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Este artículo presenta una aproximación biográfica a la figura de Catalina Bravo, una actriz relegada al olvido. Recorre su trayectoria artística en los principales teatros madrileños, Príncipe y de la Cruz, y en el Teatre de la Santa Creu de Barcelona, destacando el repertorio que interpretó, su evolución en la jerarquía de actrices y su reflejo retributivo, así como la recepción de su trabajo por la crítica. Recientemente se ha conocido que la actriz interpretó la única intervención musical del drama de Hartzenbusch Los amantes de Teruel. Se pretende, desde esta investigación, recuperar la trayectoria escénica de Catalina Bravo prestando atención a su vertiente musical para poder discernir si la actuación en el drama de Hartzenbusch fue anecdótica o si su repertorio acredita que pueda ser considerada una canta-actriz, de la misma manera que sus coetáneas Matilde Díez o Bárbara Lamadrid.

Giovanni Paolo Martelli passed away on 8 January 2020 [...]

Abstract An interconnected system employing Kinect Azure and Fitbit Sense for continuous and non-intrusive data collection was used in the PRO-HOME protected discharge program, aiming at monitoring functional and clinical parameters in hospitalized older patients at different risks of frailty. The present study shows the findings on 30 older patients included in the PRO-HOME project. The Fitbit Sense recorded the mean daily and hourly number of steps, mean daily walked distance, and time spent inactive. Moreover, Kinect infrared camera captured gait speed and daily mean latero-lateral (body sway) and antero-posterior oscillations (lean-in). Patients underwent a standard Comprehensive Geriatric Assessment (CGA) to compute the Multidimensional Prognostic Index (MPI), including basic and instrumental activities of daily living (ADL, IADL), cognition (Short Portable Mental Status Questionnaire, SPMSQ) and nutrition, risk of pressure sores (Exton-Smith Scale, ESS), comorbidity, number of drugs and cohabitation status. Significant correlations between the mean hourly number of steps and MPI (p = 0.022), IADL (p = 0.013), SPMSQ (p = 0.006), ESS (p = 0.009), and both mean and maximum automated gait speed (p = 0.046 and p = 0.048) were found. Automated gait speed was also correlated with mean walked distance per day (p = 0.007) and lean-in (p = 0.047). Domotic technological monitoring through Fitbit Sense and Kinect Azure provides information on multidimensional frailty, including mobility and cognitive and functional status, in older people.

Abstract Background Multicomponent interventions based on a comprehensive geriatric assessment (CGA) could promote active aging and improve health status in older people with Noncommunicable Chronic Diseases (NCDs), but conflicting evidences are available. Aim To evaluate the efficacy of a CGA-based multicomponent personalized preventive program (PPP) in reducing unplanned hospitalization rates during 12-month follow-up in community-dwelling older people with NCDs. Materials and methods In this randomized clinical trial (RCT), 1216 older adults recruited by 33 general practitioners (GPs) will be randomly allocated to intervention group (IG) or usual care control group (CG). The IG will receive a multicomponent PPP developed on the findings of the CGA-based Multidimensional Prognostic Index short-form (Brief-MPI), including structured interventions to improve functional, physical, cognitive, and nutritional status, to monitor NCDs and vaccinations, and to prevent social isolation. Participants in the CG will receive usual care. Brief-MPI, resilience, and health-related quality of life will be assessed after 6 and 12 months. Moreover, saliva samples will be collected at baseline in IG to measure biomarkers of oxidative stress, inflammatory cytokines, and oral microbiome. Expected results The CGA-based PPP might reduce unplanned hospitalization rates and potentially institutionalization rates, emergency department (ED) and unplanned GP visits, and mortality. Further outcomes explored in the IG will be the adherence to PPP, resilience, health-related quality of life, and multidimensional frailty as assessed by the Brief-MPI. Conclusions Results will suggest whether the CGA-based multicomponent PPP is able to improve specific outcomes in a primary care setting. Trial registration ClinicalTrials.gov; identifier: NCT06224556 ; Registered January 25, 2024.

Abstract Backgroud Discharge planning from the hospital of frail older patients is an important step to avoid inappropriate long‐stay hospitalizations and to prevent the risks related to the prolonged hospitalization. In this frame, we developed an experimental trial—‘PRO‐HOME’, a multicomponent programme of interventions for multimorbid and polytreated hospitalized older patients. Aim The main aim of the study was to develop a protected discharge facility using a mini apartment equipped with advanced architectural and technological components to reduce the length of hospital stay of older participants (aged 65+ years old) admitted to the hospital for an acute event, deemed stable and dischargeable. Materials and Methods This is a pilot randomized controlled study, comparing 30 hospitalized participants included in a multidimensional, transitional care programme based on information and communication technologies to 30 patients in standard usual care until hospital discharge. Results We presented the study design of the PRO‐HOME programme, including architectural and technological components, the enrolment procedures, the components of the intervention that is physical activity, cognitive training and life‐style education and the evaluation method of the intervention based on the Comprehensive Geriatric Assessment to explore the changes in the individual domains that are target of the multicomponent intervention. Conclusions The final results will suggest whether the PRO‐HOME programme represents a useful and feasible intervention to reduce the length of hospital stay of multimorbid and polytreated hospitalized older patients and improve their physical and cognitive performances and overall quality of life. Patient or Public Contribution Due to the characteristics of the population of interest of the PRO‐HOME study, we involved in the study design and programme of the activities the participants enrolled in a previous smart home‐based project named MoDiPro carried‐out during a 3‐year period. The elderly participants from the local population involved were asked, by means of focus groups, for feedback on their experience in MoDiPro, and their suggestions were integrated into the design phase of the current PRO‐HOME project. The focus groups included open group interviews with a qualitative collection of the patients' feedback so that the participants could interact with each other.

IntroductionThe World Health Organization (WHO) acknowledges the presence of a significant body of research on the positive effects of the arts on health, considering a variety of factors including physical well-being, quality of life, and social and community impact. The model that underlies cultural welfare puts the performing arts, visual arts, and cultural heritage at the service of people personal and societal well-being. The potential connections between movements of the body and artistic content have been extensively studied over time, considering movement as a non-verbal language with a universal character.MethodsThis pilot study presents the results of the validation of an innovative multimodal system, the DanzArTe-Emotional Wellbeing Technology, designed to support active and participative experience of older people providing physical and cognitive activation through a full-body physical interaction with a traditional visual work of art of religious subject. DanzArTe supports a replicable treatment protocol for multidimensional frailty, administered through a low cost and scalable technological platform capable of generating real-time visual and auditory feedback (interactive sonification) from the automated analysis of individual as well as joint movement expressive qualities. The study involved 45 participants, 23 of whom participated in the DanzArTe program and 22 who were included in the control group.ResultsThe two groups were similar in terms of age (p = 0.465) and gender (p = 0.683). The results showed that the DanzArTe program had a positive impact on participants' self-perceived psychological health and well-being (Mean Psychological General Well-Being Index—Short T1 = 19.6 ± 4.3 Vs. T2 = 20.8 ± 4.9; p = 0.029). The same trend was not observed in the control group (p = 0.389).DiscussionThe findings suggest that such programs may have a significant impact particularly on the mental and social well-being of older adults and could be a valuable tool for promoting healthy aging and improving quality of life.

Introduction Perianal fistula is a common colorectal disease which is caused mainly by cryptoglandular disease. Although most cases are treated successfully by surgery, management of complex perianal fistulas (CPAF) remains a challenge with limited results in recurrence and sometimes associated with fecal incontinence. The CPAF treatment with autologous adipose-derived mesenchymal stem cells (ASCs) had become a research hotspot. The technique started to be used in the treatment of Crohn's disease (CD) fistulas, where the studies showed safe and goods result from the procedure. Cultured ASCs have been used but this approach requires the preceding collection of adipose tissue, time for isolation of ASCs and subsequent in vitro expansion, need for laboratory facilities, and expertise in cell culturing. These factors have been getting over by using the commercially available alternative, allogenic ASCs. Treatment with allogeneic ASCs has shown good results in patients with CD fistulas, however with the disadvantage of being expensive. Objective To show that the injection with freshly collected adipose tissue is an alternative to treatment with autologous or allogenic ASCs with several advantages. Methods: In this case report, we show our first experience in the treatment of CPAF with the application of collected adipose tissue in a tertiary referral hospital from Belo Horizonte, Brazil. Results The patient had a good postoperative recuperation with a complete fistula healing after 8 months without adverse effects. Conclusion Injection with freshly collected adipose tissue is a promising and apparently safe sphincter-sparing technique in the treatment of CPAF.

Objective: Characterize the risk factors associated with the development of cervical intraepithelial neoplasia (CIN) and determine the prevalence of High-risk Human Papillomavirus (HR-HPV) infection in women without cytological abnormalities and women diagnose with CIN 2 and 3, living in metropolitan region Curitiba, Paraná state, Brazil. Materials and Methods: Case-control study consisting of 382 women without cytological abnormalities, 233 women with high-grade intraepithelial lesions, which were subdivided in 131 women with CIN 2 and 102 women with CIN 3 diagnose by histological analysis of the cervical segment conical excision material. The age range of the women in the study was 15-45 years old, collected in the period of 2009 to 2012. The detection of HR-HPV DNA was performed by Hybrid Capture 2 test (CH2). An epidemiological questionnaire assessed the risk factors associated with the presence of HR-HPV and CIN 2/3 in each group. Statistical analysis was performed using the Chi-Square test and Results: The HR-HPV was detected in 12.5% of controls, 87% in CIN 2 women and 93.1% in the CIN 3 women. Risk factors associated with the development of CIN were HR-HPV infection (OR = 62.054; 95% CI: 34.57-111.37), smoking (OR = 1.837, 95% CI: 1.061-3.178), use of hormonal contraceptives (OR = 1.845, 25 years old are the most susceptible to infection (p

Objective: To evaluate the HLA-C gene in the progression and regression of cervical lesions caused by HPV infection, the present study aimed to analyze the genetic diversity and allelic variants of HLA-C gene in women CIN 2 and CIN 3 diagnosed, comparing with those without abnormalities on cervical cytology with and without the presence of infection HPV. Materials and Methods: The study group consisted of 84 women with CIN 2 and 90 women with CIN 3; the control group had no abnormality in cervical cytology consisted of 102 women negative for the presence of the HPV and 76 women with positive HPV infection. Samples were obtained from the metropolitan region of Curitiba-PR, Brazil, aged between 15 and 45 years old. The study group was treated in the Department of Pathology of the Cervical Erasto Gaertner Hospital, Curitiba and the control group was recruited in cervical cancer prevention campaigns promoted by public entities in association with the Department of Obstetrics and Gynecology, Hospital de Clínicas, Federal University of Parana and Histocompatibility and Immunogenetics Laboratory, Department of Genetics, UFPR. The HPV detection was performed by the Hybrid Capture 2 (CH2®) methodology. The DNA was extracted from peripheral blood samples and HLA-C genotyping was performed PCR-SSOP method. Results: Using G test it was observed that alleles HLA-C* 05:01 (p = 0.0096), HLA-C * 07:01P (p = 0.0096), HLA-C*07:02 (p = 0.0024), HLA-C*12:03 (p = 0.0010), HLA-C*15:02P (p = 0.0176) and HLAC*16:01 (p = 0.0415) were significantly more frequent in the study. The homozygous genotype HLAC*04:01P/*04:01P was the most frequent, reflecting the high frequency in the population studied. Allelic variants HLA-C*05:01 (p = 0.009; OR = 4.57; 95%CI 0.5749 – 36.3774), HLA-C*07:02 (p = 0.002; OR = 11.42; 95%CI 1.5173 – 86.2209) and HLA-C*12:03 (p = 0.001; OR = 7.59; 95%CI 0.9886 – 58.3472) were more frequent in women with CIN than in women with no cytological abnormalities, positive for the presence of HPV. The presence of the HLA-C*07:02 suggests susceptibility to progression of cervical intraepithelial lesion. Conclusion: Additional studies should be conducted to assess the significance of the risk of developing CC, especially in the context of KIR ligand HLA-C interactions in order to evaluate the interaction of immune system with the development of cervical cancer response.

Osteoarthritis (OA) is one of the most common musculoskeletal diseases and highly prevalent in older people. Whilst the management of knee OA is usually multidisciplinary, the use of comprehensive geriatric assessment (CGA) for this condition is still limited. Given this background, with this systematic review, we summarized the current literature regarding the importance of CGA in people affected by knee OA. A systematic search across several databases was run until 10th April 2022 and updated on 21st November 2022 for any study investigating the use of CGA in patients with knee OA. The data were summarized descriptively. Among 295 articles initially included, three studies made in the context of the osteoarthritis initiative (OAI) were included. All the three studies used the OAI multidimensional prognostic index (MPI), a composite score derived from the CGA. Higher MPI values were associated with a higher risk of falls, cardiovascular conditions, and fractures across a follow-up period of 8 years and after adjusting for potential confounders. In conclusion, in this systematic review we summarized the current evidence of CGA in knee OA, finding that the MPI, a CGA derived tool, could be useful to early find people at higher risk of conditions that are associated with knee OA and therefore that can be the target of personalized interventions for preventing these conditions.

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