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Arthrogryposis multiplex congenita is a condition characterised by contractures and deformity in two or more body areas. Physiotherapy may be an appropriate treatment. The aim was to systematically review the evidence for rehabilitation in arthrogryposis multiplex congenita. A systematic review was performed following the PRISMA 2020 criteria. The search was conducted in PubMed, ScienceDirect, Scielo, Scopus, Web of Science, ENFISPO, JSTOR, Google Scholar, ProQuest, Cochrane Library and PEDro from inception until October 2022. To assess the methodological quality, we used the different aspects of the critical appraisal tool JBI. We included 14 studies (6 case reports, 5 case series, 2 cross-sectional and 1 qualitative study). Sample sizes ranged from 1 to 50 participants, with an age range between 11 days and 35 years. Most studies employed multicomponent therapy, mainly kinesitherapy, massage therapy, use of physical agents and stretching, some combined it with orthopaedic therapy, or it was complementary to surgical treatment. The key to improving the clinical picture was early and individualised care, tailored to the characteristics of the patients. Regarding methodological quality, the main conflicts encountered were in the reporting of participant characteristics and experimental interventions. Rehabilitation provides satisfactory results in the treatment of arthrogryposis multiplex congenita. More scientific production and randomised clinical trials are needed.

Objectives: This study evaluated the efficacy of an ultra-low-dose 0.005 % estriol vaginal gel in the prevention of urinary tract infections in postmenopausal women with genitourinary syndrome of menopause., Study Design: Randomized, double-blind, placebo-controlled, multicenter clinical trial conducted across 28 Spanish sites involving specialists in gynecology, urology, and primary care. A total of 108 postmenopausal women were randomly assigned in a 1:1 ratio to receive 1 g of vaginal gel with 50 micrograms of estriol or an identical moisturizing vaginal gel without estriol., Main Outcome Measures: The primary outcome was the number of episodes of urinary tract infection by the end of the 24-week treatment. Secondary measures encompassed percentage of patients without recurrence, time to first recurrence, use of antibiotic treatment, vaginal pH, safety, and tolerability, among others., Results: The incidence rate of urinary tract infections (new cases per 100 women-year) was 26 % lower in the group that received estriol vs. the group that received placebo (32.34 vs. 43.76 (RR = 0.74) p < 0.001). The frequency of urinary tract infections fell during treatment in all patients in the estriol group. Favorable pH changes from baseline were observed in the estriol arm at all follow-up visits., Conclusions: Ultra-low-dose 0.005 % estriol vaginal gel is safe and effective in preventing recurrent urinary tract infections in postmenopausal women with genitourinary syndrome of menopause, reducing the incidence and potentially decreasing the susceptibility to urogenital infections by improving vaginal pH. Study registration N°: 2018-001481-42. Date of registration: 09-04-2018., Competing Interests: Declaration of competing interest Susana Duce Tello declares to have received payments or fees for lectures, presentations, manuscript writing or educational events from Novartis, Pfizer. Payment for expert testimony from Italfarmaco, and support for attending meetings and/or travel from Viatris. Milagros González has been sponsored in communications at conferences and training courses by Chiesi, Menarini, GSK, Pfizer, Daichi Sankio, Alter, Astra Zeneca and Zentivia. Javier Rosado declares to have received fees for lectures and as a consultant from Astra-Zéneca, Boehringer Ingelgheim, Chiesi, Italfármaco, Merck Sharp and Dohme, Novartis, Pfizer, Sanofi-Aventis, Recordati, Daichi-Sankyo, Almirall, Servier, Medtronic. Laura Noguera, Ana Doyle Sanchez, Amelia Rodríguez and Eva Aguilar are full time employees at ITF Research Pharma. All other authors declare that they have no competing of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Introduction: Subjective memory complaints (SMC) might be an early sign of further deterioration in cognitive functions. However, no population studies have been published covering all Spain to determine the SMC prevalence. The objective of the present study was to determine the SMC prevalence in the general population residing in Spain >50 years of age and also which related actions were done., Materials and Methods: Interviews were conducted with a nationally representative sample >50 years of age using an online/computer assisted web interview (CAWI) questionnaire. The survey consisted of 34 items divided into two blocks. Presence of SMC was considered when in question 1 the subject answered that "Yes" he had some memory problem., Results: Two thousand three hundred people (53.7% women; 23.9% ≥75 years old) were interviewed. 31% answered that they considered they had a memory problem (no differences between sexes, mean time with memory problems of 3.0 years). A higher prevalence of SMC was observed in ≥75 years old (44%). 90% did not include any specific foods in their diet for their memory problems, neither were taking any pharmaceuticals, diet supplements or nutritional supplements (92%). 78% of those interviewed with SMC have not consulted health professionals for their memory problems., Conclusions: SMC are considerably prevalent in our environment affecting almost a third of people ≥50 years of age. Most of the interviewees with SMC did not go to health professionals to manage their SMC., (Copyright © 2023 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: Nausea and vomiting is a very prevalent condition during pregnancy. Combination of doxylamine and pyridoxine is placed as first-line pharmacological option for its treatment in most clinical guidelines. Among different release forms available, Cariban ® is a fixed-dose combination of doxylamine/pyridoxine 10/10 mg, formulated as modified-release capsules., Objectives: In the present study, we aimed to characterize the bioavailability performance of Cariban ® in vitro and in vivo., Methods: An in vitro dissolution test was performed to evaluate the release profile of Cariban ® , together with immediate- and delayed-release formulations available on the market. A single-center, single-dose, open-label bioavailability study following Cariban ® administration in 12 healthy adult female patients was carried out to explore the drug behavior in vivo (protocol NBR-002-13; EUDRA-CT 2013-005422-35). These data were additionally used to perform a computational pharmacokinetic simulation of the posology approved for this drug., Results: Cariban ® capsules demonstrate a prolonged-release performance, with an early, gradual, and progressive release of both actives until reaching a complete dissolution after 4-5 h in solution. The pharmacokinetic features of these capsules show that doxylamine and pyridoxine metabolites are early absorbed, being all detectable in plasma within 1 h following oral administration. Computational pharmacokinetic simulation predicts that different posology provides distinct profiles of metabolites in plasma, with 1-1-2 (morning-midafternoon-night) being the one that concentrates higher plasma levels but lower dose dumping for 24 h., Conclusion: Cariban ® behaves as a prolonged-release formulation, which correlates with rapid absorption and arising of the actives in the plasma, but also long-lasting and sustained bioavailability, especially when administered following the complete posology. These results would underlie its demonstrated efficacy to relieve nausea and vomiting of pregnancy (NVP) under clinical settings., (© 2023. The Author(s).)

Background: Melatonin is an endogenous substance which plays a key role in sleep induction by reducing sleep onset latency; it has been approved by the European Food Safety Authority as a food supplement for exogenous administration. Oniria ® is a food supplement formulated as 1.98 mg of prolonged-release melatonin tablets; it displays a dual dissolution profile in vitro., Objectives: The main objective of the present study was to evaluate the relative oral bioavailability of Oniria ® , in comparison with immediate-release tablets (IRT) with a similar melatonin content as a reference. We also attempted to characterize the circadian rhythm of endogenous melatonin., Methods: We performed an open-label, cross-over, randomized, phase I clinical study with two sequences and three periods involving 14 healthy volunteers. We characterized the endogenous melatonin circadian profile (period 1) and pharmacokinetics (PK) of both Oniria ® and the reference melatonin (periods 2 and 3)., Results: Two phases were clearly differentiated in the PK profile of Oniria ® . An initial one, from dosing up to 2 h, and a delayed one from 2 to 11 h post-administration. During the initial phase, both melatonin formulations were equivalent, with a C max value close to 4000 pg/mL. However, in the delayed phase, Oniria ® showed significantly higher melatonin concentrations than the IRT (three times higher at 4-6 h post-administration). Moreover, Oniria ® exhibited concentrations above the endogenous melatonin peak of 80 pg/mL for up to 2.5 h versus the reference formulation, potentially suggesting an effect of Oniria ® , not only in the induction of sleep, but also in the maintenance., Conclusion: Oniria ® could be a highly promising food supplement, not only for sleep induction but also for the maintenance of sleep., (© 2022. The Author(s).)

DDT and Lindane (gamma-HCH) which were used until 1999 in Mexico, have provided great benefits in the combat of vectors that spread infection-borne diseases and in agriculture for crop protection. The persistence in the environment and their accumulative properties results in bioconcentration in lipid rich tissues of the human body that reflect the extent of environmental pollution. Human adipose tissue samples were taken during 2009 from abdominal cavities of 69 pregnant women by cesarean surgery and from 34 samples of control donors by autopsy in Veracruz State. The samples were analyzed by gas chromatography with ECD. The results of mean levels (mg/kg on fat basis) were higher in controls compared to pregnant women beta-HCH 0.064 vs 0.027; pp'DDE 1.187 vs. 0.745; op'DDT 0.016 vs. 0.011; pp'DDT 0.117 vs. 0.099 and Sigma-DDT 1.337 vs. 0.854. The pregnant women group was divided according to age: up to 20, 20-30, and more than 30 years, and presented an increase for the more persistent pesticides with age in terms of mean concentrations and a more pronounced higher correlation in medians levels. Pairing Body Mass Index to organochlorine pesticide mean levels revealed no correlation between these factors in pregnant women.