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Purpose: Brain plasticity after multistep surgery in low-grade glioma is highly variable; the neurosurgical approach must be individualised and functional imaging can be used for this purpose. In supplementary motor area complex (SMAC) tumors, the early and adequate functional recovery of patients raises the possibility of a latent bihemispheric or "mirror" cortico-subcortical network, which would develop depending on the needs of each patient., Methods: Functional and DTI-MR data from 4 right-handed patients with left frontal low grade gliomas near the SMAC, who were operated at least in two occasions were collected. The time of the reintervention was variable (18 months- 8 years), related to the tumor growth. All patients were evaluated by a neuropsychologist and imaged before each surgery, in a 3 T MR, with a 24 multichanel head coil Motor and expressive language task-fMRI and DTI sequences were obtained to evidence the main cortico-subcortical components of the SMAC. Data were processed with Brainwave (GE Medical Systems) and with an Iplan Fiber Tracking tool (MEDTRONIC), respectively RESULTS: None of our patients presented permanent neurological deficits after the first or second functional surgery. Three patients with partial or complete resection of the left middle and / or inferior frontal gyrus, and the left frontal aslant tract evidenced new right hemispherical cortical activity. This right shift were not observed in the patient without left middle gyrus resection, indeed with partial absent of the left frontal aslant tract., Conclusion: SMAC is a latent cortico-subcortical bihemispheric network that allows it to reorganize itself in response to specific neurological deficits. We highlight the importance in the cortical reorganization of the left middle frontal gyrus in the SMAC, closely connected with the essential language areas of this region, but also we focused in the potential cortioco-subcortical changes to compensate the functionality of the FAT., Competing Interests: Declaration of Competing Interest The authors have no relevant financial or non-financial interest to disclose., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background and Objectives: Although there is strong evidence of the positive effects of physical exercise on health, adherence to face-to-face exercise programs in the adult population is low, identifying several barriers that hinder their practice. There is research that demonstrates the viability of physical exercise programs with the use of Mobile Health in Ecological Momentary Assessment (EMA) mode, which contributes to overcoming many reported barriers. To synthesize the methodological characteristics and health effects of physical exercise programs based on mobile health in EMA modality in adults in developing countries. Materials and Methods: This systematic review was conducted according to guidelines established by the PRISMA statement in APA PsycArticles and CINAHL databases by EBSCOhost, Cochrane Library, PubMed, and Web of Science for articles published between 2008 and March 2024. Results: Telephone counseling on clinical-behavioral factors is believed to reduce morbidity and mortality in developed countries, but this aspect is not explored in developing countries. We included nine randomized controlled trials with a total of 4394 male and female participants aged 18 to 60 years. The interventions were mainly carried out by text messages, lasting between 20 to 80 min per session, 3 to 5 days per week, and most were carried out over 12 months. The interventions on the variables of physical activity, nutrition, and medical assessments showed significant effects, and variables such as quality of life and anthropometric measurements were not significant in most studies. Conclusions: This systematic review included studies from different developing countries, the most common diseases being diabetes, overweight, obesity, and hypertension. All the studies used mobile devices as the technology, finding a profile of the adults studied, as well as the characteristics of exercise programs based on mobile health in EMA modality.

Cerebral white-matter lesions (cWML) can be caused by dilation of Virchow-Robin spaces or may correspond to true lacunar ischemic lesions. The aim of our study was to evaluate in asymptomatic divers the relationship between the presence of patent foramen ovale (PFO) and cWML, as well as their possible effects on cortical cerebral blood flow (CBF) by magnetic resonance (MRI) through the arterial spin labeling (ASL) sequence. Transthoracic echocardiography was performed for the identification of PFO, and cerebral magnetic resonance including the 3D-ASL sequence for CBF quantification. Thirty-eight divers, with a mean age 45.8 ± 8.6 years, were included. Nineteen healthy volunteers, mean age 41 ± 15.2 years, served as the control group. A total of 28.9% of divers had completed more than 1000 dives. It was found that 26.3% of divers presented with PFO in the echocardiographic study. cWML was evidenced in 10.5% of diver MRI studies. There was no statistically significant relationship between the presence of PFO and cWML ( p = 0.95). We observed a lower blood flow in all brain areas assessed by the 3D-ASL sequence in the group of divers, compared with the control group. We did not find statistical differences in CBF as a function of the presence or absence of PFO, number of dives, or cWML evidence.

Introduction: COVID-19 pandemic has challenged healthcare systems worldwide. The aim of this study was to assess the results of a Respiratory Telerehabilitation Program implemented to patients post-COVID-19 in postacute phase of mild to critical course of COVID-19 who had persistent respiratory symptoms and had not received any vaccination. The intervention was performed during confinement., Methods: A quasi-experimental nonrandomized study was conducted in Spain during confinement. Respiratory Telerehabilitation Program was guided by a specialized physical therapist through a web platform (Zoom by Zoom Video Communications, San Jose, CA, USA). Participants were recruited through social webs. Outcome measures included respiratory rate, heart rate, percutaneous oxygen saturation, Mahler's Dyspnea Index, anxiety status, and quality of life [EuroQol 5 Dimension 5 (EQ-5D)]., Results: A total number of 148 participants were recruited, with a final number of 100 participants completing the protocol (50 experimental group (EG)/50 control group (CG)). A total of 500 telerehabilitation sessions were performed for this study. In the EG, pre-post intervention comparative analysis showed significative changes in Mahler's functional dyspnea ( p  < 0.001), the State-Trait Anxiety Inventory ( p  < 0.001), oxygen saturation ( p  < 0.001), heart rate ( p  < 0.001), quality-of-life questionnaire ( p  < 0.001), and respiratory rate ( p  < 0.001). Participants in the CG showed an improvement in all the variables, but the differences were not statistically significant except in Mahler's functional dyspnea ( p  = 0.001) and in the quality-of-life questionnaire ( p  = 0.043). Percentage changes in pre-post intervention were calculated and compared between EG and CG. There were statistically significative differences in all the outcomes in favor of the EG., Conclusion: The implementation of a pulmonary telerehabilitation program for COVID-19 not vaccinated survivors in postacute phase with mild to critical course of COVID-19 with respiratory sequelae has proven its benefits in cardiorespiratory variables and dyspnea-related anxiety.

The high demand for health information from pregnant women has encouraged the creation of an informative program through a weekly digital newsletter. The objective of this study is to evaluate its quality as a digital communication medium, in terms of satisfaction and loyalty to the pregnancy follow-up and delivery service. A cross-sectional, prospective study was carried out, surveying 179 patients by means of an online self-referral questionnaire including variables related to humanization, information needs, perceived accompaniment and satisfaction, as well as factors related to its influence on their decision to remain loyal to the center. A total of 81.2% of the participants showed high levels of satisfaction with the program. Satisfaction among nulliparous patients was significantly lower in several aspects. The resolution of doubts and the perception of peace of mind following the information received was positive for 54.8%. Of the patients in the program, 88.8% finally remained at the center, showing a strong influence of the program on their decision (mean value 75 on 1 to 100 scale). A weekly digital newsletter with specific information reduced the demand for information from pregnant women, generating high levels of satisfaction and positively influencing the decision to remain loyal to the Center.

Background: Back pain is a normal symptom during pregnancy and is expected to become worse beyond the first three months after childbirth., Objectives: To determine the effectiveness of wearing unstable shoes instead of conventional shoes, regarding pain intensity, low back mobility and stability, among women with lumbopelvic pain (LPP) during the postpartum period., Design and Setting: Prospective, single-blinded, randomized clinical trial conducted at a podiatry and physiotherapy clinical center., Methods: A nine-week program of wearing either unstable shoes (A) or conventional shoes (B) was implemented. The following outcomes were measured in three assessments: pain intensity, using a visual analogue scale (VAS); low-back mobility, using a modified Schober test; and stability, using a pressure platform., Results: The lateral stability speed, anterior stability speed and anterior center of pressure (COP) showed significant (P < 0.05) decreases in the unstable shoes group after nine weeks, in relation to the conventional group. Intra-group measurements showed significant differences (P < 0.05) in VAS between the second and third assessments and between the first and third assessments in both groups. Intra-group evaluations also showed statistically significant differences (P < 0.05) in the lateral stability speed and anterior stability speed., Conclusions: Unstable shoes were effective in decreasing the pain intensity at five and nine weeks in women with postpartum LPP. In addition, their use produced decreases in lateral stability speed, anterior stability speed and anterior COP at nine weeks.

Background: Data on the occurrence of acute kidney injury (AKI) in patients undergoing cardiac resynchronization therapy (CRT) implantation is limited and no previous studies investigated its impact in an elderly population. CRT implantation requires a relatively low quantity of contrast medium. Previous studies, however, focused primarily on contrast medium as etiological factor for AKI, reporting a high incidence (8-14%). The high incidence of AKI in absence of use of substantial amounts of contrast volume, suggests the existence of other factors that contribute to AKI., Objectives: To determine the predictive value of patient and procedure-related risk factors for the occurrence of AKI post CRT, as well as the AKIs impact on length of in-hospital stay (LOS) and 1-year mortality., Methods: Retrospective observational study, including consecutive patients that underwent CRT implantation in a single center., Results: 60 patients with a mean age of 77 ± 8.4 years were included in the study and Twelve (20%) developed AKI. Prior renal insufficiency (p = 0.03; OR = 15.4), larger procedure time (p = 0.02; OR = 1.03), intra-operative hypotension (p < 0.01; OR = 1.72) and bleeding (p = 0.01 (OR = 7.86), showed to predict AKI significantly. AKI associated a significantly longer LOS (12 vs 3 days, p < 0.01). No significant differences regarding 1-year mortality were observed (p = 0.19; HR = 2.7 for patients with AKI)., Conclusions: AKI is a frequent complication of CRT implantation with an important impact on in-hospital stay, especially in the elderly. In addition to contrast administration, clinical factors could play a significant role in the occurrence of AKI., Competing Interests: The authors declared that there is no conflict of interest., (© 2020 The Author(s).)

Background: The role of culture-independent techniques (galactomannan, (1-3)-β-d-glucan) in the early diagnosis of invasive fungal diseases (IFD) is well assessed in hematological patients, but there are no clear conclusions in patients with chronic obstructive pulmonary disease (COPD)., Aims: To study the usefulness of nonculture-based techniques in the diagnosis of IFD in COPD-patients at risk for IFD., Methods: A prospective observational study based on monitoring COPD patients at risk for IFD during 2007-2010 was carried out. The presence of galactomannan, (1-3)-β-d-glucan and an indirect immunofluorescence of Candida albicans germ tube specific antibodies (CAGTA) were performed., Results: Among 43 COPD patients, 16 (37.2%) were diagnosed with IFD: seven cases were proven IFD (five invasive candidemia - IC, one invasive aspergillosis - IA and a rhinocerebral zygomycosis) and nine probable IFD (seven IA and two IC). In the diagnosis of IC and IA, the negative predictive value (NPV) of (1-3)-β-d-glucan was 100%. Regarding CAGTA in IC, NPV was 96.2%. Finally, NPV of galactomannan in IA was 91.2%. The area under the ROC curve for (1-3)-β-d-glucan in IC and for the rest of the IFD cases was 0.86 (95% CI, 0.79-0.93) and 0.60 (95% CI, 0.43-0.77), for CAGTA in IC was 0.83 (95% CI, 0.74-0.91) and for galactomannan in IA was 0.71 (95% CI, 0.56-0.85). Positive (1-3)-β-d-glucan preceded the growth of Candida (average of 1.7 days) in blood culture., Conclusions: In COPD patients at risk for IFD the assayed techniques are especially useful to rule out the presence of IFD., (Copyright © 2018 Asociación Española de Micología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: Demonstrate the role of the virulence factors of Helicobacter pylori, the sex, and tobacco and alcohol use in the development of peptic ulcer in patients infected by H. pylori., Patients and Methods: One hundred and seventy-four patient with dyspepsia were studied after they went consecutively for gastroscopy. The diagnosis of infection by H. pylori was carried out by culture and/or histology. Through western-blot the presence of specific anti-H. pylori antibodies was determined. The tobacco and alcohol use data were collected., Results: One hundred and twenty-five patients (32 with ulceration, 12 with duodenitis and 81 with functional dyspepsia) showed H. pylori infection with anti-bacterium IgG antibodies. The detection of the proteins CagA and VacA, male sex and heavy consumption of alcohol and tobacco were associated with the finding of peptic ulcer. In the multivariate analysis only anti-CagA antibodies (OR: 4.1; 95% CI: 1.1-15.3; p = 0.036), anti-VacA (OR: 3.9; 95% CI: 1.4-10.8; p = 0.009) and male sex (OR: 3.1; 95% CI: 1.2-8.3; p = 0.02) were associated with the ulcerative disease., Conclusions: The proteins CagA and VacA, and the male sex, contribute independent risk factors for peptic ulcer in patients infected by H. pylori.

Background: Respiratory infections are the most frequent reason for primary health care consultation. Although generally not severe, they are responsible for a large number of days of laboral and scholar absenteeism and an excessive use of antibiotics., Methods: The clinical and epidemiologic data of extrahospitalary infections in primary health care centers throughout Spain were collected according to the one day cut off system repeated trimestrally over one year., Results: Data of 3,732 days of consultation were collected in which a total of 144,608 patients were attended. Of these, 20,614 had respiratory infections and 11,684 extrarespiratory infections. The most frequent processes were pharyngitis (33.7%), common cold (31.7%) followed by bronchitis (18.7%), otitis (11%), influenza (4.6%), laryngitis (4%), sinusitis (3.6%) and pneumonia (1.8%). Antibiotic treatment was prescribed in 13,488 patients (65%). The type of antibiotic was analyzed in the 11,977 patients treated for only one infection. Penicillins were the antibiotics most used followed by cephalosporins. The antibiotic prescribed was considered adequate in 70% of the 8,484 patients treated for potentially bacterial infection. A total of 3,493 patients had infection considered to be of viral etiology., Conclusions: Twenty-two percent of the patients attending a primary health care center presented infection and of these two out of three cases had respiratory infection. Pharyngitis and common cold were the most frequent processes observed. Two thirds of the patients consulting for respiratory infection received antibiotic treatment, with 29.2% being diagnosed with infections considered to be of viral etiology. The empiric treatment chosen for the two thirds of the potentially bacterial infections was considered as adequate.