696 results on '"Cauli Omar"'
Search Results
252. Decrease in Serum Vitamin D Level of Older Patients with Fatigue.
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Pennisi, Manuela, Malaguarnera, Giulia, Di Bartolo, Giuseppe, Lanza, Giuseppe, Bella, Rita, Chisari, Eleonora Margherita, Cauli, Omar, Vicari, Enzo, and Malaguarnera, Michele
- Abstract
Fatigue is characterized by reduced energy level, decreased muscle strength, and a variable degree of cognitive impairment. Recent evidences seem to link vitamin D deficiency to fatigue. The aim of this study was to assess and compare vitamin D status in a cohort of older subjects with and without fatigue. We recruited a total of 480 subjects, 240 patients with fatigue and 240 controls without fatigue, from the Cannizzaro Hospital of Catania (Italy). Fatigue severity was measured by the fatigue severity scale, whereas mental and physical fatigue were measured through the Wessely and Powell fatigue scale, respectively. We also measured several blood parameters and 25-OH vitamin D. Subjects with fatigue showed lower levels of vitamin D as compared with those without fatigue. Blood levels of parameters related to fatigue were normal in both groups of subjects, however, platelet, hemoglobin, hematocrit (p < 0.05), mean corpuscular volume, C-reactive protein (CRP), iron, vitamin B12, and folic acid (p < 0.001) were significantly higher in the fatigue group with respect to the control group. Moreover, compared to controls, patients showed higher scores in the physical (p < 0.001), mental (p < 0.001), and severity (p < 0.001) fatigue scales. Finally, vitamin D inversely correlated with fatigue severity (r = −0.428, p < 0.01), whereas creatine kinase and CRP levels did not correlate with vitamin D. In conclusion, our data showed a direct link between vitamin D and fatigue in older subjects, suggesting translational implications in the diagnosis and management of these patients. [ABSTRACT FROM AUTHOR]
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- 2019
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253. Beneficial Effects of Leucine Supplementation on Criteria for Sarcopenia: A Systematic Review.
- Author
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Martínez-Arnau, Francisco M., Fonfría-Vivas, Rosa, and Cauli, Omar
- Abstract
Objective: Treating sarcopenia remains a challenge, and nutritional interventions present promising approaches. We summarize the effects of leucine supplementation in treating older individuals with sarcopenia associated with aging or to specific disorders, and we focus on the effect of leucine supplementation on various sarcopenia criteria, e.g., muscular strength, lean mass, and physical performance. Methods: A literature search for articles related to this topic was performed on the relevant databases, e.g., the PubMed/Medline, Embase, EBSCO, Cochrane, Lilacs, and Dialnet. The identified articles were reviewed according to Preferred Reporting Items for Systematic reviews and meta-analyses (PRISMA) guidelines. Results: Of the 163 articles we consulted, 23 met our inclusion criteria, analysing the effect of leucine or leucine-enriched protein in the treatment of sarcopenia, and 13 of these studies were based on randomized and placebo-controlled trials (RCTs). In overall terms, the published results show that administration of leucine or leucine-enriched proteins (range 1.2–6 g leucine/day) is well-tolerated and significantly improves sarcopenia in elderly individuals, mainly by improving lean muscle-mass content and in this case most protocols also include vitamin D co-administration. The effect of muscular strength showed mix results, and the effect on physical performance has seldom been studied. For sarcopenia-associated with specific disorders, the most promising effects of leucine supplementation are reported for the rehabilitation of post-stroke patients and in those with liver cirrhosis. Further placebo-controlled trials will be necessary to determine the effects of leucine and to evaluate sarcopenia with the criteria recommended by official Working Groups, thereby limiting the variability of methodological issues for sarcopenia measurement across studies. [ABSTRACT FROM AUTHOR]
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- 2019
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254. Assessing Gait in Parkinson's Disease Using Wearable Motion Sensors: A Systematic Review.
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Brognara, Lorenzo, Palumbo, Pierpaolo, Grimm, Bernd, Palmerini, Luca, and Cauli, Omar
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MOTION detectors ,PARKINSON'S disease ,AMED (Information retrieval system) ,META-analysis ,SCIENTIFIC literature - Abstract
Abstract: Parkinson's disease (PD) is a progressive neurodegenerative disorder. Gait impairments are common among people with PD. Wearable sensor systems can be used for gait analysis by providing spatio-temporal parameters useful to investigate the progression of gait problems in Parkinson disease. However, various methods and tools with very high variability have been developed. The aim of this study is to review published articles of the last 10 years (from 2008 to 2018) concerning the application of wearable sensors to assess spatio-temporal parameters of gait in patients with PD. We focus on inertial sensors used for gait analysis in the clinical environment (i.e., we do not cover the use of inertial sensors to monitor walking or general activities at home, in unsupervised environments). Materials and Methods: Relevant articles were searched in the Medline database using Pubmed. Results and Discussion: Two hundred ninety-four articles were initially identified while searching the scientific literature regarding this topic. Thirty-six articles were selected and included in this review. Conclusion: Wearable motion sensors are useful, non-invasive, low-cost, and objective tools that are being extensively used to perform gait analysis on PD patients. Being able to diagnose and monitor the progression of PD patients makes wearable sensors very useful to evaluate clinical efficacy before and after therapeutic interventions. However, there is no uniformity in the use of wearable sensors in terms of: number of sensors, positioning, chosen parameters, and other characteristics. Future research should focus on standardizing the measurement setup and selecting which spatio-temporal parameters are the most informative to analyze gait in PD. These parameters should be provided as standard assessments in all studies to increase replicability and comparability of results. [ABSTRACT FROM AUTHOR]
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- 2019
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255. The Relationship between Walking Speed and Step Length in Older Aged Patients.
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Morio, Yuji, Izawa, Kazuhiro P., Omori, Yoshitsugu, Katata, Hironobu, Ishiyama, Daisuke, Koyama, Shingo, Yamano, Yoshihisa, and Cauli, Omar
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WALKING speed ,WALKING ,GAIT in humans ,KNEE muscles ,OLDER people ,RECEIVER operating characteristic curves ,REGRESSION analysis - Abstract
Compared with elderly people who have not experienced falls, those who have were reported to have a shortened step length, large fluctuations in their pace, and a slow walking speed. The purpose of this study was to elucidate the step length required to maintain a walking speed of 1.0 m/s in patients aged 75 years or older. We measured the 10 m maximum walking speed in patients aged 75 years or older and divided them into the following two groups: Those who could walk 1.0 m/s or faster (fast group) and those who could not (slow group). Step length was determined from the number of steps taken during the 10 m-maximum walking speed test, and the step length-to-height ratio was calculated. Isometric knee extension muscle force (kgf), modified functional reach (cm), and one-leg standing time (s) were also measured. We included 261 patients (average age: 82.1 years, 50.6% men) in this study. The fast group included 119 participants, and the slow group included 142 participants. In a regression logistic analysis, knee extension muscle force (p = 0.03) and step length-to-height ratio (p < 0.01) were determined as factors significantly related to the fast group. As a result of ROC curve analysis, a step length-to-height ratio of 31.0% could discriminate between the two walking speed groups. The results suggest that the step length-to-height ratio required to maintain a walking speed of 1.0 m/s is 31.0% in patients aged 75 years or older. [ABSTRACT FROM AUTHOR]
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- 2019
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256. Chemotherapy-Induced Neuropathy and Diabetes: A Scoping Review.
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Sempere-Bigorra, Mar, Julián-Rochina, Iván, and Cauli, Omar
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NEUROPATHY , *DRUG utilization , *TREATMENT effectiveness , *PERIPHERAL neuropathy , *PEOPLE with diabetes , *ONCOLOGIC surgery - Abstract
Although cancer and diabetes are common diseases, the relationship between diabetes, neuropathy and the risk of developing peripheral sensory neuropathy while or after receiving chemotherapy is uncertain. In this review, we highlight the effects of chemotherapy on the onset or progression of neuropathy in diabetic patients. We searched the literature in Medline and Scopus, covering all entries until 31 January 2021. The inclusion and exclusion criteria were: (1) original article (2) full text published in English or Spanish; (3) neuropathy was specifically assessed (4) the authors separately analyzed the outcomes in diabetic patients. A total of 259 papers were retrieved. Finally, eight articles fulfilled the criteria, and four more articles were retrieved from the references of the selected articles. The analysis of the studies covered the information about neuropathy recorded in 768 cancer patients with diabetes and 5247 control cases (non-diabetic patients). The drugs investigated are chemotherapy drugs with high potential to induce neuropathy, such as platinum derivatives and taxanes, which are currently the mainstay of treatment of various cancers. The predisposing effect of co-morbid diabetes on chemotherapy-induced peripheral neuropathy depends on the type of symptoms and drug used, but manifest at any drug regimen dosage, although greater neuropathic signs are also observed at higher dosages in diabetic patients. The deleterious effects of chemotherapy on diabetic patients seem to last longer, since peripheral neuropathy persisted in a higher proportion of diabetic patients than non-diabetic patients for up to two years after treatment. Future studies investigating the risk of developing peripheral neuropathy in cancer patients with comorbid diabetes need to consider the duration of diabetes, cancer-induced neuropathic effects per se (prior chemotherapy administration), and the effects of previous cancer management strategies such as radiotherapy and surgery. [ABSTRACT FROM AUTHOR]
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- 2021
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257. Evaluating video virtual reality teaching for nursing students.
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Trapero, Isabel, Sánchez‐Martínez, Vanessa, Cauli, Omar, and Buigues, Cristina
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TEACHER-student relationships , *ONLINE education , *COMPUTER software , *SCHOOL environment , *TEACHING methods , *VIRTUAL reality , *MOTIVATION (Psychology) , *NURSING education , *TEACHING aids , *NURSING students , *VIDEO recording - Abstract
The article discusses the use of virtual reality teaching material Brainstorm Edison Pro 4.1.13 software in 2023. Topics covered include the importance of visual contact between teacher and students and of motivating visual material on the students to maintain their attention. Also noted are the contents of the virtual reality nursing education software and their implementation.
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- 2023
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258. Salivary Brain-Derived Neurotrophic Factor and Cortisol Associated with Psychological Alterations in University Students.
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Ballestar-Tarín, María Luisa, Ibáñez-del Valle, Vanessa, Mafla-España, Mayra Alejandra, Navarro-Martínez, Rut, and Cauli, Omar
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BRAIN-derived neurotrophic factor , *SLEEP quality , *SLEEP latency , *UNHEALTHY lifestyles , *PSYCHIATRIC diagnosis , *SLEEP interruptions , *COLLEGE students - Abstract
Introduction: Recent evidence reported mental health issues in university students such as anxiety and depressive symptoms and poor sleep quality. Decreased plasma brain-derived neurotrophic factor (BDNF) levels have been proposed as a biomarker of depressive symptoms, whereas cortisol levels are an index of energy mobilization and stress and have been linked to sleep quality. Given that salivary biomarkers represent an interesting new field of research, the aim of this cross-sectional study was to evaluate salivary BDNF and cortisol levels in university students to assess whether they have associations with psychological disturbances such as anxiety and depressive symptoms, sleep quality, and stress level. Methods: Salivary BDNF and cortisol levels were measured by specific immunoassays in 70 students whose mental health was also evaluated on the same day through the evaluation of anxiety and depression symptoms (Goldberg scale), sleep quality (Pittsburg Sleep Quality Index and Athens Insomnia Scale), and stress (self-perceived stress scale) and healthy lifestyle habits (alcohol consumption, smoking, regular exercise, and body mass index) were also measured. Multivariate regression analyses were performed in order to identify the strengths of associations between psychological alterations and the concentrations of BDNF, cortisol, and other variables. Results: Salivary BDNF levels were significantly higher in students with more depressive symptoms, whereas no significant differences were found for cortisol levels. When performing the binary logistic regression model, BDNF levels are included as a predictor variable for a high-depressive-symptoms burden (p < 0.05). Students with worse sleep quality on the Pittsburg Scale had higher cortisol levels (p < 0.05). The subdomains of sleep latency and sleep medication were those significantly associated with salivary cortisol levels in logistic regression analyses (OR = 15.150, p = 0.028). Sleep medication only appeared to be related to cortisol levels (OR = 185.142, p = 0.019). Perceived stress levels and anxiety symptoms were not associated with BDNF or cortisol levels. Conclusions: BDNF could play a key role in the pathophysiology of mood-related disorders, and elevation of its peripheral levels could contribute to protecting neurons from the development of mental illness. Higher salivary cortisol levels measured in the morning are accompanied by poorer sleep quality. More research is needed, focusing on salivary biomarkers of disorders related to depressive symptoms and poor sleep quality as a potential tool for the diagnosis and prevention of mental illness. [ABSTRACT FROM AUTHOR]
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- 2024
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259. Inflammatory Biomarkers and Gait Impairment in Older Adults: A Systematic Review.
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Brognara, Lorenzo, Luna, Oscar Caballero, Traina, Francesco, and Cauli, Omar
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OLDER people , *GAIT in humans , *WALKING speed , *BIOMARKERS , *DATABASES - Abstract
Peripheral inflammation and gait speed alterations are common in several neurological disorders and in the aging process, but the association between the two is not well established. The aim of this systematic literary review is to determine whether proinflammatory markers are a positive predictor for gait impairments and their complications, such as falls in older adults, and may represent a risk factor for slow gait speed and its complications. The systematic review was performed in line with the Preferred Report Items for Systematic Review and Meta-Analyses (PRISMA). A protocol for literature searches was structured a priori and designed according to the International Perspective Register of Systemic Review (PROSPERO: CRD42023451108). Peer-reviewed original articles were identified by searching seven electronic databases: Excerpta Medica Database (EMBASE), SciVerse (ScienceDirect), Scopus, PubMed, Medline, Web of Science, and the Cochrane Library. The search strategy was formulated based on a combination of controlled descriptors and/or keywords related to the topic and a manual search was conducted of the reference lists from the initially selected studies to identify other eligible studies. The studies were thoroughly screened using the following inclusion criteria: older adults, spatiotemporal gait characteristics, and proinflammatory markers. A meta-analysis was not performed due to the heterogeneity of the studies, and the results were narratively synthesized. Due to the clinical and methodological heterogeneity, the studies were combined in a narrative synthesis, grouped by the type of biomarkers evaluated. A standardized data extraction form was used to collect the following methodological outcome variables from each of the included studies: author, year, population, age, sample size, spatiotemporal gait parameters such as gait velocity, and proinflammatory markers such as TNF-α, high sensitivity C-reactive (CRP) proteins, and IL-6. We included 21 out of 51 studies in our review, which examined the association between inflammatory biomarkers and gait impairment. This review highlights the role of TNF-α, CRP, and IL-6 in gait impairment. Biomarkers play an important role in the decision-making process, and IL-6 can be an effective biomarker in establishing the diagnosis of slow gait speed. Further longitudinal research is needed to establish the use of molecular biomarkers in monitoring gait impairment. [ABSTRACT FROM AUTHOR]
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- 2024
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260. Salivary Interleukin 1-Beta Concentration Associates With Sleep Quality in Older Individuals.
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Ibáñez-del Valle, Vanessa, Ballestar-Tarín, Maria Luisa, Mafla-España, Mayra Alejandra, Cauli, Omar, and Navarro-Martínez, Rut
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COMPLICATIONS of alcoholism , *SALIVA analysis , *INTERLEUKINS , *SLEEP quality , *RESEARCH , *SCIENTIFIC observation , *CONFIDENCE intervals , *CROSS-sectional method , *GERIATRIC Depression Scale , *RISK assessment , *COMPARATIVE studies , *PSYCHOLOGICAL tests , *INDEPENDENT living , *MENTAL depression , *CAFFEINE , *DESCRIPTIVE statistics , *RESEARCH funding , *INSOMNIA , *SMOKING , *STATISTICAL correlation , *RECEIVER operating characteristic curves , *SENSITIVITY & specificity (Statistics) , *DISEASE risk factors , *OLD age - Abstract
Background: Poor sleep quality is prevalent in older people and impairs their quality of life. Various studies show an association between sleep disorders and altered levels of inflammatory cytokines. The cytokine IL-1β has been shown to display both somnogenic and insomnia-promoting effects in experimental animals. Objectives: to evaluate the relationship between insomnia and salivary IL-1β concentration and the role of associated factors such as the symptoms of depression, use of hypnotics, intake of caffeinated beverages, smoking, and alcohol use in older individuals. An analytical, cross-sectional, observational research was carried out with a population of community-dwelling individuals over 60 years of age in Valencia (Spain). Sleep quality was measured with the Athens insomnia scale (AIS) and depressive symptoms with Geriatric Depression Scale (GDS). Results: 287 individuals participated in the study (mean age 74.08 years (76.7% women). 41.5% of the participants had insomnia, 36.9% took drugs for sleep problems, and 32.4% had relevant depressive symptoms. There was a significant inverse correlation between the IL-1β and total AIS score (rho = −0.302, p < 0.001), the sleep difficulty subdomain (rho = −0.259, p < 0.001), and the daytime sleepiness subdomain (rho = −0.322, p < 0.001). No significant correlation was observed between GDS and salivary IL-1β concentration. The IL-1β concentration was significantly lower in individuals taking drugs for sleeping compared with those not taking those drugs (1.11 ± 0.09 and 1.48 ± 0.08, respectively; p = 0.001). Regarding the AIS score, there was no significant difference in marital status, smoking, or the number of cups of tea or cola drinks, but there was a significant association with alcohol intake (p = 0.019) and in the number of daily intakes of coffee (p = 0.030). The receiver operating characteristic (ROC) curve analysis of IL-1β for diagnosis of moderate-severe insomnia showed an area under the curve (AUC) value of 0.78 (95% confidence interval 0.71–0.85). At the cut-off of 0.83 pg/µL of Il-1β, it had a sensitivity of 70.3% and a specificity of 69.8%. [ABSTRACT FROM AUTHOR]
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- 2024
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261. Plasma Androstenedione Concentration Can Discriminate Frail versus Non-Frail Men with Prostate Cancer under Androgen Deprivation Therapy.
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Mafla-España, Mayra Alejandra, Torregrosa, María Dolores, Beamud-Cortés, Manel, Bermell-Marco, Lorena, Rubio-Briones, José, and Cauli, Omar
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ANDROGEN deprivation therapy , *PROSTATE cancer patients , *ANDROSTENEDIONE , *ANDROGEN receptors , *FRAILTY , *SLEEP quality , *GAIT in humans - Abstract
Background: Androgen deprivation therapy (ADT) is a mainstay of prostate cancer in both adjuvant and palliative settings. Since androgens are crucial for functional status and psychological functions, we evaluated whether blood testosterone, androstenedione, or DHEA concentrations were associated with functional status and psychological alterations in patients with localised (PCa) or metastatic prostate cancer (mPCa) receiving ADT with analogues of luteinising hormone-releasing hormone (LHRH). Methods: The five Fried criteria were considered to identify frailty syndrome. In addition, complementary evaluations were carried out to measure other variables of interest. Sleep quality was assessed using the Athens Insomnia Scale, cognitive functions were assessed using the Mini-Mental State Examination, and symptoms of depression were measured using the Yesavage Geriatric Depression Scale. Logistic regression analysis was performed to determine if the androgens level could be related to frailty syndrome, sleep impairment, depressive symptoms, and cognitive functions. Results: The results of the multivariate analyses show that high concentrations of androstenedione were significantly associated with frailty syndrome in both groups (p = 0.018; odds ratio = 4.66, 95% confidence interval [1.30–16.6]). There were significant relationships between frailty syndrome and the systemic concentration of androstenedione (p = 0.01), but not the concentration of testosterone (p = 0.60) or DHEA (p = 0.42). In addition, the results of the non-parametric tests show significant results between a decreased gait speed in the two groups (metastatic and localised) and the concentration of androstenedione (p = 0.015). High androstenedione levels were associated with a slow walking speed in the mCaP group (p = 0.016), while high testosterone levels were associated with a better walking speed in the localised CaP group (p = 0.03). For the concentration of androstenedione in plasma, the area under the curve was 0.72, with a 95% CI of 0.55–0.88 with acceptable values, and with a cut-off point of 4.51 pg/mL, a sensitivity of 82.9%, and specificity of 53.8%. No relationships between the concentration of androgens in plasma and sleep quality, cognitive functions, or symptoms of depression suggest that the changes were specific to frailty syndrome. Conclusions: Further research into the role of androstenedione should be evaluated in follow-up studies in order to recommend its use as a suitable biomarker of frailty syndrome in prostate cancer patients. [ABSTRACT FROM AUTHOR]
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- 2023
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262. Quality of life related to clinical features in patients with Rett syndrome and their parents: a systematic review.
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Corchón, Silvia, Carrillo-López, Irene, and Cauli, Omar
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RETT syndrome , *EPILEPSY , *QUALITY of life , *WELL-being , *MENTAL health - Abstract
Patients with a neurodevelopmental disorder such as Rett syndrome (RS), as well as their families, have complex needs that affect their quality of life (QoL). Therefore, both families and patients with RS must be provided with multidisciplinary health care that can identify the clinical features that most affect their QoL and mental health risks. The main objective of this paper is to provide a comprehensive overview of the QoL subdimensions of families affected by RS, including both the parents and children. We conducted a systematic review, following PRISMA criteria, of the data in the PubMed, PsycINFO, Cuiden, and LILACS databases. The results indicated that when considering the family as a whole, RS equally affects the physical and psychological QoL dimensions; the next most affected was the social dimension. According to parents’ reports, seizures are one of the main factors that decreases their QoL. Thus, from a clinical point of view, controlling seizure activity of children with RS is the main way of improving the QoL of their parents. Interventions in patients affected by RS should be based on the improvement of visual contact and concentration, reducing somnolence, and increasing mobility. The subdimensions of QoL that were most affected in parents of girls with RS were those related to mental health and feelings of well-being. [ABSTRACT FROM AUTHOR]
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- 2018
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263. Relationship between Cognitive Impairment and Depressive Symptoms with Somatosensory Functions in Diabetic and Non-Diabetic Older Adults and Its Impact on Quality of Life.
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Sempere-Bigorra, Mar, Julián-Rochina, Iván, Pérez-Ros, Pilar, Navarro-Flores, Emmanuel, Martínez-Arnau, Francisco Miguel, and Cauli, Omar
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COGNITION disorders , *QUALITY of life , *TRAIL Making Test , *GERIATRIC Depression Scale , *MENTAL depression , *SOMATOSENSORY cortex - Abstract
Aging is an inevitable process that impacts the peripheral and central nervous systems and is considered one of the strongest risk factors for neurodegenerative diseases. In addition, when it also presents with diabetes mellitus, the risk of neurological damage may be further increased. This current study aimed to explore the relationships between peripheral sensory system decline and cognitive functions, the symptoms of depression, and quality of life (QoL) as metrics of central nervous system impairment in institutionalized older adults. A total of 95 individuals participated in this case-control study, which included diabetics and non-diabetics. The superficial sensory pathway was assessed in terms of thermal sensation, nociception, and non-discriminative touch, and the deep sensory pathway was evaluated by assessing vibration and light touch-pressure sensations. To assess function at the intellectual level, the Mini-Mental State Examination (MMSE) and Trail Making Test (TMT) cognitive functional tests were used, while the symptoms of depression and QoL were explored by employing the Yesavage Geriatric Depression Scale and EuroQol 5D questionnaire (EQ-5D), respectively. In the overall population analyses, altered thermal sensation was significantly associated with cognitive impairment (CI; p < 0.05). In turn, bivariate analyses and a binary logistic regression showed that the symptoms of depression and QoL were significantly related to altered vibratory sensation when assessed using a medical tuning fork (p < 0.05). In the group of diabetic patients, those with CI also had significantly lower thermal sensation (p < 0.05) and non-discriminative touch sensation, although this was only a trend (p = 0.055). Diabetics with depression had a significantly worse non-discriminative touch (p < 0.05) and vibratory sensation when tested with a tuning fork (p < 0.05). In addition, poorer QoL was associated with reduced sensitivity to heat (p < 0.05), light touch pressure (p < 0.05), and vibrations when assessed either with a tuning fork (p < 0.05) or a biothesiometer (p < 0.05). In contrast, no relationships were found between sensory functions and cognitive assessments in non-diabetic patients. These findings indicate that superficial sensitivity damage was related to CI, while deep sensation alterations were related to depression and poor QoL, with diabetes apparently further strengthening these relationships. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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264. Hair cortisol concentration associates with insomnia and stress symptoms in breast cancer survivors.
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Ahabrach, Hanan, El Mlili, Nisrin, Mafla-España, Mayra Alejandra, and Cauli, Omar
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CANCER survivors , *BREAST cancer , *SLEEP quality , *HYPERSOMNIA , *INSOMNIA , *HYDROCORTISONE - Abstract
Stress, depressive symptoms and sleep quality are important and modifiable determinant of health and their association with hair cortisol concentrations (HCC) in breast cancer survivors has not been evaluated. We selected a random sample of 65 participants (mean age 57.9 years old, range 44–75 years) recruited from local patients' associations of breast cancer survivors. Each provided a hair sample at enrollment and basic clinical data and psychological evaluation regarding self-perceived stress (PSS-scale), depressive (GDS scale) and insomnia symptoms (Athens scale). We observed a direct and significant (p = 0.001) association between HCC and stress-levels. Depressive symptoms associated significantly (p < 0.01) with stress levels but not with HCC. There were also a significant and direct correlation between hair cortisol concentration and totals core of insomnia symptoms (p = 0.002), and the subdimension of sleep difficulty symptoms (p = 0.002), and with daytime sleepiness symptoms (p = 0.016). Further investigations into the association between stress and insomnia and changes in HCC in breast cancer survivors are warranted in order to validate this biomarker for diagnosis of psychological alterations and to tailor the effects of interventions aimed to reduced stress and improve sleep quality in these women. • Psychological symptoms are frequent in breast cancer survivors even many years ago from cancer diagnosis. • Chronic stress stimulated cortisol production which accumulated in hair (HCC). • High HCC is accompanied by high stress level and high insomnia symptoms. • HCC represents a suitable biomarker to evaluate these psychological alterations in breast cancer. [ABSTRACT FROM AUTHOR]
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- 2023
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265. Relationship between adipic acid concentration and the core symptoms of autism spectrum disorders.
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Puig-Alcaraz, Carmen, Fuentes-Albero, Milagros, and Cauli, Omar
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AUTISM spectrum disorders in children , *ADIPIC acid , *SYMPTOMS , *PATHOLOGICAL physiology , *VITAMIN metabolism , *DIETARY supplements , *THERAPEUTICS - Abstract
Dicarboxylic acids are an important source of information about metabolism and potential physiopathological alterations in children with autism spectrum disorders (ASDs). We measured the concentration between dicarboxylic adipic and suberic acids in children with an ASD and typically-developing (TD) children and analyzed any relationships between the severity of the core symptoms of ASDs and other clinical features (drugs, supplements, drugs, or diet). The core symptoms of autism were evaluated using the DSM-IV criteria, and adipic acid and suberic acid were measured in urine samples. Overall, no increase in the concentration of adipic acid in children with ASDs compared to TD children, however when considering vitamin B supplementation in ASD there were significantly increased level of urinary adipic acid in children with an ASD not taking vitamin B supplementation compared to supplemented children or to TD children. No significant difference were observed in suberic acid. Interestingly, the increase in adipic acid concentration was significantly and indirectly correlated with the severity of the deficit in socialization and communication skills in children with an ASD. Therefore, therapeutic treatments aimed at decreasing adipic acid concentration might not be beneficial for treating the core symptoms of ASDs. [ABSTRACT FROM AUTHOR]
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- 2016
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266. The Effects of 3D Custom Foot Orthotics with Mechanical Plantar Stimulation in Older Individuals with Cognitive Impairment: A Pilot Study.
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Brognara, Lorenzo, Mafla-España, Mayra Alejandra, Gil-Molina, Isabel, Castillo-Verdejo, Yolanda, and Cauli, Omar
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OLDER people , *FRAIL elderly , *COGNITION disorders , *PILOT projects , *ORTHOPEDIC apparatus , *FOOT movements - Abstract
Recent scientific evidence supports the idea that foot plantar stimulation increases the functional connectivity of brain regions involved in visuo-spatial and sensory-motor integration. In this before–after, non-randomised intervention study we assessed the change in several gait and postural parameters using inertial sensor measurements after acute plantar stimulation using custom 3D-printed insoles. The pilot study was performed on 22 institutionalised, older individuals with a high comorbidity burden who either walked autonomously or with the help of a cane. The intensity of the effects in the first mechanical plantar stimulation session (at one week) strongly predicted a change in the 180° turn duration (p < 0.05) and the standard deviation of the step duration (p < 0.05) during the timed up-and-go test. Based on these effects, researchers also predicted decreases in some postural parameters such as the root mean square of displacement on the anterior–posterior axis (p < 0.01). Thus, these preliminary findings provide a strong rationale for performing controlled clinical trials with larger samples to investigate the efficacy and mechanisms of mechanical plantar stimulation in frail elderly individuals. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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267. Foot Orthosis and Sensorized House Slipper by 3D Printing.
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Brognara, Lorenzo, Fantini, Massimiliano, Morellato, Kavin, Graziani, Gabriela, Baldini, Nicola, and Cauli, Omar
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THREE-dimensional printing , *ACRYLONITRILE butadiene styrene resins , *POLYLACTIC acid , *POLYCARBONATES , *FOOT orthoses , *STRAINS & stresses (Mechanics) , *MECHANICAL behavior of materials , *INDUSTRIAL engineering - Abstract
Background: In clinical practice, specific customization is needed to address foot pathology, which must be disease and patient-specific. To date, the traditional methods for manufacturing custom functional Foot Orthoses (FO) are based on plaster casting and manual manufacturing, hence orthotic therapy depends entirely on the skills and expertise of individual practitioners. This makes the procedures difficult to standardize and replicate, as well as expensive, time-consuming and material-wasting, as well as difficult to standardize and replicate. 3D printing offers new perspectives in the development of patient-specific orthoses, as it permits addressing all the limitations of currently available technologies, but has been so far scarcely explored for the podiatric field, so many aspects remain unmet, especially for what regards customization, which requires the definition of a protocol that entails all stages from patient scanning to manufacturing. Methods: A feasibility study was carried out involving interdisciplinary cooperation between industrial engineers and podiatrists. To that end: (i) For patient-specific data acquisition, 3D scanning of the foot is compared to traditional casting. (ii) a modelling GD workflow is first created to design a process permitting easy creations of customized shapes, enabling the end user (the podiatrist) to interactively customize the orthoses. Then, (iii) a comparison is made between different printing materials, in order to reproduce the same mechanical behavior shown by standard orthoses. To do this, the mechanical properties of standard materials (Polycarbonate sheets), cut and hand-shaped, are compared with four groups of 3D printed samples: poly(ethylene glycol) (PETG), poly(acrylonitrile-butadiene.styrene) (ABS), polycarbonate (PC) and poly(lactic acid) (PLA) obtained by Fused Filament Fabrication (FFF). Results: Differences found between the foot plaster model obtained with the plaster slipper cast in a neutral position and the model of the real foot obtained with 3D scanning in the same position can be ascribed to the non-stationarity of the patient during the acquisition process, and were limited by a locking system with which no substantial differences in the almost entire sole of the foot scan were observed. Conclusions: Using the designed GD workflow, podiatrists with limited CAD skills can easily design and interactively customize foot orthoses to adapt them to the patients' clinical needs. 3D printing enables the complex shape of the orthoses to be reproduced easily and quickly. Compared to Polycarbonate sheets (gold standard), all the printed materials were less deformable and reached lower yield stress for comparable deformation. No modifications in any of the materials as a result of printing process were observed. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
268. Chronic hyperammonemia, glutamatergic neurotransmission and neurological alterations.
- Author
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Llansola, Marta, Montoliu, Carmina, Cauli, Omar, Hernández-Rabaza, Vicente, Agustí, Ana, Cabrera-Pastor, Andrea, Giménez-Garzó, Carla, González-Usano, Alba, and Felipo, Vicente
- Subjects
- *
HYPERAMMONEMIA , *HEPATIC encephalopathy , *EXCITATORY amino acid agents , *NEURAL transmission , *GLUTAMATE receptors , *ANTI-inflammatory agents , *LABORATORY rats , *THERAPEUTICS - Abstract
This mini-review focus on our studies on alterations in glutamatergic neurotransmission and their role in neurological alterations in rat models of chronic hyperammonemia and hepatic encephalopathy (HE). Hyperammonemia impairs the glutamate-nitric oxide (NO)-cGMP pathway in cerebellum, which is responsible for reduced learning ability. We studied the underlying mechanisms and designed treatments to restore the pathway and learning. This was achieved by treatment with: phosphodiesterase 5 inhibitors, cGMP, anti-inflammatories (ibuprofen), p38 inhibitors or GABA receptor antagonists (bicuculline). Hyperammonemia alters signal transduction associated to metabotropic glutamate receptors (mGluRs). Hypokinesia in hyperammonemia and HE is due to increased extracellular glutamate and mGluR1 activation in substantia nigra; blocking this receptor restores motor activity. The motor responses to mGluRs activation in nucleus accumbens (NAcc) are altered in hyperammonemia and HE, with reduced dopamine and increased glutamate release. This leads to activation of different neuronal circuits and enhanced motor responses. These studies show that altered responses to activation of NMDA receptors and mGluRs play essential roles in cognitive and motor alterations in hyperammonemia and HE and provide new treatments restoring cognitive and motor function. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
269. Salivary IL-6 Concentration Is Associated with Frailty Syndrome in Older Individuals.
- Author
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Gómez-Rubio, Pablo, Trapero, Isabel, Cauli, Omar, and Buigues, Cristina
- Subjects
- *
FRAILTY , *OLDER people , *INTERLEUKIN-6 , *RECEIVER operating characteristic curves , *WEIGHT loss - Abstract
Background: One of the physiological changes that is most closely associated with frailty is the increase in pro-inflammatory cytokines, and IL-6 in particular. Most studies have demonstrated this association using blood samples. We analyzed the relationship between frailty syndrome, individual frailty criteria, and IL-6 levels obtained by saliva tests. Methods: A cross-sectional pilot study was performed among women institutionalized in nursing homes. Frailty was defined as having three or more of the following components: low lean mass, weakness, self-reported exhaustion, low activity level, and slow walking speed; prefrailty was defined as having one or two of those components. Results: There was a significant and positive correlation between the frailty score and salivary IL-6 concentration. Regarding the associations between IL-6 and individual dichotomized frailty criteria, there were significant differences in salivary IL-6 concentration in two frailty criteria: weight loss (p = 0.002) and low physical activity (p = 0.007). Receiver operating characteristic curve analysis showed that IL-6 concentration significantly (p < 0.05) (although moderately) discriminated patients that progressed in the frailty syndrome (the area under the curve value was 0.697 with 95% CI 0.566–0.827). Conclusions: Salivary IL-6 concentration can be used as potential biomarker of frailty syndrome and as a tool to monitor the effects of interventions in frail individuals. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
270. Role of extracellular cGMP and of hyperammonemia in the impairment of learning in rats with chronic hepatic failure: Therapeutic implications
- Author
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Erceg, Slaven, Monfort, Pilar, Cauli, Omar, Montoliu, Carmina, Llansola, Marta, Piedrafita, Blanca, and Felipo, Vicente
- Subjects
- *
LIVER failure , *HEPATIC encephalopathy , *LEARNING ability , *LABORATORY rats - Abstract
Abstract: Hepatic encephalopathy is a complex neuropsychiatric syndrome present in patients with chronic or acute liver disease. We review here some recent advances in the study, in animal models, of the mechanisms involved in the impairment in intellectual function in hepatic encephalopathy. These studies show that the function of the glutamate–nitric oxide–cGMP pathway is impaired in brain in vivo in rats with chronic hyperammonemia or liver failure and from patients died in hepatic encephalopathy. This impairment leads to a reduced extracellular concentration of cGMP in the cerebellum and is associated with reduced learning ability in these animal models. Moreover, learning ability of hyperammonemic rats was restored by increasing cGMP by: (1) continuous intracerebral administration of zaprinast, an inhibitor of the cGMP-degrading phosphodiesterase, (2) chronic oral administration of sildenafil, an inhibitor of the phosphodiesterase that crosses the blood–brain barrier and (3) continuous intracerebral administration of cGMP. The data summarized indicate that impairment of learning ability in rats with chronic liver failure or hyperammonemia is due to impairment of the glutamate–nitric oxide–cGMP pathway. Moreover, increasing extracellular cGMP by pharmacological means may be a new therapeutic approach to improve cognitive function in patients with hepatic encephalopathy. [Copyright &y& Elsevier]
- Published
- 2006
- Full Text
- View/download PDF
271. Modulation of NMDA receptors in the cerebellum. II. Signaling pathways and physiological modulators regulating NMDA receptor function.
- Author
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Sanchez-Perez, Ana, Llansola, Marta, Cauli, Omar, and Felipo, Vicente
- Subjects
- *
NEURAL transmission , *NEUROTRANSMITTERS , *ADRENALINE , *AMINO acids , *PSYCHOLOGY of learning , *MOTOR learning - Abstract
NMDA receptors in cerebellum have specific characteristics that make their function and modulation different from those of NMDA receptors in other brain areas. The properties of the NMDA receptor that modulate its function: Subunit composition, post‐translational modifications and synaptic localization are summarized in an accompanying article. In this review we summarize how different signaling molecules modulate the function of NMDA receptors. The function of the receptors is modulated by the co‐agonists glycine and serine and this modulation is different in cerebellum than in other areas. The NMDA receptor also has binding sites for polyamines that regulate its function. Other signaling molecules that modulate NMDA receptors function are: cAMP, neurotrophic factors such as BDNF, FGF‐2 or neuregulins. These and other molecules allow an interplay between NMDA receptors and other receptors for neurotransmitters that may in this way modulate NMDA receptor function. This has been reported, for example, for metabotropic glutamate receptors. The expression and function of NMDA receptor is also modulated by synaptic activity, allowing an adaptation of the receptors function to the external inputs. NMDA receptors modulate important cerebral processes. NMDA receptors in different brain areas seem to modulate different processes. Cerebellar NMDA receptors play a special role in the modulation of motor learning and coordination. This is also briefly reviewed. [ABSTRACT FROM AUTHOR]
- Published
- 2005
- Full Text
- View/download PDF
272. Modulation of NMDA receptors in the cerebellum. 1. Properties of the NMDA receptor that modulate its function.
- Author
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Llansola, Marta, Sanchez-Perez, Ana, Cauli, Omar, and Felipo, Vicente
- Subjects
- *
MEMBRANE proteins , *GLYCOSYLATION , *TYROSINE , *AMINO acids , *MOTOR learning , *BRAIN - Abstract
NMDA receptors modulate important cerebral processes such as synaptic plasticity, long‐term potentiation, learning and memory, etc. NMDA receptors in cerebellum have specific characteristics that make their function and modulation different from those of NMDA receptors in other brain areas. In this and the accompanying review we summarize the information available on the modulation of NMDA receptors in cerebellum. We review the properties of the NMDA receptor that modulate its function: subunit composition, post‐translational modifications and synaptic localization. NMDA receptors are heteromeric ligand‐gated ion channels assembled from two families of subunits, NR1 and NR2. There are at least eight splicing variant isoforms of the NR1 subunit and four types of NR2 subunits: NR2A, NR2B, NR2C and NR2D. NMDA receptors with different subunit composition or different splice variants of NR1 subunit have different properties. The expression of the different subunits and splicing variants varies during development. Two special characteristics of NMDA receptors in cerebellum that do not occur in other brain areas are the enrichment in the NR2C subunit and in the splice variant NR1b. As a consequence of these and other factors the pharmacology of NMDA receptors is also different in cerebellum than in other brain areas. The function and localization of NMDA receptors is also modulated by postranslational modifications including phosphorylation, glycosylation and nytrosylation. NMDA receptors are phosphorylated in serines of both NR1 and NR2 subunits and in tyrosines of NR2 subunits. Another factor modulating NMDA receptors function is the synaptic localization. The trafficking and clustering of NMDA receptors is modulated by phosphorylation and by interaction with other proteins. The signaling pathways and physiological modulators regulating NMDA receptor function as well as the role of these receptors in motor learning and coordination are reviewed in an accompanying article. [ABSTRACT FROM AUTHOR]
- Published
- 2005
- Full Text
- View/download PDF
273. Plasma Aromatase Activity Index, Gonadotropins and Estrone Are Associated with Frailty Syndrome in Post-Menopausal Women with Breast Cancer.
- Author
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García-Sánchez, Javier, Mafla-España, Mayra Alejandra, Tejedor-Cabrera, Carlos, Avellán-Castillo, Olga, Torregrosa, María Dolores, and Cauli, Omar
- Subjects
- *
FRAIL elderly , *FOLLICLE-stimulating hormone , *CROSS-sectional method , *ANDROGENS , *CANCER chemotherapy , *ESTROGEN , *DISEASES , *GERIATRIC assessment , *GONADOTROPIN , *SEVERITY of illness index , *POSTMENOPAUSE , *DESCRIPTIVE statistics , *AROMATASE , *LOGISTIC regression analysis , *RECEIVER operating characteristic curves , *SENSITIVITY & specificity (Statistics) , *WOMEN'S health , *BREAST tumors - Abstract
Frailty syndrome is associated with poor outcomes, morbidity and premature mortality. We performed a cross-sectional study to evaluate the presence of frailty syndrome based on Fried's frailty phenotype in post-menopausal women with breast cancer. We further analyzed the association between frailty syndrome with geriatric assessments and the association with the concentration of gonadotropins LH and FSH, estrogens, androgens and the aromatase activity index in the blood. We enrolled 47 post-menopausal women with localized breast cancer (mean age 66.8 ± 1.3 years (range 52–83)) prior to the starting of adjuvant endocrine therapy. Patients were identified as "non-frail" (robust) or "prefrail/frail" if they fulfilled at least one frailty criteria. In order to determine associations among variables and to control for other variables potentially affecting frailty syndrome (age, comorbidity index and previous chemotherapy treatment), we performed a logistic regression analysis. The receiver operating characteristic curve was performed to assess the sensitivity and specificity of the hormonal concentration to discriminate prefrail/frail versus non-frail individuals. Significant positive associations were observed between the severity of frailty syndrome and estrone, FSH and LH concentrations and the aromatase activity index in the blood (p < 0.05). Further research into the role of hormonal biomarkers should be evaluated in follow-up studies in order to recommend their use as suitable biomarkers of frailty syndrome in breast cancer patients. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
274. Prenatal exposure to phthalates and its effects upon cognitive and motor functions: A systematic review.
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Martínez-Martínez, María Isabel, Alegre-Martínez, Antoni, and Cauli, Omar
- Subjects
- *
COGNITIVE ability , *PHTHALATE esters , *PREGNANT women , *PREGNANCY outcomes , *MOTOR ability , *STATISTICAL association - Abstract
• Exposure to phthalates in pregnant women decreases the scores of the offspring in cognitive tests. • Both sexes are affected, but statistical association is higher in boys. • For many phthalates there are no statistical association, or even some positive associations. Phthalates are chemicals widely used in packaging and consumer products, which have been shown to interfere with normal hormonal function and development in some human and animal studies. In recent decades, pregnant women's exposure to phthalates has been shown to alter the cognitive outcomes of their babies, and some studies have found delays in motor development. Methods: electronic databases including PubMed/MEDLINE and Scopus were searched from their inception to March 2021, using the keywords "phthalate", "cognitive" and "motor". Results: most studies find statistically significant inverse relationships between maternal urinary phthalate concentration during pregnancy and subsequent outcomes in children's cognitive and motor scales, especially in boys rather than girls. However, many associations are not significant, and there were even positive associations, especially in the third trimester. Conclusion: the relationship between exposure to phthalates during pregnancy and low results on neurocognitive scales is sufficiently clear to adopt policies to reduce exposure. Further studies are needed to analyze sex differences, coordination and motor scales, and phthalate levels during breastfeeding. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
275. The Association between Cognitive Impairment and Diabetic Foot Care: Role of Neuropathy and Glycated Hemoglobin.
- Author
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Brognara, Lorenzo, Volta, Iacopo, Cassano, Vito Michele, Navarro-Flores, Emmanuel, and Cauli, Omar
- Subjects
- *
DIABETIC foot , *GLYCOSYLATED hemoglobin , *FOOT care , *COGNITION disorders , *GLYCEMIC control , *RECEIVER operating characteristic curves , *WOUND healing - Abstract
Diabetes mellitus is associated with impairment in cognitive functions which can complicate adherence to self-care behaviors. We evaluated the incidence of cognitive impairment in patients with diabetes mellitus to determine the strength of the association between diabetic foot (a complication that occurs in about 10% of diabetic patients), adherence to the clinician's recommendations, glycemic control, and cognitive function. A prospective study was carried out in a probabilistic sample of older patients with diabetic foot living in three nursing homes. Cognitive functions were evaluated by the MMSE (Mini-Mental State Examination), the Trail Making test (TMT), and the Michigan neuropathy screening instrument (MNSI). There were no significant associations between cognitive function and neuropathy or foot alterations, although glycated hemoglobin (HB1Ac > 7%) significantly (p < 0.05) associated with MMSE and adherence to treatment in the 1 month follow-up visit. Receiver operating characteristic curve analysis showed that both HB1Ac and the MNSI score significantly (p < 0.05) discriminate subsequent adherence to treatment for foot complication, with a sensitivity of 80.0–73.3% and specificity 70.6–64.7%, respectively. Proper control of foot complications in diabetic patients involves appropriate glycemic control and less severe neuropathy, and seems to be unrelated to cognitive dysfunction, and warrants further studies in order to tailor appropriate treatments to central and peripheral nervous system disorders. Poor glycemic control (Hb1Ac level > 7%) and a neuropathy score of 5.5 in the MNSI are the best-cut off points to discriminate poor adherence to the clinician's recommendations for self-care behaviors in people with diabetic foot complication. In this study, we observed that foot disorders were associated with impaired global cognitive function in elderly patients (aged ≥ 65). Podiatrists and physicians should consider cognitive dysfunction as an important chronic complication in the management of diabetic foot. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
276. Relationship between deep and superficial sensitivity assessments and gait analysis in diabetic foot patients
- Author
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Mar Sempere‐Bigorra, Lorenzo Brognara, Iván Julian‐Rochina, Antonio Mazzotti, Omar Cauli, Sempere-Bigorra, Mar, Brognara, Lorenzo, Julian-Rochina, Iván, Mazzotti, Antonio, and Cauli, Omar
- Subjects
Neurologia ,Diabetis ,peripheral diabetic neuropathy ,superficial sensory pathway ,Surgery ,gait parameter ,Dermatology ,deep sensory pathway - Abstract
Peripheral neuropathy is a prevalent complication of diabetes that can lead to gait impairment and its adverse consequences. This study explored the potential utility of different parameters of gait analysis using a single sensor unit as a simple tool to detect peripheral neuropathy in 85 diabetic patients (DP) with diabetic foot in whom different somato-sensitivity tests in the feet were performed. Gait spatiotemporal parameters were examined by sensor inertial measurement placed in the lumbar area, while the superficial sensitivity pathway was assessed by nociception tests and deep sensitivity was examined by light touch-pressure and vibration sensitivity tests. Correlations between each sensory test and gait parameters were analysed in a logistic regression model in order to assess if gait parameters are associated with two different sensory pathways. Impaired deep sensory pathways were significantly (P
- Published
- 2023
277. The Effects of 3D Custom Foot Orthotics with Mechanical Plantar Stimulation in Older Individuals with Cognitive Impairment: A Pilot Study
- Author
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Lorenzo Brognara, Mayra Alejandra Mafla-España, Isabel Gil-Molina, Yolanda Castillo-Verdejo, Omar Cauli, Brognara, Lorenzo, Mafla-España, Mayra Alejandra, Gil-Molina, Isabel, Castillo-Verdejo, Yolanda, and Cauli, Omar
- Subjects
inertial sensor ,executive function ,fall risk ,General Neuroscience ,foot orthosi ,cognitive impairment ,gait ,posture ,3D printing ,foot orthosis - Abstract
Recent scientific evidence supports the idea that foot plantar stimulation increases the functional connectivity of brain regions involved in visuo-spatial and sensory-motor integration. In this before–after, non-randomised intervention study we assessed the change in several gait and postural parameters using inertial sensor measurements after acute plantar stimulation using custom 3D-printed insoles. The pilot study was performed on 22 institutionalised, older individuals with a high comorbidity burden who either walked autonomously or with the help of a cane. The intensity of the effects in the first mechanical plantar stimulation session (at one week) strongly predicted a change in the 180° turn duration (p < 0.05) and the standard deviation of the step duration (p < 0.05) during the timed up-and-go test. Based on these effects, researchers also predicted decreases in some postural parameters such as the root mean square of displacement on the anterior–posterior axis (p < 0.01). Thus, these preliminary findings provide a strong rationale for performing controlled clinical trials with larger samples to investigate the efficacy and mechanisms of mechanical plantar stimulation in frail elderly individuals.
- Published
- 2022
- Full Text
- View/download PDF
278. Frailty and leucocyte count are predictors of all-cause mortality and hospitalization length in non-demented institutionalized older women.
- Author
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Fernandez-Garrido, Julio, Ruiz-Ros, Vicente, Navarro-Martínez, Rut, Buigues, Cristina, Martínez-Martínez, Mary, Verdejo, Yolanda, Sanantonio-Camps, Laura, Mascarós, Mª. Carmen, and Cauli, Omar
- Subjects
- *
HOSPITAL care , *LEUCOCYTES , *FLOW cytometry , *DISEASES in older women , *FRAGILITY (Psychology) - Abstract
Alteration in the immune system such as the number of white blood cells count (WBC) has been associated with frailty syndrome but their role in institutionalized older individuals have been rarely investigated. We evaluated the relationships between white blood cell subtypes, geriatric assessment, depression and frailty syndrome based on the criteria of physical phenotype. In particular, we aimed to analyze by a two-year follow-up and prospective study the predictive value of alterations in WBC, frailty and functional impairment in terms of hospitalizations and all-cause mortality in institutionalized older women. There was a significant and inverse correlation between the frailty score and lymphocyte count at baseline but it did not display any predictive effect for the outcomes (hospitalizations and mortality). In contrast, monocytes count was significantly correlated with number of hospital stays and predicted hospitalizations in the follow-up. High frailty score directly and better functional status (Barthel score) inversely predicted mortality in the follow-up with an HR of 1.87 (95%CI: 1.04–3.35), and 0.97 (95% CI: 0.96–0.99) (p < .05 in both cases). Further investigation into the role of white blood cell subtypes in aging and its associated adverse outcomes in older adults is warranted. Physical phenotype of frailty besides general population, also predicted mortality in older institutionalized women and deserves specific intervention in this subgroup of older individuals. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
279. Clinical staging and serum cytokines in bipolar patients during euthymia.
- Author
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Tatay-Manteiga, Amparo, Balanzá-Martínez, Vicent, Bristot, Giovana, Tabarés-Seisdedos, Rafael, Kapczinski, Flavio, and Cauli, Omar
- Subjects
- *
CYTOKINES , *BIPOLAR disorder , *NEUROTROPHINS , *DIAGNOSIS of bipolar disorder , *LEUCOCYTES , *PATIENTS - Abstract
Aims Changes in serum cytokines and altered neutrophin concentration have been associated with bipolar disorder (BD). Our aim here was to analyze peripheral blood biomarkers according to the clinical stages of BD. Method Euthymic BD-I patients were grouped according to their level of functioning in early-stage (n = 25) and late-stage (n = 23), and compared to healthy siblings (n = 23) and genetically unrelated healthy controls (n = 21). Neurotrophin (neurotrophin-3 and BDNF) concentration and biomarkers of inflammation, including cytokines (IL-6, IL-10 and TNF-α), leukocytes count and acute phase proteins, were measured. Results IL-10 concentration was significantly increased in early-stage patients compared to late-stage patients, healthy siblings and controls whereas TNF-α concentration was significantly increased in late-stage patients compared to controls. Total leukocytes, neutrophil and monocyte count were significantly increased in late-stage patients compared to healthy siblings and controls. The concentration of IL-6, neurotrophin-3 and BDNF was unchanged in euthymia. Healthy siblings did not show significant changes in any biomarker. Conclusions The concentration of IL-10, TNF-α, neutrophil and monocytes subtype count in blood is altered in patients with BD during euthymic state. The link between peripheral inflammation and different stages in BD deserves further studies. [ABSTRACT FROM AUTHOR]
- Published
- 2017
- Full Text
- View/download PDF
280. The Association between Cognitive Impairment and Diabetic Foot Care: Role of Neuropathy and Glycated Hemoglobin
- Author
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Omar Cauli, Lorenzo Brognara, Emmanuel Navarro-Flores, Iacopo Volta, Vito Michele Cassano, Brognara, Lorenzo, Volta, Iacopo, Cassano, Vito Michele, Navarro-Flores, Emmanuel, and Cauli, Omar
- Subjects
cognition ,medicine.medical_specialty ,HbA1c ,diabetic foot complication ,Physiology ,Trail Making Test ,030209 endocrinology & metabolism ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Diabetes mellitus ,Internal medicine ,Medicine ,QP1-981 ,030212 general & internal medicine ,Prospective cohort study ,Glycemic ,skin disease ,Diabetis ,diabetes ,business.industry ,Cognition ,General Medicine ,medicine.disease ,Diabetic foot ,Extremitats ,chemistry ,skin diseases ,executive function ,diabete ,neuropathy ,Glycated hemoglobin ,business ,Foot (unit) - Abstract
Diabetes mellitus is associated with impairment in cognitive functions which can complicate adherence to self-care behaviors. We evaluated the incidence of cognitive impairment in patients with diabetes mellitus to determine the strength of the association between diabetic foot (a complication that occurs in about 10% of diabetic patients), adherence to the clinician&rsquo, s recommendations, glycemic control, and cognitive function. A prospective study was carried out in a probabilistic sample of older patients with diabetic foot living in three nursing homes. Cognitive functions were evaluated by the MMSE (Mini-Mental State Examination), the Trail Making test (TMT), and the Michigan neuropathy screening instrument (MNSI). There were no significant associations between cognitive function and neuropathy or foot alterations, although glycated hemoglobin (HB1Ac >, 7%) significantly (p <, 0.05) associated with MMSE and adherence to treatment in the 1 month follow-up visit. Receiver operating characteristic curve analysis showed that both HB1Ac and the MNSI score significantly (p <, 0.05) discriminate subsequent adherence to treatment for foot complication, with a sensitivity of 80.0&ndash, 73.3% and specificity 70.6&ndash, 64.7%, respectively. Proper control of foot complications in diabetic patients involves appropriate glycemic control and less severe neuropathy, and seems to be unrelated to cognitive dysfunction, and warrants further studies in order to tailor appropriate treatments to central and peripheral nervous system disorders. Poor glycemic control (Hb1Ac level >, 7%) and a neuropathy score of 5.5 in the MNSI are the best-cut off points to discriminate poor adherence to the clinician&rsquo, s recommendations for self-care behaviors in people with diabetic foot complication. In this study, we observed that foot disorders were associated with impaired global cognitive function in elderly patients (aged &ge, 65). Podiatrists and physicians should consider cognitive dysfunction as an important chronic complication in the management of diabetic foot.
- Published
- 2020
281. Foot Orthosis and Sensorized House Slipper by 3D Printing
- Author
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Lorenzo Brognara, Massimiliano Fantini, Kavin Morellato, Gabriela Graziani, Nicola Baldini, Omar Cauli, Brognara, Lorenzo, Fantini, Massimiliano, Morellato, Kavin, Graziani, Gabriela, Baldini, Nicola, and Cauli, Omar
- Subjects
foot orthosi ,gait ,foot care ,foot orthosis ,mechanical properties ,polymers ,mechanical propertie ,General Materials Science - Abstract
Background: In clinical practice, specific customization is needed to address foot pathology, which must be disease and patient-specific. To date, the traditional methods for manufacturing custom functional Foot Orthoses (FO) are based on plaster casting and manual manufacturing, hence orthotic therapy depends entirely on the skills and expertise of individual practitioners. This makes the procedures difficult to standardize and replicate, as well as expensive, time-consuming and material-wasting, as well as difficult to standardize and replicate. 3D printing offers new perspectives in the development of patient-specific orthoses, as it permits addressing all the limitations of currently available technologies, but has been so far scarcely explored for the podiatric field, so many aspects remain unmet, especially for what regards customization, which requires the definition of a protocol that entails all stages from patient scanning to manufacturing. Methods: A feasibility study was carried out involving interdisciplinary cooperation between industrial engineers and podiatrists. To that end: (i) For patient-specific data acquisition, 3D scanning of the foot is compared to traditional casting. (ii) a modelling GD workflow is first created to design a process permitting easy creations of customized shapes, enabling the end user (the podiatrist) to interactively customize the orthoses. Then, (iii) a comparison is made between different printing materials, in order to reproduce the same mechanical behavior shown by standard orthoses. To do this, the mechanical properties of standard materials (Polycarbonate sheets), cut and hand-shaped, are compared with four groups of 3D printed samples: poly(ethylene glycol) (PETG), poly(acrylonitrile-butadiene.styrene) (ABS), polycarbonate (PC) and poly(lactic acid) (PLA) obtained by Fused Filament Fabrication (FFF). Results: Differences found between the foot plaster model obtained with the plaster slipper cast in a neutral position and the model of the real foot obtained with 3D scanning in the same position can be ascribed to the non-stationarity of the patient during the acquisition process, and were limited by a locking system with which no substantial differences in the almost entire sole of the foot scan were observed. Conclusions: Using the designed GD workflow, podiatrists with limited CAD skills can easily design and interactively customize foot orthoses to adapt them to the patients’ clinical needs. 3D printing enables the complex shape of the orthoses to be reproduced easily and quickly. Compared to Polycarbonate sheets (gold standard), all the printed materials were less deformable and reached lower yield stress for comparable deformation. No modifications in any of the materials as a result of printing process were observed.
- Published
- 2022
282. Brain-derived neurotrophic factor correlates with functional and cognitive impairment in non-disabled older individuals.
- Author
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Navarro-Martínez, Rut, Fernández-Garrido, Julio, Buigues, Cristina, Torralba-Martínez, Elena, Martinez-Martinez, Mary, Verdejo, Yolanda, Mascarós, Mari Carmen, and Cauli, Omar
- Subjects
- *
BRAIN-derived neurotrophic factor , *MILD cognitive impairment , *PSYCHOMETRICS , *GERIATRICS , *NEUROPLASTICITY , *BIOMARKERS , *STATISTICAL correlation - Abstract
We used a complete battery of geriatric and psychometric tests to evaluate whether plasma-borne brain-derived neurotrophic factor (BDNF), a master molecule in neuroplasticity, is associated with the severity of functional and cognitive impairment in non-disabled older individuals. There was a significant positive correlation between BDNF plasma concentrations and the Barthel index, a measurement of the ability of individuals to perform the activities of daily living ( p = 0.03) and the concentration subcategory measured with the mini mental state examination (MMSE) test ( p = 0.01). Furthermore, plasma BDNF inversely and significantly correlated with the blood eosinophil count ( p = 0.01), the total cholesterol concentration ( p = 0.04), and high-density lipoprotein cholesterol ( p = 0.04). However, BDNF did not correlate with any other socio-demographic or clinical characteristics, other analytical parameters measured in the blood, or any other geriatric assessment scales. Our results suggest that BDNF may play a role in the pathophysiology of functional impairment in the elderly and in some aspects of cognitive function. However, more studies are needed to understand the relationship between circulating BDNF and functional impairment to determine if BDNF represents a candidate biomarker for this type of cognitive impairment. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
283. Increased homocysteine levels correlate with the communication deficit in children with autism spectrum disorder.
- Author
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Puig-Alcaraz, Carmen, Fuentes-Albero, Milagros, Calderón, Jesús, Garrote, Dolores, and Cauli, Omar
- Subjects
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HOMOCYSTEINE , *AUTISM spectrum disorders , *SYMPTOMS , *COMMUNICATIVE competence , *GLUTATHIONE , *BIOMARKERS - Abstract
The clinical significance of high levels of homocysteine in autism spectrum disorder (ASD) is unknown. An experimental study was conducted in order to evaluate the concentration of homocysteine in children with ASD and typically developing children and to analyse any relationships with the severity of core symptoms of ASD and other clinical features (drugs, co-morbidities, gender, age, diet). Core symptoms of autism were evaluated by DSM-IV criteria. Homocysteine, glutathione, methionine, 3-nitrotyrosine were measured in urine. The increase in homocysteine concentration was significantly and directly correlated with the severity of the deficit in communication skills, but was unrelated to deficit in socialisation or repetitive/restricted behaviour. Urinary homocysteine concentration may be a possible biomarker for communication deficits in ASD and a potential diagnostic tool useful to evaluate new treatment options since no treatment for core symptoms of ASD are available. [ABSTRACT FROM AUTHOR]
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- 2015
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284. The value of neutrophil and lymphocyte count in frail older women.
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Fernández-Garrido, Julio, Navarro-Martínez, Rut, Buigues-González, Cristina, Martínez-Martínez, Mary, Ruiz-Ros, Vicente, and Cauli, Omar
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AGING , *NEUTROPHILS , *LYMPHOCYTES , *FRAIL elderly , *PATHOLOGICAL physiology , *PHYSICAL activity , *BLOOD cells - Abstract
Abstract: Increasing evidence suggests that systemic inflammation is associated with many pathophysiological processes including frailty in older adults. We evaluated the relationships between white blood cell subtypes, geriatric assessment, and frailty syndrome and in particular, how they correlate with individual frailty criteria (involuntary loss of weight, low energy or exhaustion, slow mobility, muscle weakness, and low physical activity) in frail older women. There was a significant and positive correlation between the frailty score and neutrophil count, but a significantly negative correlation was found when this score was compared to the lymphocyte count. These associations were significant only for two frailty criteria: poor muscular strength and low physical activity. Further investigation into the role of white blood cell subtypes in ageing and its associated adverse outcomes in older adults is warranted, in particular in the loss of muscular strength and for poor physical activity. [Copyright &y& Elsevier]
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- 2014
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285. Beneficial Effect of Foot Plantar Stimulation in Gait Parameters in Individuals with Parkinson’s Disease
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Nuria Serra-Catalá, Lorenzo Brognara, Lorenzo Iachemet, Omar Cauli, Emmanuel Navarro-Flores, Brognara, Lorenzo, Navarro-Flores, Emmanuel, Iachemet, Lorenzo, Serra-Catalá, Nuria, and Cauli, Omar
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medicine.medical_specialty ,Parkinson's disease ,medicine.medical_treatment ,STRIDE ,Stimulation ,Article ,lcsh:RC321-571 ,rehabilitation ,03 medical and health sciences ,Basal (phylogenetics) ,0302 clinical medicine ,Physical medicine and rehabilitation ,Medicine ,030212 general & internal medicine ,stride length ,lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry ,Rehabilitation ,business.industry ,medical device ,General Neuroscience ,3D printing ,medicine.disease ,Gait ,Comorbidity ,foot ,business ,human activities ,additive manufacturing ,030217 neurology & neurosurgery ,Foot (unit) ,asymmetry - Abstract
New treatments based on peripheral stimulation of the sensory-motor system have shown to be promising in rehabilitation strategies for patients with neurological disorders, including Parkinson's disease (PD), especially in regards to reducing gait impairment, and hence, the incidence of falls. The aim of this study was to evaluate the change in several gait parameters measured by sensor inertial measurement in PD patients after acute plantar stimulation, under the distal phalanx of the big toe, and underneath the head of the first metatarsal joint of both feet, using a 3D printing insole. In order to assess whether the effects are selective for PD patients, we compared the effect of the treatment in a control group (age-matched) consisting of patients with other neurological disorders which also displayed gait and balance impairment, and a similar cognitive function, depressive symptoms, body mass index, and comorbidity burden observed in the PD group. Plantar foot stimulation in PD patients eliminated the significant (p <, 0.05) alterations existing in stride asymmetry and in stride variability. When comparing the effects of post-plantar stimulation with the respective basal level, considered as 100% in both groups, we observed a significant (p = 0.019, Mann&ndash, Whitney test) increase in stride length compared to basal in the PD group and control group. No significant effects of foot plantar stimulation were observed in any of the gait parameters in the control group. Plantar foot stimulation has a positive effect on the step and stride length, and has a positive effect on walking stability, measured by the increase in stride length. No significant effect was observed on bradykinesia because it did not improve walking velocity. These findings indicate that foot plantar stimulation using a 3D printing insole seems to generate a more stable walking pattern in PD patients, with an interesting applicability, and a low-cost, for reducing gait impairment in PD patients.
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- 2020
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286. Effectiveness of cognitive behavioral therapy-based interventions on psychological symptoms in adults with type 2 diabetes mellitus: An update review of randomized controlled trials.
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Vlachou, Eugenia, Ntikoudi, Anastasia, Owens, Dimitra Anna, Nikolakopoulou, Maria, Chalimourdas, Thodoris, and Cauli, Omar
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- *
SYSTEMATIC reviews , *TYPE 2 diabetes , *MENTAL depression , *ANXIETY , *PSYCHOTHERAPY , *DISEASE complications , *PSYCHOSOCIAL factors - Abstract
Cognitive Behavioral Therapy (CBT) has long been recognized as a type of psychotherapy for the management of glycemic control and comorbid psychological disorders and symptoms in adults with diabetes, and has been previously reported with varying outcomes. The aim of this scoping review is to evaluate the randomized controlled trials (RCTs) in order to determine the effects of CBT on Type 2 diabetes mellitus (T2DM) patients regarding depressive and anxiety symptoms, diabetes distress, and quality of life. An extensive literature search was conducted of the Pubmed, Scopus, Cinahl and Medline electronic databases. The search yielded 349 studies, of which 12 eventually met the entry requirements for RCTs. The majority of the studies included in the current scoping review demonstrated the benefits of CBT intervention in the amelioration of depressive symptoms, diabetes-related distress and quality of life in patients with T2DM. However, some studies reported limited evidence to support the use of CBT as an adjuvant therapy. The considerable levels of heterogeneity associated with most RCTs included warrant caution when interpreting results. The findings of this scoping review demonstrate the positive impact of CBT on depressive symptoms and other psychological aspects of everyday life in patients with T2DM. [ABSTRACT FROM AUTHOR]
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- 2022
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287. Autism spectrum disorders associated to a deficiency of the enzymes of the mitochondrial respiratory chain.
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Guevara-Campos, José, González-Guevara, Lucía, Puig-Alcaraz, Carmen, and Cauli, Omar
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AUTISM spectrum disorders , *MITOCHONDRIA , *NEURAL development , *BRAIN diseases , *COMMUNICATIVE disorders , *ETIOLOGY of diseases , *PATIENTS - Abstract
Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders characterized by a combination of reciprocal social deficits, communication impairment, and rigid ritualistic interest and stereotypies. The etiology is generally multifactorial, including genetic, immunological and/or environmental factors. A group of ASD has been linked to mitochondrial dysfunction with subsequent deficiency in energy production. Patients with ASD and mitochondrial disease often show signs and symptoms uncommon to idiopathic ASD such as cardiac, pancreatic or liver dysfunction, cardiac, growth retardation, fatigability, but in some cases semiology is different. We show two clinical cases of ASD associated to a deficiency of the mitochondrial respiratory chain (complex I+III and IV) with different clinical presentations. In one case, signs and symptoms of mitochondrial disorder were mild and the second diagnosis was attained many years after that of ASD. These findings support the recent growing body of evidence that ASD can be associated with mitochondrial disorder. Children with ASD and abnormal neurologic or systemic findings should be evaluated for mitochondrial disorder. [ABSTRACT FROM AUTHOR]
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- 2013
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288. Behavioral deficits induced by lead exposure are accompanied by serotonergic and cholinergic alterations in the prefrontal cortex
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Mansouri, Mohammad Taghi, Naghizadeh, Bahareh, López-Larrubia, Pilar, and Cauli, Omar
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PREFRONTAL cortex , *LEAD in the body , *SEROTONINERGIC mechanisms , *CHOLINERGIC mechanisms , *BLOOD products , *LABORATORY rats - Abstract
Abstract: The effects of long-term lead (Pb) exposure producing a blood Pb concentration of lower than 20μg/dL, i.e. below that associated with overt neurological deficits in occupationally exposed individuals, was studied in adult rats. In order to assess gender differences, we performed parallel behavioral experiments in male and female rats. Exposure to Pb acetate (50ppm in drinking water) for 6months induced motor and cognitive alterations, however these effects were gender- and task-dependent. Chronic lead exposure impaired spatial learning assessed in the Morris water maze test (MWM) in both genders, whereas it only induced hyperactivity in the open field and impaired motor coordination in the rotarod test, only in male rats. Hyperactivity in male rats was accompanied by an increase in extracellular level of acetylcholine in the prefrontal cortex. Extracellular dopamine concentration in the prefrontal cortex was unaffected by lead exposure whereas serotonin concentration in the same brain area was significantly decreased in both male and female rats exposed to lead. These results unveil new molecular mechanisms underlying neuropsychiatric alterations induced by chronic lead exposure. [Copyright &y& Elsevier]
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- 2013
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289. Exploratory investigation on nitro- and phospho-proteome cerebellum changes in hyperammonemia and hepatic encephalopathy rat models.
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Brunelli, Laura, Campagna, Roberta, Airoldi, Luisa, Cauli, Omar, Llansola, Marta, Boix, Jordi, Felipo, Vicente, and Pastorelli, Roberta
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HEPATIC encephalopathy , *HYPERAMMONEMIA , *LIVER failure , *PROTEINS , *PORTACAVAL anastomosis - Abstract
Hepatic encephalopathy (HE) is a neurological disease associated with hepatic dysfunction. Current knowledge suggests that hyperammonemia, related to liver failure, is a main factor contributing to the cerebral alterations in HE and that hyperammonemia might impair signal transduction associated with post-translational modification of proteins such as tyrosine-nitration and phosphorylation. However, the molecular bases of the HE remain unclear and very little is known about the occurrence of post-translational modification on in vivo proteins. In this exploratory study we look for evidence of post-translation modifications of proteins in the cerebellum of experimental HE rat models using a proteomic approach. For the first time we showed that hyperammonemia without liver failure (HA rats) and experimental HE with liver failure due to portacaval shunt (PCS rats) lead to a reduced protein nitration in rat cerebellum, where the undernitrated proteins were involved in energy metabolism and cytoskeleton remodelling. Moreover we showed that tyrosine nitration loss of these proteins was not necessarily associated to a change in their phosphorylation state as result of the disease. Interestingly the rat cerebellum phosphoproteome was mainly perturbed in PCS rats, whereas HA rats did not shown appreciable changes in their phosphoprotein profile. Since the protein nitration level decreased similarly in the cerebellum of both HA and PCS rats, this implies that the two disease models share common effects but also present some differential signalling effects in the cerebellum of the same animals. This study highlights the interest for studying the concerted action of multiple signalling pathways in HE development. [ABSTRACT FROM AUTHOR]
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- 2012
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290. Mechanisms of developmental neurotoxicity: Molecular and behavioral correlates
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Piedrafita, Blanca, Monfort, Pilar, Cauli, Omar, Llansola, Marta, Rodrigo, Regina, Montoliu, Carmina, El Mlili, Nisrin, and Felipo, Vicente
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- 2006
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291. Cyclic GMP pathways in hepatic encephalopathy. Neurological and therapeutic implications.
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Montoliu, Carmina, Rodrigo, Regina, Monfort, Pilar, Llansola, Marta, Cauli, Omar, Boix, Jordi, ElMlili, Nisrin, Agusti, Ana, and Felipo, Vicente
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HEPATIC encephalopathy , *CYCLIC guanylic acid , *PROTEIN kinases , *PHOSPHODIESTERASES , *CIRRHOSIS of the liver - Abstract
Cyclic GMP (cGMP) modulates important cerebral processes including some forms of learning and memory. cGMP pathways are strongly altered in hyperammonemia and hepatic encephalopathy (HE). Patients with liver cirrhosis show reduced intracellular cGMP in lymphocytes, increased cGMP in plasma and increased activation of soluble guanylate cyclase by nitric oxide (NO) in lymphocytes, which correlates with minimal HE assessed by psychometric tests. Activation of soluble guanylate cyclase by NO is also increased in cerebral cortex, but reduced in cerebellum, from patients who died with HE. This opposite alteration is reproduced in vivo in rats with chronic hyperammonemia or HE. A main pathway modulating cGMP levels in brain is the glutamate-NO-cGMP pathway. The function of this pathway is impaired both in cerebellum and cortex of rats with hyperammonemia or HE. Impairment of this pathway is responsible for reduced ability to learn some types of tasks. Restoring the pathway and cGMP levels in brain restores learning ability. This may be achieved by administering phosphodiesterase inhibitors (zaprinast, sildenafil), cGMP, anti-inflammatories (ibuprofen) or antagonists of GABAA receptors (bicuculline). These data support that increasing cGMP by safe pharmacological means may be a new therapeutic approach to improve cognitive function in patients with minimal or clinical HE. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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292. Mechanical Plantar Foot Stimulation in Parkinson′s Disease: A Scoping Review
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Omar Cauli, Lorenzo Brognara, Brognara, Lorenzo, and Cauli, Omar
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030506 rehabilitation ,medicine.medical_specialty ,Parkinson's disease ,medicine.medical_treatment ,lcsh:Medicine ,Stimulation ,Review ,Disease ,gait ,rehabilitation ,03 medical and health sciences ,0302 clinical medicine ,Physical medicine and rehabilitation ,medicine ,stride length ,Neurorehabilitation ,Rehabilitation ,medical device ,business.industry ,lcsh:R ,3D printing ,medicine.disease ,Gait ,Clinical trial ,Preferred walking speed ,foot ,0305 other medical science ,business ,human activities ,asymmetry ,030217 neurology & neurosurgery - Abstract
Background: Parkinson′s disease (PD) is the second most prevalent neurodegenerative disease in older individuals. Neurorehabilitation-based interventions such as those improving gait are crucial for a holistic approach and to limit falls. Several studies have recently shown that mechanical plantar foot stimulation is a beneficial intervention for improving gait impairment in PD patients. The objective of this scoping review is to evaluate the beneficial effects of this stimulation on gait parameters, and to analyse protocols of foot stimulation and other effects in non-motor symptoms. Relevant articles were searched in the Medline database using Pubmed and Scopus, using the primary search terms ‘foot stimulation’ OR ‘plantar stimulation’ AND ‘Parkinson’s disease*’. Several protocols have been used for mechanical plantar foot stimulation (ranging from medical devices to textured insoles). The gait parameters that have been shown to be improved are stride length and walking speed. The beneficial effects are achieved after both acute and repeated plantar foot stimulation. Beneficial effects are observed in other organs and systems, such as muscle activation, brain connectivity, cardiovascular control in the central nervous system, and the release of brain-derived neurotrophic factor and cortisol in blood added evidence about this intervention’s impact on brain function. Mechanical plantar foot stimulation is a safe and effective add-on treatment able for improving gait impairments in PD patients during the L-dopa off state. Randomized and controlled clinical trials to study its eventual potentiating effect with different pharmacotherapy regimens are warranted.
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- 2020
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293. Trastornos del sueño en personas mayores
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Ibáñez del Valle, Vanessa, Cauli, Omar, and Facultat d'Infermeria i Podologia
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sueño ,personas mayores ,CIENCIAS MÉDICAS ::Patología::Otras [UNESCO] ,UNESCO::CIENCIAS MÉDICAS ::Medicina del trabajo::Salud profesional ,UNESCO::CIENCIAS MÉDICAS ::Patología::Otras ,cortisol ,CIENCIAS DE LA VIDA [UNESCO] ,UNESCO::CIENCIAS MÉDICAS ::Salud pública ,UNESCO::CIENCIAS DE LA VIDA ,CIENCIAS MÉDICAS ::Salud pública [UNESCO] ,CIENCIAS MÉDICAS ::Medicina del trabajo::Salud profesional [UNESCO] ,trastornos del sueño ,actigrafia ,detección del sueño - Abstract
En el mundo occidental, las tendencias demográficas actuales se caracterizan por un descenso de las tasas de natalidad y de mortalidad. Esta combinación de tendencias ha producido inevitablemente un progresivo envejecimiento de la población, siendo el sector de la población de edad avanzada el que ha sufrido una mayor tasa de crecimiento en las últimas décadas. Este aumento de la esperanza de vida conlleva necesariamente un aumento de la morbilidad, y por ello, un alto porcentaje de personas mayores se enfrenta actualmente a diversos deterioros físicos y cognitivos asociados a la edad. Estos deterioros requieren de recursos adicionales en los sistemas de salud que tengan como reto la prevención de la discapacidad y deterioro funcional, más que la cantidad de años conseguidos. Por tanto, uno de los objetivos principales de los actuales sistemas de salud es la prevención. Dentro de las estrategias de prevención, diagnóstico y tratamiento en geriatría, se incluye la detección de los denominados síndromes geriátricos por constituir estos una causa frecuente de incapacidad funcional o social. Los síndromes geriátricos fueron definidos por Kane en 1989, en su libro Essentials of Clinical Geriatrics como problemas geriátricos y constituyen los siguientes: inmovilidad, inestabilidad y caídas, incontinencia urinaria y fecal, demencia y síndrome confusional agudo, infecciones, desnutrición, alteraciones en vista y oído, estreñimiento, depresión/insomnio, yatrogenia, inmunodeficiencias e impotencia. En esta tesis se estudia uno de los problemas más comunes en la población de personas mayores y que constituye uno de los denominados síndromes geriátricos: el insomnio. Los trastornos del sueño son comunes en las personas mayores y el insomnio representa al más frecuente de ellos. Estos trastornos no son inherentes al proceso de envejecimiento y cuando aparecen, pueden reducir significativamente la calidad de vida, desencadenar diversas patologías y aumentar el riesgo de fragilidad. La fragilidad se considera en la actualidad un síndrome geriátrico independiente que representa la disminución de las reservas fisiológicas del adulto mayor con un aumento de su vulnerabilidad para resultados adversos de salud [Romero, 2010]. Linda Fried et al. publicaron en el año 2001 una de las definiciones más aceptadas de fragilidad. Para ello establecieron 5 criterios: pérdida de peso involuntaria de más de 5 kilos o 5% del peso corporal durante el año precedente, cansancio o baja resistencia a pequeños esfuerzos, disminución de la fuerza muscular (evaluado con un dinamómetro), actividad física reducida y velocidad lenta para la marcha. La presencia de tres de los anteriores criterios constituye la definición de fragilidad y de entre ellos, los factores predictores de fragilidad más importantes parecen ser la pérdida de peso y el cansancio o agotamiento [Xue, 2008]. El cansancio y agotamiento originado por la falta de sueño estaría por tanto asociado al riesgo de fragilidad y consecuente incapacidad. Por otro lado, la detección de trastornos del sueño es fundamental para detectar precozmente otros problemas de salud considerados a su vez síndromes geriátricos como la depresión, asociada frecuentemente al insomnio y al riesgo de fragilidad. Los trastornos del sueño afectan especialmente a las personas institucionalizadas y, sin embargo, existen pocos estudios enfocados a esta población. Es por ello que se ha elegido una población geriátrica institucionalizada como objeto de estudio en esta tesis. Como estudio previo, la tesis realiza una revisión de todos los métodos actuales de estudio del sueño. Estos métodos pueden clasificarse en métodos objetivos (como la polisomnografía o la actigrafía) y subjetivos (como los diarios y los cuestionarios del sueño). De entre todos los métodos estudiados se han escogido tres para su validación cruzada en dos poblaciones de 99 y 62 personas institucionalizadas en seis centros diferentes de la provincia de Valencia. En la primera población se estudió la calidad subjetiva del sueño, mientras que en la segunda población también se estudió la calidad objetiva del sueño. Concretamente, a partir del estudio previo de métodos de evaluación del sueño, como método objetivo se escogió la actigrafía. Todos los participantes del segundo estudio llevaron un actígrafo de muñeca durante una semana que registró sus parámetros de sueño de manera objetiva. Como métodos subjetivos se seleccionaron los cuestionarios del sueño de Atenas y Oviedo. Todos los participantes completaron ambos cuestionarios dejando constancia de la percepción subjetiva de su propio sueño. Además, en el estudio se incluyeron otras variables demográficas (género, edad, estado civil), médicas (fármacos prescritos, enfermedades, etc.), psico-geriátricas (escalas de Barthel, Tinetti y Mini-Mental; y el índice de morbilidad de Charlson), y físicas (análisis de sangre y saliva, incluyendo la concentración de cortisol). Con este estudio se pretende obtener información acerca de la relación existente entre todas esas variables, con especial interés en determinar si existe una correlación significativa entre la percepción subjetiva del sueño y la medición objetiva del mismo. El estudio pretende, además, identificar posibles marcadores para la detección temprana de trastornos del sueño. Los resultados obtenidos son, por una parte, una clasificación actualizada de los métodos de detección del sueño, así como una recopilación y comparativa histórica de los cuestionarios del sueño. Por otra parte, el análisis estadístico del estudio realizado sobre la muestra de participantes arroja diversos resultados interesantes. En primer lugar, se encontró una correlación significativa entre las puntuaciones obtenidas en el cuestionario de Atenas y la subescala 1 del cuestionario de Oviedo (rho =-0.51 p
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- 2018
294. Búsqueda de biomarcadores en el síndrome de fragilidad
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Navarro Martínez, Rut, Cauli, Omar, and Departament d'Infermeria
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biomarcadores ,UNESCO::CIENCIAS MÉDICAS ,fragilidad ,envejecimiento ,CIENCIAS MÉDICAS [UNESCO] - Abstract
En los próximos años, de mantenerse las tendencias demográficas de los ultimos años, se prevé un intenso proceso de envejecimiento. Las personas mayores son el grupo poblacional más heterogéneo en comparación con cualquier otro grupo de edad, y aunque un porcentaje accede al denominado “envejecimiento exitoso”, otros acumulan multimorbilidad y diversos deterioros asociados a la edad, con la consecuente disminución de la esperanza y la calidad de vida. Tradicionalmente, la mayor parte de la investigación del envejecimiento se ha centrado en la supervivencia y en las posibles intervenciones para prolongar la esperanza de vida. Sin embargo, la tendencia actual es considerar más importante la prevención de la discapacidad que el simple aumento de la longevidad. En este sentido, la relevancia del concepto de fragilidad ha aumentado considerablemente en los últimos años, pues parece existir cierto consenso en que ésta constituye un estado que antecede a la discapacidad. Por tanto, el diagnóstico de la fragilidad es de gran importancia al permitir identificar a las personas con mayor riesgo de desarrollar discapacidad. Una de las características más importantes de la fragilidad es que se trata de una condición dinámica, puede mejorar o empeorar con el tiempo e incluso invertirse. Por eso, el objetivo principal de la detección de la fragilidad es la intervención precoz y multidisciplinar con el fin de prevenir el deterioro funcional y la dependencia. Actualmente, el diagnóstico de fragilidad se base principalmente en la medición de parámetros funcionales, que tienen utilidad clínica limitada, consumen tiempo, en ocasiones difíciles de realizar y a veces no están validados o suficientemente estandarizados. Por ello, en los últimos años, la búsqueda de marcadores sanguíneos de fragilidad que puedan identificar o al menos contribuir a la identificación precoz de las personas frágiles de manera sencilla, a la vez que se solicita un análisis rutinario, ha cobrado especial importancia. Con este estudio se pretende identificar posibles marcadores sanguíneos de fragilidad, lo cual puede contribuir al desarrollo de nuevas herramientas clínicas con mayor poder diagnóstico y, por consecuencia, a mejora las decisiones terapéuticas con el fin de minimizar su progresión hacia la discapacidad, lo que ayudaría a disfrutar de una vejez más saludable y libre de discapacidad. IX Para alcanzar este objetivo se evaluaron, en una población geriátrica institucionalizada, sin discapacidad ni deterioro cognitivo, las relaciones existentes entre los subtipos de leucocitos, la vitamina D y el factor neurotrófico derivado del cerebro (BDNF) con la fragilidad y, en particular, con alguno de los cinco criterios de fragilidad descritos por Fried (pérdida involuntaria de peso, baja energía o agotamiento, movilidad lenta, debilidad muscular y baja actividad física). Nuestros resultados mostraron en relación con las subpoblaciones de leucocitos, una correlación positiva y significativa entre la puntuación de la escala de fragilidad de Fried y el porcentaje de neutrófilos (p < 0,05). Igualmente pudimos observar una correlación significativa entre el porcentaje de linfocitos con el número de criterios de Fried (p < 0,05), pero, en este caso, la relación fue en dirección opuesta. Estas asociaciones tambien fueron significativas para dos de los cinco criterios de fragilidad de Fried, baja fuerza muscular y baja actividad física (p < 0,05). La relación entre fragilidad y los niveles de BDNF no mostró ninguna asociación significativa, sin embargo, se observó una correlación positiva y significativa entre las concentraciones de BDNF con el índice de Barthel, una medida de la capacidad para realizar las actividades básicas de la vida diaria (p = 0,03), la subcategoría de concentración medida con mini examen del estado mental (Mini Mental State Examination (MMSE)) (p= 0,01) y el recuento de eosinófilos en sangre (p = 0,01). Además, el BDNF se correlacionó de manera inversa y significativa con la concentración de colesterol total (p = 0,04) y de colesterol de lipoproteínas de alta densidad (HDL-c) (p = 0,04). En nuestro estudio los sujetos frágiles, en comparación con los individuos robusto, presentaron una disminución significativa de las concentraciones séricas de vitamina D (p < 0,01), sin embargo, esta disminución no se correlacionó significativamente con la gravedad del síndrome de fragilidad ni con ninguno de los criterios individuales de la fragilidad. Como conclusión nuestros resultados muestran la existencia de posibles biomarcadores de fragilidad relacionados con el sistema inmune y hormonal, los cuales no sólo contribuyen a la detección temprana de la fragilidad, sino también, nos permiten conocer los mecanismos biológicos que contribuyen a su desarrollo, con la consiguiente posibilidad de desarrollar o adaptar intervenciones de enfermería adecuadas para tratar, prevenir e incluso revertir el síndrome frágil. In the coming years, if the demographic trends of the last decades are maintained, an intense process of aging is foreseen. Older people are the most heterogeneous population group in comparison with any other age group and, although a percentage accede to the so-called “successful aging”, others accumulate multimorbidity and various age-related impairments, with the consequent decrease of hope and quality of life. Traditionally, most aging research has focused on survival and possible interventions to extend life expectancy. However, the current trend is to consider prevention of disability as more important than simply increasing longevity. In this sense, the clinical and scientific relevance of the concept of fragility has increased considerably in recent years, since there seems to be some consensus that it constitutes a state that precedes disability. Therefore, the diagnosis of fragility is of great importance, allowing identifying the people with greater risk of developing disability. One of the most important characteristics of fragility is that it is a dynamic condition; it can improve or worsen over time. Therefore, the main objective of the detection of fragility is early and multidisciplinary intervention in order to prevent functional deterioration and dependence. At present, the diagnosis of fragility is based mainly on the measurement of functional parameters, which have limited clinical utility, are time consuming, sometimes difficult to perform and may not be validated or sufficiently standardized. Thus, in recent years, the search for blood markers of fragility that can identify or at least contribute to the early identification of fragile individuals in a simple way, while requesting a routine analysis, has gained special importance. This study aims to identify possible blood markers of fragility, which may contribute to the development of new clinical tools with greater diagnostic power, and consequently to improve therapeutic decisions in order to minimize their progression towards disability, which would help enjoy a healthier and disability-free old age. To achieve this objetive, the relationships between leukocyte subtypes, vitamin D (measured as total 25-hydroxyvitamin D, 25 (OH) 2 D3) and brain-derived neurotrophic factor (BDNF) with brittleness were evaluated (involuntary weight loss, low energy or exhaustion, slow mobility, XI muscle weakness and low physical activity) in an institutionalized geriatric population with no disability or cognitive impairment. Our results showed a positive and significant correlation between the Fried fragility scale score and the neutrophil count (p
- Published
- 2017
295. Exploración de un modelo de estadiaje clínico aplicado al trastorno bipolar
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Tatay Manteiga, Amparo, Balanzá Martínez, Vicent, Cauli, Omar, and Departament de Medicina
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psiquiatría ,biomarcadores ,neurocognición ,UNESCO::CIENCIAS MÉDICAS ,calidad de vida ,trastorno bipolar ,estadiaje clínico ,CIENCIAS MÉDICAS [UNESCO] ,funcionalidad - Abstract
El trastorno bipolar (TB) es una enfermedad mental crónica con una prevalencia aproximada del 2,4% en la población general que cursa con episodios recurrentes depresivos, maníacos y periodos de estabilidad clínica o eutimia. Clásicamente se consideraba que el TB tenía una evolución benigna comparada con la esquizofrenia, pero hoy en día los datos clínicos revelan que este trastorno se acompaña de una evolución en muchas ocasiones poco favorable, con una importante discapacidad global, una elevada morbilidad y una mortalidad prematura. Los pacientes que han padecido un mayor número de episodios, ya sean maníacos o depresivos, tienen una mayor dificultad para volver a su estado previo, es decir, para recuperarse. Además, hay pruebas de que, conforme aumentan las recaídas, se produce un mayor deterioro cognitivo, más altas tasas de hospitalización, mayor comorbilidad y peor respuesta a los tratamientos farmacológicos. Por todo ello, se han planteado sistemas de clasificación de estadiaje clínico con el objetivo de individualizar el tratamiento y mejorar el pronóstico a largo plazo. En este estudio se explora el modelo teórico de estadiaje clínico propuesto por Kapczinski y colaboradores en 2009 y revisado en 2014. Para ello se realizó un estudio observacional y transversal en el que se compararon un total de 92 sujetos divididos en cuatro grupos diferentes: 25 pacientes con TB eutímicos y en estadios iniciales de la enfermedad, sin deterioro; 23 pacientes con TB eutímicos pero que se encontraban en estadios avanzados del trastorno, con un deterioro funcional general; 23 sujetos sanos pero con alto riesgo genético para padecer la enfermedad, en este caso, hermanos de los pacientes con TB (estadio 0, latente); y 21 sujetos control sanos. A cada uno de los participantes se les realizó una evaluación clínica exhaustiva en la que se tuvieron en cuenta variables socio-demográficas, antropométricas y clínicas, una evaluación neuropsicológica objetiva (Test de clave de números, Test de COWA-VFT, Test de ordenación de tarjetas de Wisconsin, Trail Making test A y B, test de Stroop, TAVEC, figura de Rey y Finger tapping test) y subjetiva (escala COBRA), una determinación de biomarcadores en sangre periférica (TBARS o peroxidación lipídica, TRAP o capacidad antioxidante total, PCC o peroxidación proteica, TNF-alfa, IL-6, IL-10, BDNF y NT-3) y se les pasaron las escalas FAST y WHO-QoL BREF, que evalúan la funcionalidad global y la calidad de vida respectivamente. Los pacientes con trastorno bipolar en eutimia mostraron una disfunción cognitiva más generalizada que limitada a unos pocos dominios, en concreto en memoria de trabajo, velocidad de procesamiento, función ejecutiva, memoria/aprendizaje verbal y memoria visual. Los pacientes con trastorno bipolar en estadios avanzados mostraron rendimientos cognitivos similares a los de los pacientes en estadios iniciales, pero presentaron mayores quejas cognitivas subjetivas, peor funcionalidad y peor calidad de vida. A nivel de biomarcadores periféricos, los pacientes en estadios iniciales presentaron un aumento de las concentraciones de la citocina anti-inflamatoria IL-10, así como menores niveles de peroxidación de lípidos y de defensas antioxidantes, comparados con el resto de grupos. Los hermanos sanos de los pacientes con trastorno bipolar presentaron déficit neurocognitivos en áreas similares a los pacientes, aunque de menor intensidad. Sin embargo, esto no se tradujo en una peor funcionalidad ni calidad de vida. Así mismo, no presentaron alteraciones significativas en las concentraciones de biomarcadores con respecto a los demás grupos. En conjunto, los resultados de esta investigación sugieren la existencia de diferencias entre los distintos grupos, de forma que los pacientes en estadios avanzados presentan características distintivas de los pacientes en estadios iniciales, al igual que los hermanos sanos presentan cambios con respecto a los controles. Estas diferencias harían pensar en la posible utilidad de un modelo de clasificación del trastorno bipolar basado en el estadiaje clínico. Bipolar disorder (BD) is a chronic mental disease with a prevalence of approximately 2.4% in the general population that causes recurrent episodes of depression, mania and periods of clinical stability or euthymia. Classically it was considered that BD had a benign course compared to schizophrenia, but today the clinical data show that this disorder is accompanied by an unfavorable evolution, with a significant overall impairment, high morbidity and premature mortality. Patients who have had a greater number of episodes, either manic or depressive, have more difficulty returning to its previous state, ie, to recover. In addition, there is evidence that under increase relapse, greater cognitive impairment, higher hospitalization rates, increased morbidity and poor response to drug treatment occurs. Therefore, classification systems for clinical staging have been proposed in order to individualize treatment and improve long-term prognosis. In this study we explore the theoretical model of clinical staging for BD proposed by Kapczinski and collaborators in 2009 and revised in 2014. We did a cross-sectional and observational study that compared a total of 92 patients divided in four different groups: 25 euthymic BD patient in the early stages of the illness, without deterioration; 23 euthymic BD patients in more advanced stages of the illness, with a general functional impairment; 23 healthy subjects but with a high genetic risk for developing the disease, in this case brothers of BD patients (stage 0, latent) subjects; and 21 healthy controls. Each subject underwent a complete clinical evaluation that included socio-deomgraphic, anthropometric and clinical variables, an objective neuropsychological assessment (Digit Symbol test, COWA-VFT, Wisconsin card sorting test, Trail Making test A and B, Stroop test, TAVEC, Rey-Osterrieth complex figure test and Finger tapping test) and subjective (COBRA scale), a determination of biomarkers in peripheral blood (TBARS or lipid peroxidation, TRAP or total reactive antioxidant potential, PCC peroxidation or protein carbonyl content, TNF-alpha, IL-6, IL-10, BDNF and NT-3) and were assessed the FAST and the WHO-QoL BREF scales, evaluating the overall functionality and quality of life respectively. Euthymic BD patients showed a generalized cognitive dysfunction in some domains, specifically in working memory, processing speed, executive function, verbal learning and memory and visual memory. Advanced-stage BD patients showed a similar cognitive performance to early-stage BD patients, but had higher subjective cognitive complaints, worse functionality and worse quality of life. Concerning peripheral biomarkers, early-stage BD patients showed increased concentrations of the anti-inflammatory cytokine IL-10 and lower levels of lipid peroxidation and antioxidant defenses compared to the other groups. Healthy siblings of patients showed neurocognitive deficits in similar areas to BD patients, although less intense. However, this did not translate into a worse functionality or quality of life. They also showed no significant alterations in biomarkers concentrations compared to the other groups. Overall, the results of this research suggest that there are differences between the different groups so that advanced-stage BD patients have distinctive characteristics of early-stages BD patients, as healthy BD siblings have differences from healthy controls. These differences may suggest the potential use of a classification model of bipolar disorder based on clinical staging.
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- 2015
296. Estudio comparativo de la transmisión de la presión ejercida por la tuberosidad posterior del calcáneo en los apósitos de espuma de poliuretano
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Julián Rochina, Iván, Esclápez Valero, José Pedro, Cauli, Omar, and Departament d'Infermeria
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QUÍMICA::Química macromolecular ::Poliuretanos [UNESCO] ,prevención ,espuma ,poliuretano ,talón ,apósito ,CIENCIAS MÉDICAS ::Ciencias clínicas::Geriatría [UNESCO] ,presión ,CIENCIAS MÉDICAS ::Ciencias clínicas::Dermatología [UNESCO] ,UNESCO::CIENCIAS MÉDICAS ::Salud pública ,UNESCO::CIENCIAS MÉDICAS ::Ciencias clínicas::Dermatología ,UNESCO::CIENCIAS MÉDICAS ::Ciencias clínicas::Geriatría ,CIENCIAS MÉDICAS ::Salud pública [UNESCO] ,UNESCO::QUÍMICA::Química macromolecular ::Poliuretanos ,calcáneo ,úlcera - Abstract
Las úlceras por compresión en el talón son las segundas más prevalentes dado que esta localización anatómica presenta unas características inherentes que la hacen más vulnerable a la isquemia. La prevención de estas úlceras, al igual que en cualquier problema de salud, es el principal caballo de batalla en el ámbito clínico asistencial, ya sea a nivel hospitalario o en la comunidad. La aplicación de apósitos de espuma de poliuretano con formas adaptadas al talón es una realidad clínica, que tiene como objetivo prevenir este tipo de lesiones. Esta realidad asistencial concuerda con multitud de guías de práctica clínica publicadas en España. No obstante, tanto en publicaciones de organismos internacionales, dedicados al estudio específico de las úlceras por compresión, como en las revisiones sistemáticas realizadas por entidades como la fundación Cochrane, no se recomienda el uso de estos dispositivos en el ámbito de la prevención de úlceras por presión. Esta situación obliga a contrastar la información publicada sobre la capacidad de amortiguación de las fuerzas físicas implicadas en la aparición de las úlceras por compresión por los apósitos de espuma de poliuretano. En vista de las claras diferencias metodológicas entre los estudios que evalúan la transmisión de fuerzas de presión en el talón por parte de los apósitos de espuma de poliuretano, surge la necesidad de comprobar si estos productos son realmente efectivos para la disminución de la presión transmitida por la tuberosidad posterior del calcáneo. Con este objetivo se ha elaborado un protocolo de estudio para el que se ha creado un modelo artificial que reproduce las presiones ejercidas en el talón, medidas en voluntarios de un rango de edad muy amplio (26-90 años). Los materiales comparados han sido seleccionados entre los apósitos más utilizados en la práctica asistencial así como en los artículos de referencia (Allevyn® Heel, Mepilex® Heel, Biatain® Talón y Askina® Heel). Con motivo de poder comparar los resultados obtenidos por los apósitos evaluados, se ha introducido como material de control una espuma de células abiertas. Dicha espuma se usa principalmente como material de absorción de presión e impacto, aplicándose en soportes plantares destinados a la prevención de las úlceras neuropáticas del pie diabético (Poron®). De otro lado, dado que estos apósitos se aplican durante horas y días, se necesita conocer cómo reaccionan a la fatiga mecánica a la que son sometidos, por lo que se ha utilizado la prueba de estrés UNE-EN ISO 1856:2001 “Materiales poliméricos celulares flexibles. Determinación de la deformación remanente por compresión” (ISO 1856:2000). Tanto el modelo artificial como la plataforma de presiones utilizada para las mediciones, han pasado por un proceso de validación en el que se han obtenido unos resultados excelentes, con un “Coeficiente de Correlación Interclase” de 0,881 y 0,982 respectivamente (p
- Published
- 2015
297. Papel de los neuroesteroides en la modulación de la vía glutamato-óxido nítrico-GMP cíclico. Alteraciones en hiperamonemia crónica. Papel en las alteraciones cognitivas y motoras en encefalopatía hepática. Mecanismos moleculares e implicaciones terapéuticas
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González-Usano, Alba, Cauli, Omar, Felipo Orts, Vicente, Morcillo Sánchez, Esteban, and Departament de Farmacologia
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CIENCIAS DE LA VIDA::Neurociencias::Neurofisiología [UNESCO] ,CIENCIAS DE LA VIDA::Neurociencias::Neuroquímica [UNESCO] ,Hiperamonemia ,Neuroesteroides ,UNESCO::CIENCIAS DE LA VIDA::Neurociencias::Neurofisiología ,UNESCO::CIENCIAS DE LA VIDA::Neurociencias::Neuroquímica ,Encefalopatía hepática - Abstract
En el cerebelo de ratas hiperamonémicas existe un aumento del tono GABAérgico que está implicado en el deterioro de la función de la vía Glu-NO-GMPc y de las capacidades de aprendizaje y memoria moduladas por esta vía. Al aumento del tono GABAérgico contribuyen: • un aumento de la concentración extracelular de GABA en cerebelo. • un aumento de la cantidad de algunas subunidades de receptores GABAA. • un aumento de la concentración de neuroesteroides que modulan la activación de receptores GABAA. Los neuroesteroides pueden modular diversos receptores incluyendo el receptor GABAA, el NMDA y los receptores sigma. Esta tesis parte de las hipótesis de que: • algunos neuroesteroides modulan, a concentraciones fisiológicas, la función de la vía Glu-NO-GMPc a través de su acción sobre receptores GABAA, NMDA o sigma. • la hiperamonemia crónica puede alterar la modulación por neuroesteroides de los receptores mencionados y de la vía Glu-NO-GMPc. • algunos neuroesteroides que modulan la vía Glu-NO-GMPc pueden tener utilidad terapéutica para restaurar la función de la vía y la capacidad de aprendizaje modulada por la misma. Teniendo en cuenta estas hipótesis, los objetivos concretos de esta tesis son: 1. Analizar si distintos neuroesteroides regulan in vivo la función de la vía Glu-NO-GMPc en cerebelo de ratas control. 2. Analizar a través de qué receptores llevan a cabo la modulación de esta vía. 3. Evaluar si la hiperamonemia crónica altera la modulación por diferentes neuroesteroides de la función de la vía Glu-NO-GMPc en cerebelo y a través de qué receptores. 4. Evaluar si alguno de los neuroesteroides estudiados podría normalizar la función de la vía Glu-NO-GMPc y tener utilidad terapéutica para restaurar en ratas con hiperamonemia crónica la capacidad de aprendizaje y memoria modulados por esta vía. 5. Evaluar si este neuroesteroide restaura las alteraciones en la actividad y coordinación motoras en ratas con hiperamonemia crónica. La vía glutamato-óxido nítrico- GMPc (Glu-NO-GMPc) media muchas de las respuestas a la activación del receptor NMDA, incluyendo la modulación de algunos tipos de aprendizaje y la memoria. La vía Glu-NO-GMPc es modulada por la neurotransmisión GABAérgica. La activación de los receptores GABAA reduce la función de la vía. Varios neuroesteroides modulan la actividad de los receptores GABAA y/o NMDA, lo que sugiere que podrían modular la función de la vía Glu-NO-GMPc. Hemos evaluado por microdiálisis in vivo, los efectos de diversos neuroesteroides con diferentes efectos sobre los receptores NMDA y GABAA sobre la función de la vía Glu-NO-GMPc en el cerebelo de ratas control.
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- 2013
298. Diagnostic accuracy of isometric knee extension strength as a sarcopenia criteria in older women.
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Pérez-Ros P, Barrachina-Igual J, Pablos A, Fonfria-Vivas R, Cauli O, and Martínez-Arnau FM
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- Humans, Female, Aged, Cross-Sectional Studies, Aged, 80 and over, Isometric Contraction physiology, Hand Strength physiology, Geriatric Assessment methods, Muscle, Skeletal physiopathology, Knee physiopathology, Sarcopenia diagnosis, Sarcopenia physiopathology, Muscle Strength physiology
- Abstract
Background: Muscle strength is one of the most reliable measures used for the identification of sarcopenia. The European Working Group on Sarcopenia in Older People update (EWGSOP2) proposed the use of grip strength and chair stand tests, while clarifying that isometric torque methods can be used when performing the grip strength test is impossible. This study aims to evaluate the diagnostic accuracy of isometric knee extension strength in screening for sarcopenia., Methods: This cross-sectional study included community-dwelling women aged 70 years and over. IKE and sarcopenia criteria (EWGSOP2) were assessed. Skeletal muscle mass was assessed by bioelectrical impedance analysis; muscle mass strength by handgrip; and physical performance by the 5 times sit-to-stand test, the Short Physical Performance Battery, and gait speed. The diagnostic accuracy for each sarcopenia criterion was calculated using sensitivity, specificity, positive and negative predictive value, and the area under the curve (AUC). Cutoff points for sarcopenia from IKE were defined with the ROC curve., Results: The sample comprised 94 women with a mean age of 75.9 years (standard deviation 5.6, range 70-92), of whom 25.5% (n = 24) met criteria for sarcopenia-mainly severe sarcopenia (73.8%, n = 17). Correlations were observed between IKE and each individually analyzed sarcopenia criterion except skeletal muscle mass, with AUC values exceeding 0.70 in all cases. The IKE cutoff showing the highest accuracy for the diagnosis of sarcopenia was 12.5 kg or less (AUC 0.76, 95% confidence interval [CI] 0.64-0.88; sensitivity: 65.2%, 95% CI 45.7-84.7; specificity 77.4%, 95% CI 60.3-94.5; positive predictive value 62.5%, 95 CI% 42.7-82.3; negative predictive value 88.8%, 95% CI 75.9-100)., Conclusions: IKE could be a suitable tool for measuring muscular strength in sarcopenia when other strength parameters cannot be assessed or in people with walking difficulties., Competing Interests: Declarations. Ethics approval and consent to participate: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee for Human Research of the University of Valencia (protocol code 1534298 approved 14 January 2021). Following a briefing about the study and its aims, all participants signed informed consent as a precondition for taking part. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)
- Published
- 2024
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299. Impact of a Physical Exercise and Health Education Program on Metabolic Syndrome and Quality of Life in Postmenopausal Breast Cancer Women Undergoing Adjuvant Treatment with Aromatase Inhibitors.
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Cespedes P, Martínez-Arnau FM, Torregrosa MD, Cauli O, and Buigues C
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- Humans, Female, Aged, Middle Aged, Health Education methods, Health Education standards, Chemotherapy, Adjuvant adverse effects, Surveys and Questionnaires, Exercise Therapy methods, Breast Neoplasms drug therapy, Breast Neoplasms psychology, Breast Neoplasms complications, Aromatase Inhibitors therapeutic use, Aromatase Inhibitors adverse effects, Quality of Life psychology, Metabolic Syndrome complications, Postmenopause psychology, Exercise psychology
- Abstract
Background and Objectives : Adjuvant treatment with aromatase inhibitors (AIs) in breast cancer (BC) survivors can cause adverse effects such as metabolic syndrome (MS) (insulin resistance, central obesity, atherogenic dyslipidemia, and hypertension) associated with morbidity and premature mortality. We evaluate the effect of a multimodal program based on physical exercise and health education on MS and health-related quality of life (QoL) in postmenopausal women with BC under AIs. Methods : A total of 56 postmenopausal women, diagnosed with BC, aged 60 years or older (mean age 67.2 years) and on hormonal treatment with AIs, were included in the multimodal physical exercise and health education program, and evaluated before and after their participation. The assessment of the five criteria of the MS included the following: waist circumference, high blood pressure, fasting glucose, triglycerides, and high-density lipoprotein cholesterol. Two main instruments were used to evaluate the impact of the intervention on QoL: the EORTC QLQ C30 (questionnaire for cancers in general) and the EORTC QLQ BR23 (specifically for breast cancer patients). The EuroQol 5D (EQ-5D) was also used to compare these results. Results : The percentage of women meeting the MS criteria was 37.7% at baseline and fell to 15.1% at 3 months after the intervention ( p = 0.02). The intervention significantly reduced hypertension ( p < 0.001), central obesity ( p < 0.001), and the concentration of triglycerides ( p = 0.016). No significant changes were observed in fasting glucose and HDL concentration. A statistically significant improvement was found in QoL (on both the QLQ30 and BR23 scales). A multivariate regression model analysis identified marital status (being married) (95% CI: 1.728-131.615, p = 0.014), and percentage of attendance at health education sessions (95% CI: 1.010-1.211, p = 0.029) as positive predictive variables of improvement in MS. Conclusions : The implementation of multimodal, community-based programs of physical exercise and health education improve the prevalence of MS and specific criteria of MS and QoL in postmenopausal women with breast cancer receiving AI treatment.
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- 2024
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300. Long-Term Caregiving Impact and Self-Care Strategies in Family Caregivers of People with Neuropsychiatric Disorders: A Mixed-Method Study.
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Sánchez-Martínez V, Cauli O, and Corchón S
- Abstract
Family caregivers of people with neuropsychiatric conditions are at risk of caregiver burden and declining health. The aims of this study were to identify the impact of caring on long-term family caregivers and their unmet needs and to explore their self-care strategies for achieving a successful caregiving experience. A mixed-method study was conducted using semi-structured interviews and a questionnaire in which standardized, self-reported measures of burden, health behaviors, sleep, and mental well-being were administered. Participants were family caregivers of people with neuropsychiatric disorders. Convenience sampling of 28 caregivers: 13 of people with mental health disorders (schizophrenia and bipolar disorder) and 15 with Alzheimer's disease. Based on the analysis of the semi-structured interviews, data saturation was reached. Analysis of self-reported measures indicated that 32.1% of long-term caregivers had high caregiver burden, 64.3% had reduced quality of life, 39.3% had low sleep quality, 21.4% had low adherence to the Mediterranean diet, 50.0% had a physical activity below the recommendation, 42.9% had high anxiety symptoms, 35.7% had high depressive symptoms, and 71.4% had reduced self-care agency. Content analysis and statistical analysis were conducted. Two themes were identified: (1) the impact of long-term caregiving and unmet needs and (2) successful self-care strategies. Caregivers of people with Alzheimer's disease spent less time doing physical activity, had higher caregiver burden, and poorer health-related quality of life. The negative impact of caregiving could be prevented/managed by assessing the individual's circumstances for the development of cross-sectional self-care strategies involving physical, emotional, and social spheres.
- Published
- 2024
- Full Text
- View/download PDF
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