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BACKGROUND: With the increasing number of older adults and their declining motor and cognitive function, it is crucial to find alternative methods for assessing physical functionality. The Short Physical Performance Battery (SPPB), the Time Up and Go (TUG) test, the 4 Meter Walk Test and the Barthel Index (BI) have been used to evaluate mobility and fragility and predict falls. But some of these functional test tasks could be difficult to perform for frail older adults or bedridden patients that cannot ambulate. This study aimed to evaluate the relationship between these functional tests and the power elbow flexion (PEF test). MATERIAL AND METHODS: A correlation study was designed with 41 older adults over 65 years of age. The upper limb muscle power was measured using a linear encoder (VITRUBE VBT) with the flexion of the elbow. RESULTS: Strong correlations were found between the PEF test and the 4mWT (rho = 0.715, p = 0.001) and TUG (rho= -0.768, p = 0.001), indicating that the greater the upper limb muscle power is, the greater physical performance will be. Moderate correlations were also found between the PEF and Barthel Index (rho = 0.495, p = 0.001) and SPPB (rho = 0.650, p < 0.001). CONCLUSIONS: There is a strong correlation between PEF and the functional tests, proving that older adults that have greater upper limb muscle power have better physical performance. Upper limb muscle power and PEF could be an interesting tool for the assessment of physical performance in bedridden older adults.

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The use of information and communication technologies (ICTs) has become widespread in recent years, leading to an increase in addiction cases. A total of 118 patients who attended the Behavioral Addictions Unit of Consorci Sanitari de Terrassa (Barcelona, Spain) between October 2005 and December 2021 were included in the study. The sample was divided into three groups according to the time period in which they started treatment: between 2005 and 2010 (before the rise in new technologies, named the pre-ICT period), between 2011 and 2019 (a time of major ICT development, named the ICT period) and between 2020 and 2021 (with massive use of the internet due to effects of the pandemic, named the COVID-19 period). We found an increase in the incidence of screen addiction cases related to the development of technology throughout the study years, and this increase was accentuated during the COVID-19 period. This increase was not equal for all types of content consumed via the internet, with patients with video game addiction increasing to a greater extent than patients with internet/social network addiction. In addition, patients with video game addiction were younger and had started gaming at a younger age than those with internet/social network addiction. These results contribute to a better understanding of the phenomenon of technology addiction and to the design of appropriate treatment protocols and preventive programs.

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Aging is associated with a decrease in functional capacity, manifested by a loss of strength, physical performance and muscle quality. Multicomponent training (MCT), characterized by the combination of at least three types of training, could be a good strategy to counteract these changes. To date there are no studies evaluating the effectiveness of MCT in improving both physical performance and muscle quality simultaneously. The aim of this study is to evaluate the changes produced by an MCT program on both physical performance and muscle quality in a population of healthy older adults. Sixteen healthy older adults were recruited to perform a 15-session multicomponent training intervention. Physical performance was assessed by different functional tests, and muscle quality was assessed by tensiomyography and myotonometry. The main results of this study show some improvement in functional tests, but not in muscle quality parameters, except for vastus lateralis stiffness. MCT is able to generate improvements in the physical performance of older adults, but these improvements are not reflected in muscle quality parameters measured by tensiomyography and myotonometry.

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Introducción: A pesar de la falta de evidencia, tradicionalmente se ha recomendado seguir una dieta baja en grasas tras la colecistectomía. El objetivo principal fue analizar la correlación potencial entre los síntomas postoperatorios y el tipo de dieta tras la colecistectomía. Métodos: Los síntomas fueron evaluados de forma prospectiva mediante el cuestionario Gastrointestinal Quality of Life Index (GIQLI) antes de la intervención, al mes y 6 meses después de la colecistectomía en 83 pacientes operados en nuestro centro. Los pacientes completaron un cuestionario sobre su dieta y fueron clasificados en 4 grupos de acuerdo a la cantidad de grasa ingerida. Las diferencias en la puntuación GIQLI dependiendo del tipo de dieta se evaluaron en el tiempo. Resultados: La puntuación GIQLI total y varias dimensiones aumentaron significativamente tras la cirugía respecto al valor basal, independientemente de la ingesta de grasa en la dieta. Entre los síntomas evaluados por el GIQLI, la diarrea y la urgencia defecatoria empeoraron mientras que el estreñimiento mejoró. Más del 50% de los pacientes experimentaron cambios en el ritmo deposicional después de la cirugía, que fueron persistentes durante 6 meses en el 23% de los casos. Conclusiones: La dieta baja en grasas no parece influir en la mejoría de los síntomas tras la colecistectomía. No obstante, los resultados de un estudio aleatorizado que se está realizando en nuestro centro contribuirán a confirmar los resultados de este estudio prospectivo

Introduction: Even though evidence is lacking, a low-fat diet has been traditionally recommended after cholecystectomy. The main aim of this study was to assess the potential correlation between postoperative symptoms and type of diet after cholecystectomy. Methods: Symptoms were prospectively assessed by the Gastrointestinal Quality of Life Index (GIQLI) score at baseline, one month and 6 months after cholecystectomy in 83 patients operated on at our institution. Patients completed a questionnaire about their diet and were classified into 4 groups according to the amount of fat intake. Differences in the GIQLI score depending on the type of diet were assessed over time. Results: The overall GIQLI score and most subdomains significantly increased after surgery compared to baseline, regardless of the intake of dietary fat. Constipation improved after cholecystectomy compared to baseline, whereas diarrhea and bowel urgency got worse. More than 50% of patients experienced a change in their bowel habit after surgery, which persisted 6 months later in 23% of cases. Conclusions: A low fat diet does not seem to have an influence on the improvement of symptoms after cholecystectomy. However, a randomized study is ongoing at our institution to confirm the results of this prospective study

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INTRODUCTION: Even though evidence is lacking, a low-fat diet has been traditionally recommended after cholecystectomy. The main aim of this study was to assess the potential correlation between postoperative symptoms and type of diet after cholecystectomy. METHODS: Symptoms were prospectively assessed by the Gastrointestinal Quality of Life Index (GIQLI) score at baseline, one month and 6 months after cholecystectomy in 83 patients operated on at our institution. Patients completed a questionnaire about their diet and were classified into 4 groups according to the amount of fat intake. Differences in the GIQLI score depending on the type of diet were assessed over time. RESULTS: The overall GIQLI score and most subdomains significantly increased after surgery compared to baseline, regardless of the intake of dietary fat. Constipation improved after cholecystectomy compared to baseline, whereas diarrhea and bowel urgency got worse. More than 50% of patients experienced a change in their bowel habit after surgery, which persisted 6 months later in 23% of cases. CONCLUSIONS: A low fat diet does not seem to have an influence on the improvement of symptoms after cholecystectomy. However, a randomized study is ongoing at our institution to confirm the results of this prospective study.

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Background: Gambling landscape has changed in recent years with the emergence of online gambling (OG). Greater accessibility and availability of this betting modality can increase the risk of developing a gambling disorder (GD). Online sports betting (OSB) is currently the most common type of OG, but little is known about the clinical characteristics of OSB compared to slot-machine (SM) gamblers, the most common offline gambling disorder. Methods: This was a prospective study conducted between October 2005 and September 2019, and included outpatients diagnosed with GD seen in a Pathological Gambling and Behavioral Addictions referral unit. Only patients with OSB and SM disorders were included. The main objective was to assess the clinical profile of OSB compared to SM gamblers, and to define clinical predictors for developing OSB gambling disorder. Logistic regression was performed to determine the effects of variables on the likelihood of this disorder. Results: Among 1,186 patients attended in our Unit during the study period, 873 patients were included; 32 (3.7%) were OSB gamblers and 841 (96.3%) were SM gamblers. Overall, mean age was 45 ± 13 years and 94.3% were men. Compared to SM patients, OSB patients were younger (34.9 ± 9.5 vs. 45.3 ±13), more frequently single (43.8 vs. 20.6%) and had a university education level (43.8 vs. 4.5%); they were also more frequently non-smokers (18.7 vs. 66.7%) and had fewer psychiatric comorbidities (12.5 vs. 29.4%) than SM gamblers. GD duration before treatment initiation was shorter in OSB patients than in SM gamblers, most of them (81.3 vs. 42.4%) with ≤ 5 years of GD duration. OSB gamblers showed significant differences in weekly gambling expenditure, spending higher amounts than SM patients. Younger age (OR: 0.919; 95% CI: 0.874-0.966), university education level (OR: 10.658; 95% CI: 3.330-34.119), weekly expenditure >100€ (OR: 5.811; 95% CI:1.544-21.869), and being a non-smoker (OR:13.248; 95% CI:4.332-40.517) were associated with an increased likelihood of OSB gambling behavior. Conclusions: We identified different profiles for OSB and SM gamblers. Younger age, university education level, higher weekly expenditure, and non-smoking habit were associated with OSB compared to SM disorders. Prevention strategies should help young people become aware of the severe risks of OSB.

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PURPOSE: The impact of the low anterior resection syndrome (LARS) on quality of life has underscored the importance of measuring functional outcomes after treatment for rectal cancer. The aim of this study was to evaluate whether the LARS score as a single questionnaire was useful enough in the clinical setting. METHODS: Patients treated by curative anterior resection for rectal cancer were sent the LARS score and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 questionnaires by post. Patients classified as "minor" and "major" LARS according to the LARS score were visited. Assessment included several scores (Vaizey score, Altomare Obstructed Defecation Syndrome score, Bristol scale). Patients with urgency/faecal incontinence also filled in a bowel diary and the FIQL score. RESULTS: Seventy patients returned the questionnaires, 49 of whom ("major LARS" and "minor LARS") were visited and 19 ("no LARS") were assessed by phone. Four different clinical patterns were identified. The group with urgency/faecal incontinence was the largest (33.8 %), whereas 17.7 % referred evacuatory dysfunction. The LARS score did not correctly evaluate 18 patients: 5 who were classified as no LARS but had severe evacuatory dysfunction and 13 patients categorized as LARS but without significant bowel dysfunction, 9 of whom were classified as major LARS. CONCLUSION: The LARS score may overestimate the impact on quality of life in some patients and may underestimate the impact of severe evacuatory dysfunction. Due to the complexity of the LARS, the LARS score as a single questionnaire might not be enough to assess bowel function. A complete clinical evaluation and additional questionnaires might be required.

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Objetivo: comparar la eficacia, seguridad y coste de dos pautas para la maduración cervical en la inducción del parto: misoprostol vaginal versus dinoprostona. Sujetos y método: comparación retrospectiva de dos cohortes de pacientes ingresadas en el primer y segundo semestre de 2013 (90 pacientes tratadas con dinoprostona y 89 con misoprostol). Resultados: no hemos encontrado diferencias estadísticamente significativas en cuanto al tipo de parto, ni el tiempo hasta el parto vaginal, tampoco en los resultados perinatales. Se ha objetivado menor necesidad de uso de oxitocina y una menor necesidad de retirada de la medicación o uso de tocólisis en el grupo de misoprostol. El coste ha sido menor con el uso de misoprostol. Conclusiones: el misoprostol es un fármaco eficaz, equiparable a la dinoprostona en los casos seleccionados, con mejor perfil de seguridad y más económico (AU)

Objetive: To compare the efficacy, safety and cost of two different methods for cervical priming before induction vaginal misoprostol vs. dinoprostone Material and methods: Retrospective cohort study in two groups of patients: 90 patients (group 1) with dinoprostone and 89 patients (group 2) with misoprostol. Results: No significant differences were found in the route of delivery, mean time to vaginal delivery, or neonatal outcomes. The misoprostol group had significantly lower oxytocin infusion requirements and less need for removal of vaginal medication or tocolysis. The cost was also lower with the use of misoprostol Conclusions: Misoprostol is an effective drug, similar to dinoprostone in selected patients, and is safer and more cost-effective (AU)

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ObjetivoConocer la viabilidad de la realización de la exploración oftalmológica básica de la patología ocular del paciente diabético desde el ámbito de la Atención Primaria de Salud (APS).DiseñoEstudio transversal observacional prospectivo y multicéntrico.Participantes y métodoMuestra de 712 diabéticos tipo II. Intervenciones: realización, por parte de un optometrista, de una exploración de la agudeza visual, medición de la presión intraocular y fotografía de fondo de ojo con cámara de retina no midriática. Interpretación de los resultados e indicación de derivación realizada, a doble ciego, por oftalmólogos y médicos APS.ResultadosAlteración agudeza visual: médico APS 43,7%, oftalmólogo 36,1%, concordancia 70%; sospecha glaucoma: médico APS 8,8%, oftalmólogo 7,6%, concordancia 94%; retinopatía diabética: médico APS 28,2%, oftalmólogo 13,4%, concordancia 78%. Derivación Servicios Oftalmología: médico APS 56,8%, oftalmólogo 41,3% (p=0,001).ConclusionesEl nivel de concordancia en los diagnósticos entre médico APS y oftalmólogo hace fiable la exploración oftalmológica del paciente diabético desde el ámbito de la APS. A pesar del supradiagnóstico y del 16% de derivación no justificada realizada por parte del médico APS, se evita la derivación a las consultas de oftalmología, de cerca de la mitad de los pacientes diabéticos(AU)

ObjectiveTo study the feasibility of a basic ophthalmological examination for the eye disease in diabetic patients by Primary Health Care (PHC).InterventionsVisual acuity examination, intraocular pressure measurement and the eye fundus photograph with a non-mydriatic camera taken by an optometrist. The interpretation and subsequent referral to an ophthalmology department by ophthalmologists and general practitioners (GP).ResultsVisual acuity deficiency: GP, 43.7%; ophthalmologist, 36.1%; concordance, 70%; glaucoma suspicion: GP, 8.8%; ophthalmologist, 7.6%; concordance, 94%; diabetic retinopathy: GP, 28.2%; ophthalmologist, 13.4%; concordance, 78%. Ophthalmology Department referral: GP, 56.8%; ophthalmologist, 41.3% (P=0.001).ConclusionsAgreement between GP and ophthalmologist leads to a reliable ophthalmological examination of the diabetic patient in PHC. Despite an over-diagnosis and 16% of non-justified referrals by the GP, Ophthalmology Department referral is avoided in almost half of the diabetic patients(AU)

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OBJECTIVE: To study the feasibility of a basic ophthalmological examination for the eye disease in diabetic patients by Primary Health Care (PHC). PATIENTS AND METHODS: A multi-centre prospective study. A sample of 712 type 2 diabetics. INTERVENTIONS: Visual acuity examination, intraocular pressure measurement and the eye fundus photograph with a non-mydriatic camera taken by an optometrist. The interpretation and subsequent referral to an ophthalmology department by ophthalmologists and general practitioners (GP). RESULTS: Visual acuity deficiency: GP, 43.7%; ophthalmologist, 36.1%; concordance, 70%; glaucoma suspicion: GP, 8.8%; ophthalmologist, 7.6%; concordance, 94%; diabetic retinopathy: GP, 28.2%; ophthalmologist, 13.4%; concordance, 78%. Ophthalmology Department referral: GP, 56.8%; ophthalmologist, 41.3% (P=0.001). CONCLUSIONS: Agreement between GP and ophthalmologist leads to a reliable ophthalmological examination of the diabetic patient in PHC. Despite an over-diagnosis and 16% of non-justified referrals by the GP, Ophthalmology Department referral is avoided in almost half of the diabetic patients.

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Objetivo: Demostrar la utilidad del taponamiento mecánico del útero con balón en el tratamiento de la hemorragia posparto. Material y métodos: 5 gestantes a término, tratadas por hemorragia posparto precoz. El criterio para colocar el balón fue el sangrado persistente a pesar del tratamiento farmacológico. Resultados: La colocación del balón fue exitosa en el 100% de los casos. El descenso medio de hemoglobina fue de 3,2g/dl (rango [r]=1-5) y se requirió una media de 3 concentrados de hematíes por paciente (r=0-6). El volumen medio de suero por balón fue de 312ml (r=160-420) y el tiempo medio de tratamiento fue de 22h (r=: 12-30). Conclusiones: El taponamiento uterino con balón constituye un método eficiente para el control de la hemorragia uterina posparto. Su aplicación no precisa entrenamiento y puede evitar la cirugía. Por su fácil manejo y coste asequible, es aplicable en cualquier medio hospitalario (AU)

Objective: To demonstrate the usefulness of uterine balloon tamponade in postpartum hemorrhage. Material and methods: Five term pregnancies with postpartum hemorrhage were studied. The criterion for balloon placement was persistent bleeding despite pharmacological treatment. Results: Balloon placement was successful in 100% of the patients. The mean decrease in hemoglobin was 3.2g/dl (range: 1-5) and an average of three units of packed red blood cells per patient were required (range: 0-6). The mean volume of saline solution per balloon was 312ml (range: 160-420) and the mean duration of treatment was 22hours (range: 12-30). Conclusions: Uterine balloon tamponade is an efficient method to control postpartum hemorrhage. Training is not required for the application of this technique, which can obviate the need for surgery. Because of its ease of use and reasonable cost, this method can be used in any hospital setting (AU)

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ObjetivosValorar los factores de riesgo cardiovascular (FRCV) de una población no diabética conocida, su relación con la resistencia a la insulina (RI) y la función de la célula betapancreática (FBP) y seguir su evolución durante un período de 5 años.DiseñoEstudio tipo de casos y controles anidado desarrollado en 2 fases: identificación y caracterización de la cohorte para estudio, y seguimiento.EmplazamientoCentro de atención primaria de ámbito urbano. Participantes: muestra de población no diabética de 40 a 75 años.Mediciones principalesAntecedentes de FRCV, exploración física (índice de masa corporal, perímetro abdominal, presión arterial), analítica (glucemia basal, perfil lipídico e insulinemia basal) y cálculo de RI y FBP mediante el programa matemático HOMA (Homeostasis Model Assessment).ResultadosFase de identificación: 326 personas. Entre los FRCV, el 32,5% tenía dislipidemia; el 28,8%, tabaquismo; el 28,2%, obesidad, y el 24,8%, hipertensión arterial (HTA). Con respecto al número de FRCV, el 37,7% presentaba uno, el 21,5% presentaba 2, el 10,1% presentaba 3 y el 2,1% presentaba 4. Con respecto a la relación entre el número de FRCV y la RI, era mayor la RI en hipertensos, obesos y dislipidémicos. La fase de seguimiento (5 años) se realizó en 121 personas. Se observó un aumento significativo de la proporción de dislipidemia y de la glucosa basal alterada (GBA).ConclusionesLos FRCV más prevalentes fueron la dislipidemia, el tabaquismo, la obesidad y la HTA, con una mayor RI en los pacientes con HTA, dislipidemia, obesidad y un mayor número de FRCV asociados, en comparación con el resto de la población. A los 5 años de seguimiento, solamente se observó un aumento en la proporción de dislipidemia y de GBA y no se ha conseguido disminuir el porcentaje de fumadores activos(AU)

ObjectivesTo evaluate the cardiovascular risk factors (CVRF), their relationship with insulin resistance (IR) and pancreatic beta-cell (PBC) function in a known non-diabetic population, and to follow its progress over a period of 5 years.DesignNested case-control study developed in two phases: the identification and characterisation of the cohort to study and the follow up.SettingUrban Primary Care Centre.ParticipantsA non-diabetic population sample from 40 to 70 years.Main measurementsHistory of CVRF, physical examination (body mass index, abdominal girth, blood pressure), laboratory tests (fasting glucose, lipid profile and fasting insulin) and calculation of IR and PBC using the Homeostasis Model Assessment mathematical program.ResultsIdentification phase: 326 subjects. CVRF 32.5% dyslipaemia, 28.8% smoking, 28.2% obesity and 24.8% increased blood pressure. Number of CVRF: 37.7% had one, 21.5% two, 10.1% three and 2.1% four. Relationship between number of CVRF and IR. More IR in hypertensive, obese and dyslipaemic subjects. Follow up phase (5 years): 121 subjects. Significant proportion of dyslipaemia and impaired fasting glucose (IFG).ConclusionsThe most common CVRF were dyslipaemia, smoking, obesity and raised blood pressure, with more IR in patients with high blood pressure, dyslipaemia and obesity and a higher number of CVRF in comparison with the rest of the population. At five years of follow up, an increase was only observed in the number of dyslipaemia and IFG and no reduction was achieved in the percentage of active smokers(AU)

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OBJECTIVES: To evaluate the cardiovascular risk factors (CVRF), their relationship with insulin resistance (IR) and pancreatic beta-cell (PBC) function in a known non-diabetic population, and to follow its progress over a period of 5 years. DESIGN: Nested case-control study developed in two phases: the identification and characterisation of the cohort to study and the follow up. SETTING: Urban Primary Care Centre. PARTICIPANTS: A non-diabetic population sample from 40 to 70 years. MAIN MEASUREMENTS: History of CVRF, physical examination (body mass index, abdominal girth, blood pressure), laboratory tests (fasting glucose, lipid profile and fasting insulin) and calculation of IR and PBC using the Homeostasis Model Assessment mathematical program. RESULTS: Identification phase: 326 subjects. CVRF 32.5% dyslipaemia, 28.8% smoking, 28.2% obesity and 24.8% increased blood pressure. Number of CVRF: 37.7% had one, 21.5% two, 10.1% three and 2.1% four. Relationship between number of CVRF and IR. More IR in hypertensive, obese and dyslipaemic subjects. Follow up phase (5 years): 121 subjects. Significant proportion of dyslipaemia and impaired fasting glucose (IFG). CONCLUSIONS: The most common CVRF were dyslipaemia, smoking, obesity and raised blood pressure, with more IR in patients with high blood pressure, dyslipaemia and obesity and a higher number of CVRF in comparison with the rest of the population. At five years of follow up, an increase was only observed in the number of dyslipaemia and IFG and no reduction was achieved in the percentage of active smokers.

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