions on CP management, based on pain intensity, quality of life (QoL), and functional disability assessment, compared to conventional treatment or nonintervention., Methods: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines were followed to conduct a systematic review of randomized controlled trials (RCTs) published in PubMed, Web of Science, Scopus, and Physiotherapy Evidence Database (PEDro) databases from February to March 2022. No filters were used. The eligibility criteria were RCTs of adults (≥18 years old) with CP, intervened with mHealth systems based on mobile apps for monitoring pain and health-related outcomes, for pain and behavioral self-management, and for performing therapeutic approaches, compared to conventional treatments (physical, occupational, and psychological therapies; usual medical care; and education) or nonintervention, reporting pain intensity, QoL, and functional disability. The methodological quality and risk of bias (RoB) were assessed using the Checklist for Measuring Quality, the Oxford Centre for Evidence-Based Medicine Levels of Evidence, and the Cochrane RoB 2.0 tool., Results: In total, 22 RCTs, involving 2641 patients with different CP conditions listed in the International Classification of Diseases 11th Revision (ICD-11), including chronic low back pain (CLBP), chronic musculoskeletal pain (CMSP), chronic neck pain (CNP), unspecified CP, chronic pelvic pain (CPP), fibromyalgia (FM), interstitial cystitis/bladder pain syndrome (IC/BPS), irritable bowel syndrome (IBS), and osteoarthritis (OA). A total of 23 mHealth systems were used to conduct a variety of CP self-management strategies, among which monitoring pain and symptoms and home-based exercise programs were the most used. Beneficial effects of the use of mHealth systems in reducing pain intensity (CNP, FM, IC/BPS, and OA), QoL (CLBP, CNP, IBS, and OA), and functional disability (CLBP, CMSP, CNP, and OA) were found. Most of the included studies (18/22, 82%) reported medium methodological quality and were considered as highly recommendable; in addition, 7/22 (32%) studies had a low RoB, 10/22 (45%) had some concerns, and 5/22 (23%) had a high RoB., Conclusions: The use of mHealth systems indicated positive effects for pain intensity in CNP, FM, IC/BPS, and OA; for QoL in CLBP, CNP, IBS, and OA; and for functional disability in CLBP, CMSP, CNP, and OA. Thus, mHealth seems to be an alternative to improving pain-related outcomes and QoL and could be part of multimodal strategies for CP self-management. High-quality studies are needed to merge the evidence and recommendations of the use of mHealth systems for CP management., Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42022315808; https://www.crd.york.ac.uk/prospero/display&#95;record.php?RecordID=315808., (©Marta Moreno-Ligero, Jose A Moral-Munoz, Alejandro Salazar, Inmaculada Failde. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 02.02.2023.)

COVID-19 infection triggered a global public health crisis during the 2020-2022 period, and it is still evolving. This highly transmissible respiratory disease can cause mild symptoms up to severe pneumonia with potentially fatal respiratory failure. In this cross-sectional study, 41 PCR-positive patients for SARS-CoV-2 and 42 healthy controls were recruited during the first wave of the pandemic in Mexico. The plasmatic expression of five circulating miRNAs involved in inflammatory and pathological host immune responses was assessed using RT-qPCR (Reverse Transcription quantitative Polymerase Chain Reaction). Compared with controls, a significant upregulation of miR-146a, miR-155, and miR-221 was observed; miR-146a had a positive correlation with absolute neutrophil count and levels of brain natriuretic propeptide (proBNP), and miR-221 had a positive correlation with ferritin and a negative correlation with total cholesterol. We found here that CDKN1B gen is a shared target of miR-146a, miR-221-3p, and miR-155-5p, paving the way for therapeutic interventions in severe COVID-19 patients. The ROC curve built with adjusted variables (miR-146a, miR-221-3p, miR-155-5p, age, and male sex) to differentiate individuals with severe COVID-19 showed an AUC of 0.95. The dysregulation of circulating miRNAs provides new insights into the underlying immunological mechanisms, and their possible use as biomarkers to discriminate against patients with severe COVID-19. Functional analysis showed that most enriched pathways were significantly associated with processes related to cell proliferation and immune responses (innate and adaptive). Twelve of the predicted gene targets have been validated in plasma/serum, reflecting their potential use as predictive prognosis biomarkers.

Background: The challenge posed by multimorbidity makes it necessary to look at new forms of prevention, a fact that has become heightened in the context of the pandemic. We designed a questionnaire to detect multimorbidity patterns in people over 50 and to associate these patterns with mental and physical health, COVID-19, and possible social inequalities., Methods: This was an observational study conducted through a telephone interview. The sample size was 1592 individuals with multimorbidity. We use Latent Class Analysis to detect patterns and SF-12 scale to measure mental and physical quality-of-life health. We introduced the two dimensions of health and other social determinants in a multinomial regression model., Results: We obtained a model with five patterns (entropy = 0.727): 'Relative Healthy', 'Cardiometabolic', 'Musculoskeletal', 'Musculoskeletal and Mental', and 'Complex Multimorbidity'. We found some differences in mental and physical health among patterns and COVID-19 diagnoses, and some social determinants were significant in the multinomial regression., Conclusions: We identified that prevention requires the location of certain inequalities associated with the multimorbidity patterns and how physical and mental health have been affected not only by the patterns but also by COVID-19. These findings may be critical in future interventions by health services and governments.

Background: Approximately 3% of the population suffers a first episode of psychosis (FEP), and a high percentage of these patients subsequently relapse. Because the clinical course following a FEP is hard to predict, it is of interest to identify cognitive and biological markers that will help improve the diagnosis, treatment, and outcome of such events and to define new therapeutic targets. Here we analyzed the plasma oxytocin and prolactin levels during an FEP, assessing their correlation with clinical and cognitive features., Methods: The oxytocin and prolactin in plasma was measured in 120 FEP patients and 106 healthy controls, all of whom were subjected to a clinical and neuropsychological assessment. Most patients were under antipsychotics. Statistical analyses aimed to identify factors associated with the FEP and to search for associations between the variables. This study is preliminary and exploratory because the P-values were not corrected for multiple comparisons., Results: FEP patients had less oxytocin, more prolactin, and a poor premorbid IQ, and they performed worse in sustained attention. Male patients with higher prolactin levels experienced more severe psychotic symptoms and required higher doses of antipsychotics. Low oxytocin was associated with poor sustained attention in women, whereas low oxytocin and high prolactin in men correlated with better performance in sustained attention., Conclusion: Low oxytocin, high prolactin, and poor premorbid IQ and sustained attention are factors associated with an FEP, representing potential therapeutic targets in these patients. These biological factors and cognitive domains might play an important role during a FEP, which could help us to develop new strategies that improve the outcomes of this disorder and that should perhaps be gender specific., (© The Author(s) 2022. Published by Oxford University Press on behalf of CINP.)

Background: In the last decades, the birth of premature babies has increased, it is important to know the impact of certain variables, especially in the most vulnerable groups., Purpose: To analyse the relationship of gestational age (GA), weight and sex of the children, as well as the educational level and age of the parents with the cognitive, motor and language development of a group of very preterm births, assessed at 36 months., Design and Methods: The research followed a descriptive, observational and cross-sectional design. Children's development was measured using the Bayley-III Scale. Descriptive analysis, bivariate and linear regression models were carried out., Results: Although the cognitive, motor and language development is within average levels, worse results are evidenced in the group of extreme premature, as opposed to the very premature. Boys score lower than girls, with these differences being more pronounced in the motor area. It also shows how the education level of both parents is related to the levels of development at 3 years of age of children born very prematurely, especially in language., Conclusions: Lower GA, male sex and lower parental educational level are associated with higher risk of developmental difficulties., Practice Implications: The findings of this study are relevant to clinical practice because they suggest to develop protocols of evaluation and the follow up of all premature children beyond 36 months, as well as developing specific intervention programmes for the most vulnerable of the premature groups., Competing Interests: Declaration of Competing Interest The authors declare that they do not have conflict of interest., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Aim: To provide a comprehensive overview of breast cancer in Colombia., Methods: Data on breast cancer in Colombia are scarce. We present incidence data from population-based cancer registries that represent 4 distinct regions of the country. Other data originate from non-governmental institutions and healthcare providers within Colombia, official sources, expert opinion, Colombian legislation, and the Cancer Mortality Atlas publishes by Colombian National Cancer Institute., Results: In Colombia, the age-standardized incidence rate remained relatively stable between 2012 and 2020 (43.1 to 47.8 cases per 100,000 women-years); Additionally, survival since 1995 has presented a substantial improvement from 65.7 to 72.1. In 33% of cases, the diagnosis of breast cancer was made in advanced stages, stage III or higher. The health demography survey conducted in 2015 showed that the participation in mammography screening in women aged 40 to 69 remains low 48.1%. Some limitations regarding access to early detection and diagnosis include economic strata, health insurance coverage, origin, and accessibility. On average, a 90-day period was reported from onset of symptoms to diagnosis of breast cancer., Conclusion: The first action towards improving outcomes in breast cancer should be to improve stage at diagnosis and timely access to care.

Background: Chronic pain is a major health issue requiring an approach that not only considers medication, but also many other factors included in the biopsychosocial model of pain. New technologies, such as mobile apps, are tools to address these factors, although in many cases they lack proven quality or are not based on scientific evidence, so it is necessary to review and measure their quality., Objective: The aim is to evaluate and measure the quality of mobile apps for the management of pain using the Mobile App Rating Scale (MARS)., Methods: This study included 18 pain-related mobile apps from the App Store and Play Store. The MARS was administered to measure their quality. We list the scores (of each section and the final score) of every app and we report the mean score (and standard deviation) for an overall vision of the quality of the pain-related apps. We compare the section scores between the groups defined according to the tertiles via analysis of variance (ANOVA) or Kruskal-Wallis test, depending on the normality of the distribution (Shapiro-Wilk test)., Results: The global quality ranged from 1.74 (worst app) to 4.35 (best app). Overall, the 18 apps obtained a mean score of 3.17 (SD 0.75). The best-rated sections were functionality (mean 3.92, SD 0.72), esthetics (mean 3.29, SD 1.05), and engagement (mean 2.87, SD 1.14), whereas the worst rated were app specific (mean 2.48, SD 1.00), information (mean 2.52, SD 0.82), and app subjective quality (mean 2.68, SD 1.22). The main differences between tertiles were found on app subjective quality, engagement, esthetics, and app specific., Conclusions: Current pain-related apps are of a certain quality mainly regarding their technical aspects, although they fail to offer information and have an impact on the user. Most apps are not based on scientific evidence, have not been rigorously tested, and the confidentiality of the information collected is not guaranteed. Future apps would need to improve these aspects and exploit the capabilities of current devices., (©Alejandro Salazar, Helena de Sola, Inmaculada Failde, Jose Antonio Moral-Munoz. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 25.10.2018.)

Objectives: to analyse the evolution of Health Related Quality of Life (HRQL) in coronary patients (CP) and to identify predictive factors influencing this evolution in a situation with missing data and time-dependent variables., Design: prospective study with repeated measures., Setting and Participants: a total of 175 CP were included. General Estimating Equations (GEE) models were used to assess the evolution of HRQL in these patients. These models, not commonly used in this context, are applied here as an alternative to traditional techniques that do not handle missing data and time-dependent covariates properly., Main Outcome Measures: HRQL assessed by SF-36v1 Questionnaire at baseline, 3 and 6 months after discharge., Results: role physical, bodily pain, general health, vitality, and the physical component summary of SF-36 improved over the follow-up. Being woman, older, and having higher scores on GHQ-28 were associated to a decrease in HRQL throughout time. Previous history of coronary heart disease, comorbidities, revascularisation, rehospitalisation, and episode of angina had a negative impact on HRQL, especially between 3 and 6 months after discharge., Conclusion: the analysis of the evolution of HRQL with a longitudinal approach using GEE models shows the predictive effect of the variables analysed during the follow-up, including the time itself and time-dependent covariates such as the evolution of mental health. In addition, it allows to particularise the predictive effect of covariates at each period within the follow-up.

The high demand for less polluting, newer, and cheaper fuel resources has increased the search of the most innovative options for the production of the so-called biofuels. Chlamydomonas reinhardtii is a photosynthetic unicellular algae with multiple biotechnological advantages such as easy handling in the laboratory, a simple scale-up to industrial levels, as well as a feasible genetic modification at nuclear and chloroplast levels. Besides, its fatty acids can be used to produce biofuels. Previous studies in plants have found that the over expression of DOF-type transcription factor genes increases the synthesis and the accumulation of total lipids in seeds. In this context, the over-expression of a DOF-type transcription factor in C. reinhardtii was applied as approach to increase the amount of lipids. The results indicate higher amounts (around 2-fold) of total lipids, which are mainly fatty acids, in the genetically C. reinhardtii modified strains when compared with the non-genetically modified strain. In order to elucidate the possible function of the introduced Dof-type transcription factor, we performed a transcription profile of 8 genes involved in fatty acid biosynthesis and 6 genes involved in glycerolipid biosynthesis, by quantitative real time (qRT-PCR). Differential expression profile was observed, which can explain the increase in lipid accumulation. However, these strains did not show notable changes in the fatty acid profile. This work represents an early effort in generating a strategy to increase fatty acids production in C. reinhardtii and their use in biofuel synthesis., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Objective: The aim of this study is to investigate the attitudes towards mental illness and psychiatry among fifth year Spanish medical students., Methods: The study included 171 students from three medical schools located in different areas of Spain: Cádiz; UCA (n = 113), Madrid; San Pablo-CEU (n = 22), and Barcelona; UAB (n = 36). They responded, prior to their undergraduate medical course in psychiatry, to the AMI questionnaire to measure the attitudes towards mental illness and to Balon's adapted questionnaire to investigate their view towards psychiatry., Results: The students (93.4 %) had a positive attitude towards mental illness (AMI). Attitudes towards psychiatry were fairly positive with a few negative views, specifically regarding the role of psychiatrists (items 11 and 13) and the prestige of the specialty (item 16). There were some statistically significant differences between the three medical schools in the perception of psychiatry as a medical discipline. A better attitude towards mental illness was associated with a better view of the overall merits of psychiatry., Conclusions: Findings suggest that Spanish medical students do not have a negative attitude towards mental illness and they have a good perception of psychiatry, although there are still some misconceptions about this specialty. These student's attitudes could favor an appropriate management of patients suffering from mental illness.

Introduction: The aim of this study was to determine the prevalence of painful musculoskeletal conditions and migraine headache or any other headache in a sample of Spanish adults with disabilities and their association with anxiety, depression, and sleep disorders., Methods: This cross-sectional study analyzed data from the Spanish national disability and dependence survey (2007-2008) of 16,932 adults aged 18 or older who have disabilities. The prevalence (95% confidence interval [CI]) of painful musculoskeletal conditions was determined according to a diagnosis of arthritis, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, muscular dystrophy, and neck or back pain. The prevalence of migraine or other headache was also calculated. Factors associated with these painful conditions were analyzed separately for men and women by using a logistic regression model., Results: The prevalence of painful musculoskeletal conditions was 66.9% (95% CI, 66.2%-67.6%) and that of migraine or other headache was 23.4% (95% CI, 22.8%-24.1%), both of which were higher in women than in men. Factors associated with these conditions in both men and women included older age, a sleep disorder, and concomitant chronic anxiety and/or depression., Conclusion: The prevalence of painful musculoskeletal conditions and migraine or other headache is high in people with disability in Spain, especially in women, and these conditions often coexist with depression, anxiety, and/or a sleep disorder. To design programs for rehabilitating and improving the quality of life of adults with disability and painful conditions, treatments for mental and/or sleep disorders should be considered in addition to conventional treatments.

Objective: The study aims to determine the prevalence of undiagnosed comorbid mood disorders in patients suffering chronic musculoskeletal pain in a primary care setting and to identify sleep disturbances and other associated factors in these patients, and to compare the use of health services by chronic musculoskeletal pain patients with and without comorbid mood disorders., Design: Cross-sectional study., Subjects: A total of 1,006 patients with chronic musculoskeletal pain from a representative sample of primary care centers were evaluated., Outcome Measures: Pain was measured using a visual analog scale and the Primary Care Evaluation of Mental Disorders questionnaire was used to measure mood disorders., Results: We observed a high prevalence of undiagnosed mood disorders in chronic musculoskeletal pain patients (74.7%, 95% confidence interval [CI] 71.9-77.4%), with greater comorbidity in women (adjusted odds ratio [OR] = 1.91, 95% CI 1.37-2.66%) and widow(er)s (adjusted OR = 1.87, 95% CI 1.19-2.91%). Both sleep disturbances (adjusted OR = 1.60, 95% CI 1.17-2.19%) and pain intensity (adjusted OR = 1.02, 95% CI 1.01-1.02%) displayed a direct relationship with mood disorders. Moreover, we found that chronic musculoskeletal pain patients with comorbid mood disorders availed of health care services more frequently than those without (P < 0.001)., Conclusions: The prevalence of undiagnosed mood disorders in patients with chronic musculoskeletal pain is very high in primary care settings. Our findings suggest that greater attention should be paid to this condition in general practice and that sleep disorders should be evaluated in greater detail to achieve accurate diagnoses and select the most appropriate treatment., (Wiley Periodicals, Inc.)

Objective: To determine the activity of cortisol in rats treated with exogenous adrenocorticotropic hormone (ACTH) and a resveratrol supplement., Methods: Forty-eight adult female rats and 16 male rats of the strain (Rattus norvegicus) that were three months old and with body weights ranging from 200 to 250 g for females and 300 to 350 g for males were used and kept in controlled environmental conditions: temperature of 20±2° C and light-dark cycles of 14 and 10 hours. They were fed a balanced diet and had free access to water. The rats were randomly divided into four groups: group 1 - was treated with 5 µg/kg of ACTH i.p. every twelve hours; group 2 - received the same treatment with ACTH plus a grape extract supplement (resveratrol) of 40 mg/kg; group 3 - only received grape extract (resveratrol); and group 4 - received a saline solution (0.9%) i.p. and oral, and served as controls. The experimental design was a 2×2 factorial with two levels ACTH and two polyphenol levels (grape extract)., Results: No significant differences were found in blood cortisol concentrations, by day and gender, or by treatment effects (0.75 µg/dL ± 0.11; p <0.001)., Conclusion: Results suggest that chronic stress and consumption of resveratrol did not directly alter levels of plasmatic cortisol in either stressed or unstressed rats. It was concluded that the given dosage levels of ACTH possibly did not produce sufficient stimulation of the adrenal gland for these animals.

Background and Objectives: The Test Your Memory (TYM) scale is a screening tool, which assesses mild cognitive impairment (MCI). It has shown better psychometric outcomes than the Mini-Mental State Examination (MMSE). We aimed to translate and adjust into Spanish a conceptually equivalent version., Subjects and Method: Translation-back translation method, complemented with qualitative methods, and pilot survey with 42 healthy Spanish people from different group of age to ensure the right comprehension., Results: While translating, 54% of the items presented no difficulty at all; 27%, medium difficulty; 18% high difficulty. Some adaptations were made for cultural, grammatical and conceptual reasons. The pilot survey showed a good comprehension of the test., Conclusions: The TYM test could be a good choice for detecting MCI in the Spanish population and could resolve the problems caused by the limitations of the MMSE., (Copyright © 2011 Elsevier España, S.L. All rights reserved.)