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BACKGROUND: Corticosteroid injections are frequently used in the short-term treatment of musculoskeletal pain, but their use is controversial as repeated exposures to corticosteroids can lead to deleterious effects on musculoskeletal tissue. Ozone injections have been proposed as a possible treatment for musculoskeletal pain; however, their effectiveness has not been compared with corticosteroids. OBJECTIVE: To evaluate the effectiveness of ozone injections for reducing pain in individuals with musculoskeletal pain in comparison with corticosteroid injections through a meta-analysis. METHODS: An online systematic search was performed using electronic databases up to September 2023. We searched for studies that compared corticosteroid injections with ozone injections in the treatment of musculoskeletal pain of diverse origins. RESULTS: Eleven studies were included comprising a total of 534 individuals. In the overall pooled analysis, a pain reduction in favor of corticosteroid injections was found in the short term (d= 0.31, 95% CI 0.01 to 0.60, p (z) 0.04, I2 = 32%). In the medium term, no significant differences were found in reducing pain between groups (d=-0.17, 95% CI -0.42 to 0.07, p (z) 0.15, I2 = 0%). CONCLUSIONS: Our results suggest that corticosteroids injections are more effective in reducing musculoskeletal pain in the short term, but equally effective in the medium term when compared with ozone injections. Nonetheless, better-quality clinical trials are necessary to corroborate these results.

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A cluster of three genes CELSR2, PSRC1, and SORT1 has been associated with cardiovascular diseases. Thus, the aim of this study was (i) to perform a systematic review and updated meta-analysis of the association of three polymorphisms (rs646776, rs599839, and rs464218) of this cluster with cardiovascular diseases, and (ii) to explore by PheWAS signals of the three SNPs in cardiovascular diseases and to evaluate the effect of rs599839 with tissue expression by in silico tools. Three electronic databases were searched to identify eligible studies. The meta-analysis showed that the rs599839 (allelic OR 1.19, 95% CI 1.13-1.26, dominant OR 1.22, 95% CI 1.06-1.39, recessive OR 1.23, 95% CI 1.15-1.32), rs646776 (allelic OR 1.46, 95% CI 1.17-1.82) polymorphisms showed an increased risk for cardiovascular diseases. PheWas analysis showed associations with coronary artery disease and total cholesterol. Our results suggest a possible involvement of the CELSR2-PSRC1-SORT1 cluster variants in the risk association of cardiovascular diseases, particularly coronary artery disease.

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OBJETIVO: No mundo, cerca de 16 milhões de mulheres vivem com HIV, muitas delas em idade reprodutiva. Esses níveis de infecção e as taxas de transmissão vertical ainda trazem grandes preocupações, devido à pouca intervenção terapêutica precoce em muitos países africanos. Em Moçambique, país da África Subsaariana, os índices de prevalência do HIV são de 13,2%, colocando o país em segundo lugar na conta de novas infecções, atrás apenas da África do Sul. OBJETIVO: Conhecer as experiências e as principais dificuldades vivenciadas pelas gestantes ou lactantes soropositivas e seus parceiros sexuais no contexto específico. METODOLOGIA: Estudo qualitativo realizado em Chókwè na província de Gaza- Moçambique. Foram realizadas entrevistas semiestruturadas com mulheres gestantes ou lactantes que vivem com HIV, com seus parceiros sexuais e com profissionais de saúde. Foram realizados grupos focais com mães mentoras e entrevista em grupo com pais mentores, as quais ocorreram no segundo semestre de 2021. As entrevistas e os encontros foram gravados com gravador de voz e transcritas na íntegra. As informações passaram pelo processo de análise temática. RESULTADOS: Participaram do estudo dez mulheres gestantes ou lactantes soropositivas e um parceiro sexual; treze mães mentoras e dois pais mentores; duas enfermeiras de Saúde Materno Infantil e uma psicóloga. Os achados revelam que as participantes associam o diagnóstico do HIV ao teste de gravidez ou ao parto, e o período da gestação e da amamentação é marcado pelo medo de infectar o filho com o vírus. As mulheres escondem seu estado sorológico do marido, da família e da comunidade por medo das consequências relacionadas com normas sociais rígidas e interferência de fatores culturais. Os resultados dos profissionais de saúde trouxeram aspectos similares aos das mulheres vivendo com HIV, entretanto, ressaltam a falta de profissionais para oferecer atendimento de qualidade. Constatou-se que na unidade de saúde e na comunidade utilizam palestras como única estratégia de educação em saúde, apesar da pouca eficácia. CONCLUSÕES: Observou-se que ainda existem muitas barreiras para prevenção da transmissão vertical em Moçambique, em especial, a qualidade do aconselhamento e dificuldades de acesso ao serviço, seja por falta de recursos ou pelas normas sociais e familiares que não reconhecem a autonomia da mulher. É necessario apoiar as mães que não desejam amamentar e aquelas que tem maior vulnerabilidade socioeconômica. Recomenda-se maior investimento nas estratégias de apoio psicossocial e envolvimento comunitário, utilizando alternativas como a Terapia Comunitária Integrativa (TCI) e Educação Popular. Sugere-se o envolvimento de lideranças comunitárias no processo de desenvolvimento de um programa de intervenção e promoção de saúde mental para mulheres gestantes ou lactantes soropositivas.

OBJECTIVE: In the world, about 16 million women are living with HIV, many of them in reproductive age. These levels of infection and vertical transmission rates are still of great concern, due to the lack of early therapeutic intervention in many African countries. In Mozambique, a country in sub-Saharan Africa, HIV prevalence rates are 13.2%, placing the country in second place in terms of new infections, behind only South Africa. OBJECTIVE: To know the experiences and the main difficulties experienced by HIV-positive pregnant or lactating women and their sexual partners in the specific context. METHODOLOGY: Qualitative study carried out in Chókwè in the province of Gaza - Mozambique. Semi-structured interviews were conducted with pregnant or lactating women living with HIV, with their sexual partners and with health professionals. Focus groups were held with mentor mothers and group interviews with mentor fathers, which took place in the second half of 2021. The interviews and meetings were recorded with a voice recorder and transcribed in full. The information went through the thematic analysis process. RESULTS: Ten seropositive pregnant or lactating women and one sexual partner participated in the study; thirteen mentor mothers and two mentor fathers; two Maternal and Child Health nurses and a psychologist. The findings reveal that the participants associate the HIV diagnosis with the pregnancy test or childbirth, and the period of pregnancy and breastfeeding is marked by the fear of infecting the child with the virus. Women hide their serological status from their husband, family and community for fear of consequences related to rigid social norms and interference of cultural factors. The results of health professionals brought similar aspects to those of women living with HIV, however, they highlight the lack of professionals to offer quality care. It was found that the health unit and the community use lectures as the only health education strategy, despite its low effectiveness. CONCLUSIONS: It was observed that there are still many barriers to preventing mother-to-child transmission in Mozambique, in particular, the quality of counseling and difficulties in accessing the service, whether due to lack of resources or social and family norms that do not recognize women's autonomy. . It is necessary to support mothers who do not wish to breastfeed and those who are more socioeconomically vulnerable. Greater investment in psychosocial support and community involvement strategies is recommended, using alternatives such as Integrative Community Therapy (ICT) and Popular Education. It is suggested the involvement of community leaders in the process of developing a program of intervention and promotion of mental health for seropositive pregnant or lactating women.

OBJETIVO: En el mundo, alrededor de 16 millones de mujeres viven con el VIH, muchas de ellas en edad reproductiva. Estos niveles de infección y tasas de transmisión vertical siguen siendo motivo de gran preocupación, debido a la falta de una intervención terapéutica temprana en muchos países africanos. En Mozambique, un país del África subsahariana, las tasas de prevalencia del VIH son del 13,2%, lo que coloca al país en el segundo lugar en términos de nuevas infecciones, solo por detrás de Sudáfrica. OBJETIVO: Conocer las vivencias y las principales dificultades vividas por mujeres embarazadas o lactantes seropositivas y sus parejas sexuales en el contexto específico. METODOLOGÍA: Estudio cualitativo realizado en Chókwè en la provincia de Gaza-Mozambique. Se realizaron entrevistas semiestructuradas con mujeres embarazadas o lactantes que viven con el VIH, con sus parejas sexuales y con profesionales de la salud. Se realizaron grupos focales con madres mentoras y entrevistas grupales con padres mentores, que se realizaron en el segundo semestre de 2021. Las entrevistas y encuentros fueron grabados con una grabadora de voz y transcritas en su totalidad. La información pasó por el proceso de análisis temático. RESULTADOS: Participaron del estudio diez mujeres embarazadas o lactantes seropositivas y una pareja sexual; trece madres mentoras y dos padres mentores; dos enfermeras de Salud Materno Infantil y una psicóloga. Los hallazgos revelan que las participantes asocian el diagnóstico de VIH con la prueba de embarazo o el parto, y el período de embarazo y lactancia está marcado por el miedo a contagiar al niño con el virus. Las mujeres ocultan su estado serológico a su esposo, familia y comunidad por temor a las consecuencias relacionadas con las normas sociales rígidas y la interferencia de factores culturales. Los resultados de los profesionales de la salud trajeron aspectos similares a los de las mujeres que viven con el VIH, sin embargo, destacan la falta de profesionales para ofrecer una atención de calidad. Se constató que la unidad de salud y la comunidad utilizan las charlas como única estrategia de educación en salud, a pesar de su baja efectividad. CONCLUSIONES: Se observó que todavía existen muchas barreras para prevenir la transmisión maternoinfantil en Mozambique, en particular, la calidad de la consejería y las dificultades para acceder al servicio, ya sea por falta de recursos o por normas sociales y familiares que no reconocer la autonomía de la mujer. Es necesario apoyar a las madres que no desean amamantar ya aquellas que son más vulnerables socioeconómicamente. Se recomienda una mayor inversión en estrategias de apoyo psicosocial y participación comunitaria, utilizando alternativas como la Terapia Comunitaria Integrativa (TIC) y la Educación Popular. Se sugiere involucrar a los líderes comunitarios en el proceso de desarrollo de un programa de intervención y promoción de la salud mental para mujeres embarazadas o lactantes seropositivas.

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BACKGROUND: The 30″ sit to stand test is a submaximal exercise test that assesses functional capacity and it has been validated for various pathologies. Although it has been used in individuals with obesity, its reproducibility in this population has not yet been determined. The main objective of this study was to determine the reproducibility and safety of the 30″ sit to stand test in individuals with overweight or obesity and with cardiovascular risk factors. METHODS: A cross-sectional study was performed. Individuals with obesity or overweight who also presented cardiovascular risk factors were evaluated with the 30″ sit to stand test. The reproducibility and safety of the 30" sit to stand test were determined, as well as its association with other functional tests and anthropometric characteristics. RESULTS: 59 individuals (27 men, 32 women) with obesity or overweight and cardiovascular risk factors, aged 57.93 (9.62) years, were included in the study. The 30″ sit to stand test showed good overall reproducibility (0.907 ICC) and significant correlation with the 6-minute walk test, handgrip strength test, body fat percentage and waist - height index, with a similar hemodynamic response to the 6-minute walk test. CONCLUSION: The 30" sit to stand test is a highly reproducible and safe test for individuals with obesity and cardiovascular risk factors, with a significant correlation to anthropometric characteristics and other functional tests regularly used for the evaluation of individuals with obesity.

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RESUMEN Fundamento: el análisis de los programas de estudio para identificar potencialidades e insuficiencias, formular propuestas para su gestión o rediseño curricular, constituye una necesidad en las universidades médicas cubanas. Objetivo: analizar el programa analítico del curso de contenido propio Terapéutica Razonada para la carrera de Medicina en Cuba. Métodos: estudio cualitativo realizado en el tercer trimestre del año 2021. Se realizaron búsquedas en internet mediante buscadores especializados y los descriptores en ciencias de salud. Se utilizaron métodos teóricos como el analítico sintético y el inductivo deductivo y como método empírico, el análisis documental, los cuales permitieron establecer los criterios para el análisis y realizar el análisis del programa propiamente dicho. Resultados: se identifican las fortalezas y debilidades en torno a la justificación, pertinencia social, aspectos generales que lo caracterizan, nexos con el currículo formal, secuencia lógica en el currículo, organización de los temas, equilibrio entre las horas teóricas, prácticas y de trabajo independiente, análisis de los componentes no personales, orientaciones metodológicas, así como el análisis de la bibliografía. Las insuficiencias de mayor relevancia se orientan hacia la necesidad de reformular los objetivos, declarar métodos de enseñanza, incluir horas para la educación en el trabajo, explicitar las orientaciones metodológicas y actualizar la bibliografía. Conclusiones: el programa responde al encargo social de las universidades cubanas y su diseño se ajusta a las exigencias curriculares contemporáneas, pero se identifican aspectos que requieren atención en aras de su perfeccionamiento.

ABSTRACT Background: the analysis of the study programs to identify potentialities and insufficiencies, formulate proposals for their management or curricular redesign, constitutes a necessity in Cuban medical universities. Objective: to analyze the analytical program of the Reasoned Therapeutics course with its own content for the Medicine career in Cuba. Methods: qualitative study carried out in the third quarter of 2021. Internet searches were carried out using specialized search engines and descriptors in health sciences. Theoretical methods were used, such as synthetic analytical and inductive-deductive, and documentary analysis as an empirical method, which allowed establishing the criteria for the analysis and carrying out the analysis of the program itself. Results: the strengths and weaknesses around the justification, social relevance, general aspects that characterize it, links with the formal curriculum, logical sequence in the curriculum, organization of topics, balance between theoretical, practical and independent work hours, analysis of the non-personal components, methodological orientations, as well as the analysis of the bibliography are identified. The most relevant insufficiencies are oriented towards the need to reformulate the objectives, declare teaching methods, include hours for education at work, explain the methodological orientations and update the bibliography. Conclusions: the program responds to the social assignment of Cuban universities and its design is adjusted to contemporary curricular demands, but aspects that require attention for the sake of its improvement are identified.

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Hand grip strength has been considered as a possible marker for metabolic and psychiatric disease. To date, however, no research has focused on the association between alexithymia and hand grip strength. The objective of the present study was to investigate the correct association between hand grip strength and alexithymia. A cross-sectional study was carried out in Comalcalco, Tabasco, México. A total of 246 individuals were included. Hand grip strength was evaluated in the dominant hand using a Takei® portable digital dynamometer. Alexithymia was measured using the Toronto Alexithymia Scale (TAS-20). Two linear regression models adjusted by confounders were used to determine the association between alexithymia and hand grip strength. The rate for positive alexithymia was 39.0% (n = 94). Individuals with alexithymia showed a weaker hand grip strength than the comparison group (t = 2.4, 244 df, p = 0.01). Individuals with alexithymia had significantly reduced levels of hand grip strength (ß = -0.39 ± 0.14; p = 0.006); after additional adjustment for clinical variables, decreased hand grip strength remained (ß = 8.00 ± 1.86; p ≤ 0.001). Our results suggest that a decrease in hand grip strength could be associated with alexithymia. This measurement could be useful as a predictive marker for the identification of alexithymia in Mexican individuals who attend outpatient clinics.

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Abstract Up to today, there is no specific treatment against SARS-CoV-2 / COVID-19 infection; there the necessity to search for alternatives that help patients with COVID-19. The objective of this study was to review the use of ozone therapy as adjunct treatment for SARS-CoV-2 / COVID-19 infection, highlighting the mechanisms of action, forms of application and current clinical evidence. A systematic review was conducted in electronic databases, searching the terminology Ozone "or" Ozone therapy "and" SARS-CoV-2 or COVID-19 or Coronavirus. Results: nineteen studies were included; ten were editorials, comments, brief reports or reviews, and nine clinical studies. We found that ozone therapy could be favorable for treating patients infected with SARS-CoV-2 / COVID-19, through a direct antiviral effect, regulation of oxidative stress, immunomodulation and improvement of oxygen metabolism. Patients who were treated with ozone therapy responded favorably; therefore, ozone therapy appears to be a promising treatment for patients infected with SARS-CoV-2 / COVID-19. Its mechanism of action justifies its use as an adjuvant therapy; however, scientific evidence is based on case series and clinical trials are necessary to corroborate its effectiveness and safety.

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This study aimed to produce and characterize biosurfactants using the Thermoanaerobacter sp. CM-CNRG TB177 strain isolated from an oil field in Mexico, as well as assessing the influence of different carbon and nitrogen sources on the capacity of the produced surfactant to reduce the surface tension of water. The thin-layer chromatography (TLC) revealed that the obtained extract corresponds to a mono-rhamnolipid; the results of the ultra-performance-liquid chromatography/mass spectrometry (UPLC/MS) analysis revealed that the Thermoanaerobacter sp. CM-CNRG TB177 strain produces a mixture of three rhamnolipids, whose masses correspond to mono-rhamnolipid. The rhamnolipids mixture obtained using 2.5% molasses as carbon source diminished the surface tension of water to 29.67 mNm-1, indicating that the concentration of molasses influenced the capacity of the produced surfactant to reduce the surface tension of water. Also, the microorganism was not capable of growing in the absence of yeast extract as nitrogen source. To the best of our knowledge, the presented results describe for the first time the nature of the biosurfactant produced by a bacterium of the Thermoanaerobacter genus.Key points• Thermoanaerobacter sp. CM-CNRG TB177 produces biosurfactants, and its glycolipid nature is described for the first time.• The HPLC analysis revealed a mixture of three rhamnolipid congeners, and UPLC/MS analysis determined that two of the congeners are the rhamnolipids Rha-C8-C10 and Rha-C12-C10.• The lowest surface tension of 29.67 mNm-1 was obtained with molasses as source of carbon at a 2.5% concentration.

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The first-order hyperpolarizability of π-conjugated organic molecules is of particular interest for the fabrication of electro-optical modulators. Thus, we investigated the relationship between the molecular structure and the incoherent second-order nonlinear optical response (ßHRS) of four salicylidene derivatives (salophen, [Zn(salophen)(OH2)], 3,4-benzophen, [Zn(3,4-benzophen)(OH2)]) dissolved in DMSO. For that, we employed the Hyper-Rayleigh Scattering technique with picosecond pulse trains. Our experimental results pointed out dynamic ßHRS values between 32.0 ± 4.8 × 10-30 cm5/esu and 58.5 ± 8.0 × 10-30 cm5/esu at 1064 nm, depending on the molecular geometry of the salicylidene molecules. More specifically, the outcomes indicate a considerable increase of ßHRS magnitude (∼30%) when in the ligands are incorporated the Zn(II) ion. We ascribed such results to the rise of the planarity of the π-conjugated backbone of the chromophores caused by the Zn(II). Furthermore, we observed an increase of ∼50% in dynamic ßHRS when there is a replacement of one hydrogen atom (salophen molecule) by an acetophenone group (3,4-benzophen). This result is related to the increase of the effective π-electron number and the higher charge transfer induced at the excited state. All these findings were interpreted and supported in the light of time-dependent density functional theory (DFT) calculations. Solvent effects were considered in the quantum chemical calculations using the integral equation formalism variant of the polarizable continuum model.

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RESUMEN La Universidad de las Ciencias de la Salud de Venezuela se establece de forma legal, como centro formador, años después de la gestión del Programa Nacional de Formación en Medicina Integral Comunitaria y el Programa Nacional de Formación Avanzada en Medicina General Integral. Las bases legales, teóricas y metodológicas de esta se sustentan en el proyecto Alma Mater y, de manera particular, en las experiencias normativas, metodológicas, didácticas e instrumentales de estos dos programas. Como universidad médica inmersa en la generación de modelos de formación que garanticen egresados transformadores de los problemas sociales, ha contribuido -a consideración de los autores de este artículo- con la Educación Médica en lo siguiente: enseñanza en el servicio asistencial y educación en el colectivo laboral, desarrollo de nuevas formas de organización de la enseñanza, trabajo metodológico desde una visión integradora de los niveles organizativos del proceso docente educativo y concepción del Servicio Comunitario Estudiantil como actividad de investigación, integración de saberes y transformación comunitaria permanente. La Universidad de las Ciencias de la Salud ha enriquecido las concepciones formativas que regulan el proceso docente educativo en las universidades encargadas de egresar profesionales para los Sistemas Públicos de Salud.

ABSTRACT The University of Health Sciences of Venezuela is legally established, as a training center, years after the management of the National Training Program in Integral Community Medicine and the National Advanced Training Program in Integral General Medicine. Its legal, theoretical and methodological bases are based on the conceptions of the Alma Mater project and, in particular, on the normative, methodological, didactic and instrumental experiences of these programs. As a medical university, immersed in the generation of training models that guarantee transformative graduates of social problems, it has contributed - to the authors of this article - with the Medical Education in the following contributions: education of students in and by the work team, teaching of the profession from the assistance service, development of new forms of organization of teaching, methodological work from an integrative vision of the organizational levels of the educational teaching process and the conception of the Student Community Service as a research activity, integration of knowledge and permanent community transformation. This University has enriched the training conceptions that regulate the teaching learning process in the university that train professionals for Public Health Systems.

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RESUMEN Fundamento: la enseñanza de la electrocardiografía clínica durante la formación del médico en Cuba se ha caracterizado por el insuficiente tratamiento de este contenido en las asignaturas del currículo, a pesar de su importancia para el desempeño profesional. Objetivo: proponer una estrategia curricular para el tratamiento del contenido de la electrocardiografía clínica en la carrera de Medicina. Métodos: la investigación se desarrolló en la Universidad de Ciencias Médicas de Cienfuegos. El análisis teórico permitió establecer las exigencias para el tratamiento de la electrocardiografía como contenido de la carrera de Medicina. Estas, junto con el diagnóstico realizado, el que constató el potencial que ofrece el currículo de la carrera de Medicina para abordar el contenido, permitieron el diseño de una estrategia curricular orientada a este objetivo. Resultados: la estrategia curricular propone una secuenciación didáctica del contenido de la electrocardiografía clínica en cada año o ciclo del currículo, modificando el papel del docente y el estudiante en el proceso de enseñanza-aprendizaje de la electrocardiografía clínica, al otorgarle una connotación especial a nivel curricular al transversalizar el tratamiento de este contenido y las tareas docentes que puede realizar el estudiante a lo largo de la carrera. La valoración por los expertos permitió corroborar la validez de la estrategia curricular en cuanto se comprobó su pertinencia, factibilidad, relevancia, sustentabilidad y transferibilidad. Conclusiones: la estrategia presentada contribuirá a resolver la insuficiencia que presenta el currículo de la carrera de Medicina en cuanto al contenido de la electrocardiografía.

ABSTRACT Foundation: teaching of clinical electrocardiography during doctor´s training in Cuba has been characterized by the insufficient content treatment in the subjects of the curriculum, despite its importance for professional performance. Objective: to propose a curricular strategy for content treatment of clinical electrocardiography in the medical training program. Methods: the research was developed at the Cienfuegos University of Medical Science. The theoretical analysis allowed establishing the requirements for the treatment of electrocardiography as content of the training program. These requirements, together with the diagnosis which confirmed the potential offered by the curriculum of the medical degree to address the content, allowed the design of a curricular strategy oriented towards this objective. Results: the curricular strategy proposes a didactic clinical electrocardiography content sequencing in each year or cycle of the curriculum, modifying the role of the teacher and the student in its teaching-learning process, by granting a special connotation at the curricular level by mainstreaming this content treatment and the teaching tasks that students can solve throughout the career. Expert´s assessment allowed us to confirm the validity of the curricular strategy as its relevance, feasibility, sustainability and transferability were verified. Conclusions: the strategy presented will help to resolve the medical career curriculum insufficiency in terms of electrocardiography content.

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El deporte actual se caracteriza por una alta carga competitiva y, en consecuencia, la recuperación tras una lesión debe ser rápida y eficiente, por lo que los modelos convencionales de rehabilitación en el deporte(RD) probablemente resulten insuficientes.El objetivo de esta carta editorial es reflexionar sobre el papel del especialista en Medicina Física y Rehabilitación (EMFR) en el proceso de RD

Today's sport is characterized by a high competitive load and, consequently, recovery from injury must be fast and efficient, so that conventional models of rehabilitation in sport (RD) are likely to be insufficient. The aim of this editorial letter is to reflect on the role of the specialist in Physical Medicine and Rehabilitation (EMFR) in the DR process.

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BACKGROUND: To evaluate the efficacy and safety of prolotherapy with hypertonic dextrose in patients with knee osteoarthritis. A systematic search was performed in electronic databases including PUBMED, SCIELO, DIALNET and Google Scholar. MAIN BODY: We searched for randomized clinical trials that evaluated therapeutic interventions in patients with knee osteoarthritis. These trials compared the effect of intra-articular and / or extra-articular infiltrations of hypertonic dextrose vs the effect of intra-articular and / or extra-articular infiltrations of other substances or some interventional procedure application, via assessing pain, physical function and secondary effects and / or adverse reactions. Ten randomized clinical trials were included in this systematic review, the total sample size comprised 328 patients treated with hypertonic dextrose (prolotherapy) vs 348 controls treated with other infiltrations such as local anesthetics, hyaluronic acid, ozone, platelet-rich plasma or interventional procedures like radiofrequency. CONCLUSIONS: In terms of pain reduction and function improvement, prolotherapy with hypertonic dextrose was more effective than infiltrations with local anesthetics, as effective as infiltrations with hyaluronic acid, ozone or radiofrequency and less effective than PRP and erythropoietin, with beneficial effect in the short, medium and long term. In addition, no side effects or serious adverse reactions were reported in patients treated with hypertonic dextrose. Although HDP seems to be a promising interventional treatment for knee OA, more studies with better methodological quality and low risk of bias are needed to confirm the efficacy and safety of this intervention.

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Abstract Background: To evaluate the efficacy and safety of prolotherapy with hypertonic dextrose in patients with knee osteoarthritis. A systematic search was performed in electronic databases including PUBMED, SCIELO, DIALNET and Google Scholar. Main body: We searched for randomized clinical trials that evaluated therapeutic interventions in patients with knee osteoarthritis. These trials compared the effect of intra-articular and / or extra-articular infiltrations of hypertonic dextrose vs the effect of intra-articular and / or extra-articular infiltrations of other substances or some interventional procedure application, via assessing pain, physical function and secondary effects and / or adverse reactions. Ten randomized clinical trials were included in this systematic review, the total sample size comprised 328 patients treated with hypertonic dextrose (prolotherapy) vs 348 controls treated with other infiltrations such as local anesthetics, hyaluronic acid, ozone, platelet-rich plasma or interventional procedures like radiofrequency. Conclusions: In terms of pain reduction and function improvement, prolotherapy with hypertonic dextrose was more effective than infiltrations with local anesthetics, as effective as infiltrations with hyaluronic acid, ozone or radiofrequency and less effective than PRP and erythropoietin, with beneficial effect in the short, medium and long term. In addition, no side effects or serious adverse reactions were reported in patients treated with hypertonic dextrose. Although HDP seems to be a promising interventional treatment for knee OA, more studies with better methodological quality and low risk of bias are needed to confirm the efficacy and safety of this intervention.

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We report a successful bilateral globus pallidus internus-deep brain stimulation (GPi-DBS) for a Parkinson disease (PD) patient with idiopathic normal pressure hydrocephalus (INPH) and an unusually long anterior commissure-posterior commissure (AC-PC) line. A 54-year-old man presented with a history of 3 months of severe shuffling gait, rigidity, slow movements of the left side limbs, and difficulty managing finances. A brain MRI revealed marked ventriculomegaly (Evans index = 0.42). The patient was diagnosed with INPH and a ventriculoperitoneal shunt was placed. Cognitive impairment improved, but walking disturbances, slowness, and rigidity persisted. Then treatment with levodopa was added, and the patient experienced a sustained improvement. He was diagnosed with PD. After 7 years, the patient developed gait freezing and severe levodopa-induced dyskinesia. The patient underwent bilateral GPi-DBS. We used MRI/CT fusion techniques for anatomical indirect targeting. Indirect targeting is based on standardized stereotactic atlas and on a formula-derived method based on AC-PC landmarks. The AC-PC line was 40 mm (the usual length is between 19 and 32 mm). Intraoperative microelectrode recording was a non-expendable test, but multiple recordings were avoided to reduce the surgical risk of ventricular involvement. There was a 71% decrease in the UPDRS III score during the on-stimulation state (28 to 8). The patient's dyskinesias resolved dramatically with a UdysRS of 15 (88% improvement) during the on-stimulation condition. The observed motor benefits and the improvement of his daily activities have persisted 6 months after surgery. Deep brain stimulation surgery in PD with ventriculomegaly is a challenge. This procedure can result in a greater chance of breaching the ventricle, with risks of intraventricular hemorrhage and migration of cerebrospinal fluid into the brain parenchyma with target displacement. Furthermore, clinical judgment is paramount when recent onset of shuffling gait coexists with ventriculomegaly because the most common dilemma is differentiating between PD and INPH. For these reasons, neurologists and surgeons may refuse to operate on PD patients with ventriculomegaly. However, DBS should be considered for PD patients with motor complications when responsiveness to levodopa is demonstrated, even in the context of marked ventriculomegaly.

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The effect of the coordination of a Ni(II) ion on the electronic and magnetic properties of the ligand salophen were experimentally and theoretically evaluated. The complex [Ni(salophen)] was synthesized and characterized through FTIR and an elemental analysis. Spectral data obtained using DMSO as a solvent showed that the ligand absorption profile was significantly disturbed after the coordination of the metal atom. In addition to a redshift of the salophen ligand absorption bands, mainly composed by π → π∗ electronic transitions, additional bands of around 470 nm were observed, resulting in a partial metal-to-ligand charge transfer. Furthermore, a significant increment of its band intensities was observed, favoring a more intense absorption in a broader range of the visible spectrum, which is a desired characteristic for applications in the field of organic electronics. This finding is related to an increment of the planarity and consequent electron delocalization of the macrocycle in the complex, which was estimated by the calculation of the current strengths at the PBE0/cc-pVTZ (Dyall.v3z for Ni(II)) level.

RESUMO

Most patients undergoing limb amputations suffer significant emotional changes. The aim of this study was to estimate the prevalence of suicide attempts and depression in a sample of Mexican patients with limb amputations and, second, to determine whether the patients' functionality correlates with the presence of depression. We studied 40 patients who had undergone a limb amputation. The suicide attempt was evaluated using the Suicide Intent Scale. The depression was assessed using the Hamilton Depression Rating Scale, whereas the functionality of the patients was measured using the Functional Independence Measure. In this sample, 90% were men, whereas only 10% were women. In terms of the suicide behavior, we identified suicide attempts in 27.5% of the patients. The rate of depression was 92.5%. In the Functional Independence Measure, we observed that 57.5% of the patients showed complete dependence. Finally, a significant correlation was found between depression and functionality (r=-0.75, P<0.001). The findings of the present study highlight the high incidence of suicide attempts and depression in Mexican patients with limb amputations. Also, we identified a correlation between the lack of functional independence and depression. Therefore, holistic interventions are necessary in these patients: rehabilitation therapy to increase their functionality, and psychological and pharmacology therapy to decrease suicidal behavior and depression. Finally, more studies using larger samples are necessary to obtain conclusive results.

Assuntos

RESUMO

El objetivo de esta revisión fue establecer una asociación entre el nivel de actividad física realizada y la reducción del riesgo de muerte en pacientes hipertensos. Para la identificación de los documentos de esta revisión se realizó una búsqueda que abarcó estudios epidemiológicos tipo cohorte; las publicaciones relevantes fueron identificadas en las bases de datos biomédicas PubMed y Cochrane Collaboration, la estrategia de búsqueda siguió las recomendaciones de PRISMA. Los resultados mostraron que existe una asociación entre el nivel de actividad física y el riesgo de muerte en pacientes hipertensos. Se encontró una disminución del riesgo de muerte que oscila entre el 17-67% en los hipertensos que realizan altos niveles de actividad física. Los resultados apoyan la teoría de que la actividad física regular se asocia con la reducción del riesgo de muerte en pacientes hipertensos y se sugiere que este efecto protector puede ser para muerte por enfermedad cardiovascular y para muerte por cualquier causa, además se observó que en los estudios que consideraron edades de 40 a 80 años, la reducción del riesgo relativo fue del 28-67%. Por lo que se sugiere que probablemente la actividad física genere mayores beneficios en los grupos etarios de mayor edad.

The objective or aim of this review was to determine a relation between the level of realized physical activity and the reduction of the risk of death in hypertensive patients. A search was conducted for the identification of the documents from this review that included epidemiological cohort studies, relevant publications were identified in the biomedical databases PubMed and Cochrane Collaboration, the search strategy follows the recommendations of PRISMA. The results showed that an association exists between the level of physical activity and the risk of death in patients with hypertension. There was a diminution of death that ranges between 17-67 % in the hypertensive ones that do high physical activity levels. The results support the theory that regular physical activity is associated with a reduction in the rates of mortality in hypertensive patients and it is suggested that this protective effect can be of great benefit in a lower incidence of disease and cardiovascular death. In addition it is noted that the studies that consider ages of 40 to 80 years, the reduction of relative risk was 28-67%. Thus it is suggested that physical activity is likely to generate higher profits in the older age groups.

Assuntos

RESUMO

Las infecciones provocadas por cepas resistentes se hacen cada día más difíciles de tratar con los antibióticos disponibles. Las causadas por Staphylococcus aureus multirresistente han alcanzado niveles sin precedentes y escasean los medicamentos efectivos para combatirla. La resistencia bacteriana es un problema global que disminuye las opciones terapéuticas en infecciones intra y extrahospitalarias y aumenta las posibilidades de fracaso y los costos de los tratamientos. Esta revisión pretende describir los mecanismos de resistencia de las cepas de Staphylococcus aureus y caracterizar las oxazolidinonas (linezolid), como una alternativa para el tratamiento de infecciones por este germen.

Infections caused by resistant strains are becoming more difficult to treat with available antibiotics. Those caused by multidrug-resistant Staphylococcus aureus have reached unprecedented levels and effective drugs to treat them are often scarce. Bacterial resistance is a global problem that decreases therapeutic options in infections of both, hospitalized and non-hospitalized patients. They increase the chances of failure as well as treatment costs. This review is aimed at describing the resistance mechanisms of Staphylococcus aureus strains and at characterizing oxazolidinones (linezolid), as an alternative for the treatment of infections caused by this germ.