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  • Ítem
    Validation of the 1,4-butanediol thermoplastic polyurethane as a novel material for 3D bioprinting applications
    (John Wiley & Sons, 2020-11) Chocarro-Wrona, Carlos; de-Vicente, Juan; Antich, Cristina; Jiménez-González, Gema; Martínez-Moreno, Daniel; Carillo-Delgado, Esmeralda; Montañez, Elvira; Gálvez-Martín, Patricia; Perán, Macarena; López-Ruiz, Elena; Marchal, Juan Antonio
    Tissue engineering (TE) seeks to fabricate implants that mimic the mechanical strength, structure, and composition of native tissues. Cartilage TE requires the development of functional personalized implants with cartilage-like mechanical properties capable of sustaining high load-bearing environments to integrate into the surrounding tissue of the cartilage defect. In this study, we evaluated the novel 1,4-butanediol thermoplastic polyurethane elastomer (b-TPUe) derivative filament as a 3D bioprinting material with application in cartilage TE. The mechanical behavior of b-TPUe in terms of friction and elasticity were examined and compared with human articular cartilage, PCL, and PLA. Moreover, infrapatellar fat pad-derived human mesenchymal stem cells (MSCs) were bioprinted together with scaffolds. in vitro cytotoxicity, proliferative potential, cell viability, and chondrogenic differentiation were analyzed by Alamar blue assay, SEM, confocal microscopy, and RT-qPCR. Moreover, in vivo biocompatibility and host integration were analyzed. b-TPUe demonstrated a much closer compression and shear behavior to native cartilage than PCL and PLA, as well as closer tribological properties to cartilage. Moreover, b-TPUe bioprinted scaffolds were able to maintain proper proliferative potential, cell viability, and supported MSCs chondrogenesis. Finally, in vivo studies revealed no toxic effects 21 days after scaffolds implantation, extracellular matrix deposition and integration within the surrounding tissue. This is the first study that validates the biocompatibility of b-TPUe for 3D bioprinting. Our findings indicate that this biomaterial can be exploited for the automated biofabrication of artificial tissues with tailorable mechanical properties including the great potential for cartilage TE applications. © 2020 The Authors. Bioengineering & Translational Medicine published by Wiley Periodicals LLC on behalf of American Institute of Chemical Engineers.
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    The role of high fat diets and liver peptidase activity in the development of obesity and insulin resistance in wistar rats
    (Multidisciplinary Digital Publishing Institute, 2020-03) Dominguez-Vías, G.; Segarra, AB.; Ramirez-Sanchez, M.; Prieto, I.
    Las dietas ricas en grasas (HFD) se han asociado ampliamente con un mayor riesgo de trastornos metabólicos y sobrepeso. Sin embargo, se ha sugerido que una ingesta elevada de fuentes ricas en ácidos grasos monoinsaturados es un agente dietético que puede influir positivamente en el metabolismo energético y la función vascular. El objetivo principal de este estudio fue analizar el papel de las grasas dietéticas en las actividades de las peptidasas hepáticas y los trastornos metabólicos. Tres dietas: estándar (S), HFD suplementada con aceite de oliva virgen (VOO) y HFD suplementada con mantequilla más colesterol (Bch), se administraron durante seis meses a ratas Wistar macho. Se recogieron muestras de plasma y hígado para el análisis de bioquímica clínica y actividades de aminopeptidasas (AP). La expresión de la óxido nítrico sintasa inducible (iNOS) también se determinó mediante Western blot en muestras de hígado. El suplemento dietético con VO no indujo obesidad, a diferencia del grupo Bch. Aunque la dieta VOO aumentó el tiempo necesario para volver a los niveles basales de glucosa plasmática, la relación insulina/glucosa en ayunas y el índice HOMA2-%B (un índice del modelo de homeostasis de la secreción de insulina y valoración de la utilidad de las células beta (% de secreción de células beta)) mejoraron. Se encontró un aumento de la actividad de la dipeptidil-peptidasa 4 unida a la membrana hepática (DPP4) solo en ratas VOO, incluso si no se obtuvieron diferencias en el péptido similar al glucagón 1 (GLP-1) plasmático en ayunas. Ambas dietas ricas en grasas indujeron cambios en el piroglutamil-AP hepático en la fracción soluble, pero solo la dieta Bch aumentó el tirosil-AP soluble. Las actividades de la angiotensina que están implicadas en el metabolismo de la angiotensina II (AngII) a AngIV aumentaron en la dieta VOO, lo que estuvo de acuerdo con la mayor actividad de la AP regulada por insulina (IRAP) en este grupo. Por otra parte, la dieta enriquecida con mantequilla aumentó la gamma-glutamil transferasa soluble (GGT) y Leucil-AP, la expresión de iNOS en el hígado y el NO plasmático. En resumen, el VOO aumentó la actividad hepática de AP que se relacionaron con el metabolismo de la glucosa (DPP4, angiotensinasas e IRAP). Sin embargo, la dieta Bch aumentó las actividades que están implicadas en el control de la ingesta de alimentos (Tirosina-AP), el índice de daño hepático (Leucina-AP y GGT) y la expresión de iNOS hepática y NO plasmático. En conjunto, estos resultados respaldan que la fuente de grasa en la dieta afecta varias actividades de peptidasas en el hígado, que podrían estar relacionadas con alteraciones en la conducta alimentaria y el metabolismo de la glucosa.
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    Neuropeptidase activity in the frontal cortex of Wistar-Kyoto and spontaneously hypertensive rats treatedwith vasoactive drugs: A bilateral study
    (Wolters Kluwer Health, 2019-03) Prieto, I.; Segarra, AB.; Villarejo, AB.; de Gasparo, M.; Martinez-Cañamero, M.; Ramírez-Sánchez, M.
    La hipertensión puede provocar trastornos del estado de ánimo que pueden empeorar o mejorar según el tipo de antihipertensivo prescrito. La depresión se asocia a modificaciones de la asimetría cerebral basal, en particular la de la corteza frontal, que está implicada en el control de la presión arterial. Además, diferentes fármacos vasoactivos pueden cambiar la asimetría del cerebro de una manera que contribuya al estado cognitivo. Estudiamos la actividad bilateral de varias neuropeptidasas en la corteza frontal como reflejo del estado funcional de ciertos neuropéptidos implicados en el estado de ánimo. Utilizando derivados de arilamida como sustratos, analizamos fluorométricamente la actividad de estas enzimas en la corteza frontal izquierda y derecha de ratas control no tratadas Wistar-Kyoto (WKY) y ratas espontáneamente hipertensas (SHR) y comparamos sus actividades con WKY o SHR tratadas con los fármacos antihipertensivos captopril (CAP) y propranolol (PRO) o con el éster metílico de N (G)-nitro-L-arginina para la hipertensión. También se midió la PAS en todos los grupos WKY y SHR. Los pacientes WKY no tratados, WKY tratados con CAP o PRO y SHR tratados con CAP mostraron valores normotensos de PAS. Sin embargo, los pacientes WKY tratados con N(G)-nitro-L-arginina metil éster, así como los pacientes SHR no tratados y los pacientes SHR tratados con PRO y N(G)-nitro-L-arginina metil éster, mostraron valores hipertensos de PAS. Los cambios en la distribución bilateral de las neuropeptidasas dependieron de la cepa, la enzima analizada y el fármaco utilizado. Los grupos WKY normotensos (WKY, CAP, PRO) revelaron correlaciones intrahemisféricas principalmente en el hemisferio izquierdo. Por el contrario, los pacientes WKY tratados con N(G)-nitro-L-arginina metil éster y los grupos SHR demostraron correlaciones intrahemisféricas principalmente en el hemisferio derecho. Las correlaciones interhemisféricas se observaron principalmente en los grupos WKY así como en los SHR con tratamientos antihipertensivos (CAP, PRO). Nuestros resultados sugieren patrones bilaterales específicos de la actividad de las neuropeptidasas en el cerebro en WKY que cambian en SHR. Esta observación puede estar relacionada con los trastornos cognitivos que se han descrito en estos animales y que cambian con el tratamiento con fármacos antihipertensivos o antihipertensivos.
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    Efficacy of extracorporeal shockwave therapy, compared to corticosteroid injections, on pain, plantar fascia thickness and foot function in patients with plantar fasciitis: A systematic review and meta-analysis
    (SAGE PUBLICATIONS LTD, 2024-05-23) Cortes-Perez, Irene; Moreno-Montilla, Laura; Ibanez-Vera, Alfonso Javier; Diaz-Fernandez, Angeles; Obrero-Gaitan, Esteban; Lomas-Vega, Rafael
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    Immersive virtual reality and augmented reality in anatomy education: A systematic review and meta-analysis
    (Wiley, 2024-02-12) García-Robles, Paloma; Cortés-Pérez, Irene; Nieto-Escámez, Francisco Antonio; García-López, Héctor; Obrero-Gaitán, Esteban; Osuna-Pérez, María Catalina
    The purpose of this review was to (1) analyze the effectiveness of immersivevirtual reality (iVR) and augmented reality (AR) as teaching/learning resources(collectively called XR-technologies) for gaining anatomy knowledge compared totraditional approaches and (2) gauge students' perceptions of the usefulness of thesetechnologies as learning tools. This meta-analysis, previously registered in PROSPERO(CRD42023423017), followed PRISMA guidelines. A systematic bibliographicalsearch, without time parameters, was conducted through four databases until June2023. A meta-analytic approach investigated knowledge gains and XR's usefulnessfor learning. Pooled effect sizes were estimated using Cohen's standardized meandifference (SMD) and 95% confidence intervals (95% CI). A single- group proportionalmeta-analysis was conducted to quantify the percentage of students who consideredXR devices useful for their learning. Twenty-seven experimental studies, reportingdata from 2199 health sciences students, were included for analysis. XR-technologiesyielded higher knowledge gains than traditional approaches (SMD = 0.40; 95%CI = 0.22 to 0.60), especially when used as supplemental/complementary learningresources (SMD = 0.52; 95% CI = 0.40 to 0.63). Specifically, knowledge performanceusing XR devices outperformed textbooks and atlases (SMD = 0.32; 95% CI = 0.10to 0.54) and didactic lectures (SMD = 1.00; 95% CI = 0.57 to 1.42), especially amongundergraduate students (SMD = 0.41; 95% CI = 0.20 to 0.62). XR devices wereperceived to be more useful for learning than traditional approaches (SMD = 0.54;95% CI = 0.04 to 1), and 80% of all students who used XR devices reported thesedevices as useful for learning anatomy. Learners using XR technologies demonstratedincreased anatomy knowledge gains and considered these technologies useful forlearning anatomy.K E Y W O R D Sanatomy, augmented reality, health sciences courses, immersive virtual reality, meta-analysis,technology-enhanced learning
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    Changes in the bacterial diversity of human milk during late lactation period (Weeks 21 to 48)
    (2020-08-27) Marín Gómez, Wendy; Grande Burgos, María José; Pérez Pulido, Rubén; Gálvez, Antonio; Lucas, Rosario
    Se recolectó leche materna de una madre soltera durante un período de lactancia de 28 semanas. La diversidad bacteriana se estudió mediante análisis de secuenciación de amplicones de la región variable V3-V4 del gen 16S rRNA. Firmicutes y Proteobacteria fueron los principales filos detectados en las muestras de leche, seguidos de Actinobacteria y Bacteroidetes . La proporción de Firmicutes a Proteobacteria cambió considerablemente dependiendo de la semana de muestreo. Se detectó un total de 411 géneros o taxones superiores en el conjunto de muestras. El género Streptococcus se detectó durante el período de muestreo de 28 semanas, en abundancias relativas entre 2.0% y 68.8%, y fue el grupo más abundante en 14 de las muestras. Carnobacterium y Lactobacillus tuvieron abundancias relativas bajas. A nivel de género, la diversidad bacteriana cambió considerablemente en ciertas semanas dentro del período estudiado. Las semanas o períodos con menor abundancia relativa de Streptococcus presentaron composiciones bacterianas más diversas, incluyendo géneros pertenecientes a Proteobacteria que estaban poco representados en el resto de las muestras.
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    Asymmetric Pattern of Correlations of Leucine Aminopeptidase Activity between Left or Right Frontal Cortex versus Diverse Left or Right Regions of Rat Brains
    (MDPI, 2023-07) Ramírez-Sánchez, Manuel; Prieto-Gómez, María Isabel; Segarra, Ana Belén; Banegas, Inmaculada; Martínez-Cañamero, Magdalena; Domínguez-Vías, Germán; Durán, Raquel; Vives, Francisco
    Previous studies demonstrated an asymmetry of left predominance for mean values of soluble leucine aminopeptidase (LeuAP) activity in the frontal cortex (FC) and hypothalamus of adult male rats, fluorimetrically analyzed by the hydrolysis of Leu-β-naphthylamide as a substrate. No asymmetries were observed in nine other left (L) and right (R) regions obtained from rostro-caudally sectioned coronal slices. Neither had inter-hemispheric differences observed for lactate dehydrogenase (LDH), analyzed simultaneously in the same brain regions (L and R) of the same animals. However, the level of intra-hemispheric or inter-hemispheric correlation of LeuAP or LDH between such brain regions has not been analyzed. In order to obtain additional suggestions on the functional heterogeneity between regions of LeuAP and LDH, in the present investigation, the level of intra-hemispheric and inter-hemispheric correlations of the frontal cortex with the rest of the regions studied is described: (A) between the left frontal cortex (LFC) and the rest of the left regions; (B) between the right frontal cortex (RFC) and the rest of the right regions; (C) between the left frontal cortex and all of the right regions; and (D) between the right frontal cortex and all of the left regions. All of the correlations obtained were positive. The intra-hemispheric analysis showed a greater heterogeneity of values in the correlations observed between RFC and the rest of the right regions than between LFC and the rest of the left regions. Greater heterogeneity is observed when comparing RFC correlations with left regions than when comparing LFC correlations with right regions. In conclusion, the greatest heterogeneity (suggesting a greater functional variability) was observed in the right intra-hemispheric analysis and in the inter-hemispheric analysis between the RFC and the left hemisphere. The results for LDH showed a great homogeneity between regions both in the intra- and inter-hemispheric studies.
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    Does participation in therapeutic exercise programs after finishing oncology treatment still ensure an adequate health status for long-term breast cancer survivors? A ≥ 5 years follow-up study
    (SPRINGER, 2023-05-18) Álvarez-Salvago, Francisco; Jiménez-García, José Daniel; Pujol-Fuentes, Clara; Atienzar-Aroca, Sandra; Molina-García, Cristina; Aibar-Almazán, Agustín
    Purpose: The aims of this study were to evaluate whether the effects of two therapeutic exercise programs are sustained over time (≥ 5 years) in long-term breast cancer survivors (LTBCS). Second, to determine the influence of the current level of physical activity (PA) performed on cancer-related fatigue (CRF) that these patients may present ≥5 years later. Methods: A prospective observational study was conducted with a cohort of 80 LTBCS in Granada during 2018. Firstly, considering their participation in one of the programs, they were allocated into two groups: usual care and therapeutic exercise program, to assess CRF, pain and pressure pain sensitivity, muscle strength, functional capacity, and quality of life. Secondly, they were also classified into 3 groups according to current level of weekly PA performed: ≤ 3, 3.1-7.4, and ≥ 7.5 (MET-hour/week) respectively, to assess its impact over CRF. Results: Although the positive effects of the programs are not sustained over time, a trend toward significance can be observed for a greater reduction in overall CRF levels, lower intensity of pain in the affected arm and cervical region, and greater functional capacity and quality of life in the group that underwent therapeutic exercise. Additionally, 66.25% of LTBCS are inactive ≥ 5 years after completion of the program and furthermore, such inactivity is accompanied by higher CRF levels (P .013 to .046). Conclusion: The positive effects of therapeutic exercise programs are not maintained over time for LTBCS. Additionally, more than half of these women (66.25%) are inactive ≥ 5 years after completion of the program, this inactivity being accompanied by higher levels of CRF.
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    Copper tolerance and antibiotic resistance in soil bacteria from olive tree agricultural fields routinely treated with copper compounds.
    (Wiley Online Libr, 2019-04-25) Glibota, N.; Grande, M.J.; Gálvez, A.; Ortega, E.
    La contaminación por metales pesados ​​puede actuar como una presión selectiva persistente que favorece la propagación de la resistencia a los antimicrobianos en entornos naturales. El objetivo de este estudio fue aislar e identificar bacterias tolerantes a metales en suelos de campos de olivos tratados rutinariamente con compuestos derivados del cobre y evaluar la tolerancia de las cepas bacterianas a otros metales y su resistencia a antibióticos clínicamente relevantes. Resultados: Se estudiaron 595 aislados bacterianos procedentes de 45 campos de cultivo de olivo. Se detectaron concentraciones mínimas inhibitorias (CMI) ≥ 16 mmol L -1 para cobre (57% de los aislados), zinc (37%) y plomo (62%), mientras que sólo el 3% presentó CMI ≥ 12 mmol L -1 para níquel. Se seleccionaron 96 cepas tolerantes a metales para su identificación y determinación de la resistencia a antibióticos. La mayoría de los aislados pertenecían a los géneros Pseudomonas (37%), Bacillus (23%) y Chryseobacterium (20%), mientras que el 6% se identificó como Variovorax, el 4% como Stenotrophomonas y el 2% como Serratia o Burkholderia. La mayor tolerancia al cobre se detectó entre Pseudomonas. Más del 75% de las cepas con alta tolerancia al cobre también fueron resistentes a la vancomicina, el 50% a la ampicilina y el 40% a la eritromicina o trimetoprima/sulfametoxazol. Conclusión: Las bacterias de los suelos del olivar son tolerantes a los metales, principalmente al cobre, pero también al zinc y al plomo, así como resistentes a antibióticos de importancia clínica, lo que podría suponer un problema en el ámbito clínico. © 2019 Sociedad de la Industria Química.
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    Antimicrobial Activity and Biodiversity Study of a Homemade Vegetable Puree Treated with Antimicrobials from Paenibacillus dendritiformis
    (2023-06-07) Mena, Laura; Grande, M.J.; Gálvez, A.
    El Paenibacillus dendritiformis UJA2219 aislado de la zanahoria produce una actividad antibacteriana de amplio espectro. El objetivo del presente estudio fue determinar el impacto de los extractos de cultivos celulares parcialmente purificados de la cepa UJA2219 sobre la carga microbiana y la diversidad bacteriana de un puré de verduras casero. El puré se expuso a un cultivo de la cepa UJA2219 durante la noche o a extractos de caldo de cultivo parcialmente purificados mediante cromatografía de intercambio catiónico (CE) o cromatografía de fase reversa (RP) e incubados durante 7 días a temperaturas de 4 °C o 25 °C. Los mejores resultados se obtuvieron a 25 °C con el extracto de RP, disminuyendo los recuentos de las presuntas Enterobacteriaceae por debajo de los niveles detectables. La diversidad bacteriana del puré de control y tratado se estudió mediante secuenciación de extremos emparejados de Illumina, utilizando ADN extraído de las muestras de puré incubadas a 25 °C durante 24 h. Los controles y el puré inoculado con la cepa UJA2219 mostraron un perfil de diversidad bacteriana casi idéntico, con Pseudomonadota (principalmente Fam. Pseudomonadaceae -gen. Pseudomonas - y Enterobacteriace como los grupos más abundantes). Las mayores diferencias en la diversidad bacteriana se obtuvieron en el puré tratado con extracto de RP, mostrando una disminución en la abundancia relativa de Pseudomonadota (especialmente gen. Pseudomonas ) y un aumento de Bacillota (principalmente de los géneros Bacillus , Enterococcus y Lactococcus ). Los resultados del estudio sugieren que las preparaciones antimicrobianas de la cepa UJA2219 tienen potencial de aplicación en la biopreservación de alimentos.
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    Effect of combined physical–cognitive training on the functional and cognitive capacity of older people with mild cognitive impairment: a randomized controlled trial
    (BMC, 2024-07-08) Castellote-Caballero, Yolanda; Carcelén-Fraile, María del Carmen; Aibar-Almazán, Agustín; Afanador-Restrepo, Diego; González-Martín, Ana María
    Background: The increase in population aging highlights the growing prevalence of mild cognitive impairment, prompting the adoption of interventions that combine physical exercise and cognitive training to improve health and cognitive performance in older adults. The aim of this study was to analyze the efficacy of a combined program on physical and cognitive health in older people with cognitive impairment. Methods: A 12-week randomized controlled clinical trial involving 95 participants (aged 72.12 ± 4.25 years), 47 individuals participated in a control group (CG) that only underwent cognitive stimulation, while 48 individuals were in an experimental group (EG) that participated in a combined program. Balance was measured using the Tinetti scale, upper body strength was assessed with the arm curl test, lower body strength was evaluated with the 30-s chair stand test, flexibility was tested using the back scratch test and chair sit-and-reach test, physical function was measured with the Timed Up and Go test, cognitive function was assessed using the Mini Mental State Examination, cognitive impairment was evaluated with the Montreal Cognitive Assessment, verbal fluency was tested with the Isaac test, and executive functions were assessed using the Trail Making Test. Results: The results of the study show significant improvements in both physical and cognitive aspects, such as balance, gait, upper and lower body strength, flexibility, physical function, cognitive function, cognitive impairment, verbal fluency, and executive functions in the group that carried out the intervention compared to the control group. Conclusion: A combined program for older individuals with mild cognitive impairment leads to enhancements in physical and cognitive health. These improvements underscore the importance of integrating physical exercise with cognitive training as an effective strategy for enhancing overall health and quality of life in older adults.
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    Associations between the impact of menopausal symptoms and fall-related self-efficacy
    (Lippincott, 2023-04-01) Espírito-Santo, João; Marques de Loureiro, Nuno Eduardo; Brandão Loureiro, Vânia; Aibar-Almazán, Agustín; Hita-Contreras, Fidel
    Objective: To analyze the association between the severity of menopausal symptoms and two important fall risk factors, namely balance confidence and fear of falling, among Portuguese and Spanish postmenopausal women aged ≥ 65 years. Methods: A cross-sectional, observational study was conducted on 363 women (66.21 ± 9.00 years) from several Portuguese and Spanish locations. The Menopause Rating Scale (MRS) was used to evaluate the severity of menopausal symptoms, while the Falls Efficacy Scale-International and Activities-specific Balance Confidence Scale-16 items were used to assess balance confidence and fear of falling, respectively. Anxiety and depression (evaluated by the Hospital Anxiety and Depression Scale), age, time since the onset of menopause, body mass index (BMI), history of falls, osteoporosis, smoking habit, physical activity level, and nocturia were considered as potential confounders. Independent associations were analyzed after adjusting for potential confounding variables. Student’s t test, bivariate correlations and multivariate linear regression analysis were performed. Results: A total of 363 women (66.21 ± 9.00 years) participated in the study, 192 from Portugal and 171 from Spain. Linear regression analysis indicates that more severe menopausal symptoms at a somato-vegetative level (beta coefficient (β) = -0.25; 95% confidence interval (95% CI):-2.09 to -0.81; p = <0.001), a higher BMI (β = -0.16; 95% CI:-1.22 to -0.22; p = 0.005), and osteoporosis (β = 0.14; 95% CI: 1.36 to 10.08; p = 0.010) were associated with lower balance confidence values. On the other hand, a higher score in the MRS somato-vegetative domain (β = 0.22; 95% CI: 0.27 to 0.79; p = <0.001), depression (β = 0.36; 95% CI: 0.59 to 1.08; p = <0.001), and years after the menopause onset (β = 0.15; 95% CI: 0.04 to 0.22; p = 0.006) were linked to increased fear of falling. Conclusions: The findings of our study show that, after taking into account possible confounders, increased severity of menopausal symptoms at a somatic level was associated with heightened fear of falling and diminished balance confidence.
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    Alteration of Postural Balance in Patients with Fibromyalgia Syndrome-A Systematic Review and Meta-Analysis
    (MDPI, 2021-01-15) Núñez-Fuentes, David; Obrero, Esteban; Zagalaz, Noelia; Ibáñez-Vera, Alfonso Javier; Achalandabaso-Ochoa, Alexander; López-Ruiz, María del Carmen; Rodríguez-Almagro, Daniel; Lomas, Rafael
    Balance problems are one of the most frequent symptoms in patients with Fibromyalgia Syndrome (FMS). However, the extent and nature of this balance disorder are not known. The objective of this work was to determine the best evidence for the alteration of postural balance in patients with FMS and analyze differences with healthy controls. To meet this objective, a systematic review with meta-analysis was performed. A bibliographical search was carried out in PubMed Medline, Scopus, Web of Science, CINAHL and SciELO. Observational studies that assessed postural balance in patients with FMS compared to healthy subjects in baseline conditions, were selected. In a random-effect model, the pooled effect was calculated with the Standardized Mean Difference (SMD) and its 95% confidence interval (CI). Nineteen studies reporting data of 2347 participants (95% female) were included. FMS patients showed poor balance with a large effect on static (SMD = 1.578; 95% CI = 1.164, 1.992), dynamic (SMD = 0.946; 95% CI = 0.598, 1.294), functional balance (SMD = 1.138; 95% CI = 0.689, 1.588) and on balance confidence (SMD = 1.194; 95% CI = 0.914, 1.473). Analysis of the Sensory Organization Test showed large alteration of vestibular (SMD = 1.631; 95% CI = 0.467, 2.795) and visual scores (SMD = 1.317; 95% CI = 0.153, 2.481) compared to healthy controls. Patients with FMS showed worse scores for different measures of postural balance compared to healthy controls. Concretely, FMS patients appear to have poor vestibular and visual scores with a possible somatosensory dependence.
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    Digital and Interactive Health Interventions Minimize the Physical and Psychological Impact of Breast Cancer, Increasing Women's Quality of Life: A Systematic Review and Meta-Analysis
    (MDPI, 2022-08-26) Obrero Gaitán, Esteban; Cortés Pérez, Irene; Calet Fernández, Tania; García López, Héctor; López Ruiz, María del Carmen; Osuna Pérez, María Catalina
    Digital and interactive health interventions (DIHIs), such as virtual-reality-based therapy (VRBT) and smartphone-app-based therapy (SABT), may be useful for reducing the impact of the signs and symptoms of breast cancer (BC) in women. The aim of this meta-analysis was to explore the effect of DIHIs on improving pain, anxiety, depression, quality of life (QoL), and upper extremity (UE) disability-related lymphedema in women with BC. Methods: We searched PubMed Medline, Web of Science, Scopus, CINAHL, Physiotherapy Evidence Database, and SciELO for the period ending February 2022. We included studies that assessed the effect of DIHIs on UE motor disability, pain, anxiety, depression, and QoL in women with BC. The effect size was calculated using Cohen's standardized mean difference (SMD) and its 95% confidence interval (95% CI). Results: Twenty studies providing data from 1613 women with BC were included. With respect to UE disability, DIHIs increased flexion (SMD, 1.92; 95%CI: -1.16, 2.68), abduction (SMD, 1.66; 95%CI: 0.91, 2.42), external rotation shoulder range of motion (SMD, 1.1; 95%CI: 0.36, 1.85), UE function (SMD, -0.72; 95%CI: -1.31, -0.13), and handgrip strength (SMD, 0.4; 95%CI: 0.21, 0.59). DIHIs reduced pain (SMD, -0.8; 95%CI: -1.31, -0.26), anxiety (SMD, -1.02; 95%CI: -1.71, -0.34), and depression (SMD, -1.57; 95%CI: -3.1, -0.08). Finally, DIHIs increased overall health (SMD, 0.6; 95%CI: 0.31, 0.89). Conclusions: Right at the end of therapy, DIHIs are effective at improving UE function, pain, anxiety, depression, and QoL in women with BC. VRBT has a greater effect than SABT for the assessed outcomes.
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    Optimal dose and type of exercise to reduce pain, anxiety and increase quality of life in patients with fibromyalgia. A systematic review with meta-analysis.
    (Frontiers, 2023-04-12) Rodríguez Almagro, Daniel; Del Moral García, María; López Ruiz, María del Carmen; Cortés Pérez, Irene; Obrero Gaitán, Esteban; Lomas Vega, Rafael
    The aim of our meta-analysis was to compile the available evidence to evaluate the effect of physical exercise-based therapy (PEBT) on pain, impact of the disease, quality of life (QoL) and anxiety in patients with fibromyalgia syndrome (FMS), to determine the effect of different modes of physical exercise-based therapy, and the most effective dose of physical exercise-based therapy for improving each outcome. A systematic review and meta-analysis was carried out. The PubMed (MEDLINE), SCOPUS, Web of Science, CINAHL Complete and Physiotherapy Evidence Database (PEDro) databases were searched up to November 2022. Randomized controlled trials (RCTs) comparing the effects of physical exercise-based therapy and other treatments on pain, the impact of the disease, QoL and/or anxiety in patients with FMS were included. The standardized mean difference (SMD) and a 95% CI were estimated for all the outcome measures using random effect models. Three reviewers independently extracted data and assessed the risk of bias using the PEDro scale. Sixty-eight RCTs involving 5,474 participants were included. Selection, detection and performance biases were the most identified. In comparison to other therapies, at immediate assessment, physical exercise-based therapy was effective at improving pain [SMD-0.62 (95%CI, -0.78 to -0.46)], the impact of the disease [SMD-0.52 (95%CI, -0.67 to -0.36)], the physical [SMD 0.51 (95%CI, 0.33 to 0.69)] and mental dimensions of QoL [SMD 0.48 (95%CI, 0.29 to 0.67)], and the anxiety [SMD-0.36 (95%CI, -0.49 to -0.25)]. The most effective dose of physical exercise-based therapy for reducing pain was 21-40 sessions [SMD-0.83 (95%CI, 1.1--0.56)], 3 sessions/week [SMD-0.82 (95%CI, -1.2--0.48)] and 61-90 min per session [SMD-1.08 (95%CI, -1.55--0.62)]. The effect of PEBT on pain reduction was maintained up to 12 weeks [SMD-0.74 (95%CI, -1.03--0.45)]. Among patients with FMS, PEBT (including circuit-based exercises or exercise movement techniques) is effective at reducing pain, the impact of the disease and anxiety as well as increasing QoL. Systematic Review Registration: PROSPERO https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021232013.
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    Recreational physical activity reduces breast cancer recurrence in female survivors of breast cancer: A meta-analysis
    (Elsevier, 2022-08) Zagalaz-Anula, Noelia; Mora-Rubio, María José; Obrero-Gaitán, Esteban; Del-Pino-Casado, Rafael
    Purpose: The aim of this review was to systematically collect the published evidence to assess the effect of recreational physical activity (PA) in reducing breast cancer (BC) recurrence in female survivors. Methods: A bibliographic search was carried out in PubMed Medline, CINAHL Complete, Scopus and Lilacs until June 2021. We selected observational studies or clinical trials comprising women diagnosed with BC, in which the risk of recurrence of BC was measured before or after performing recreational PA. As a secondary outcome, we analyzed disease free survival for recurrence/disease-specific mortality. The methodological quality of observational studies was assessed with the Newcastle-Ottawa Scale and clinical trials with the PEDro scale. A random effects model was used to estimate the relative risks (RR) and their 95% confidence intervals (CI) to infer the results for any female survivor of BC. We performed separate meta-analyses for prediagnosis and postdiagnosis recreational PA. Results: Eleven studies were included, providing data from 29,677 surviving women with BC with an age range of 18-79 years old. Postdiagnosis recreational PA reduced the risk of BC recurrence by 16% (RR, 0.84; 95% CI: 0.78 to 0.91) and the risk of recurrence/disease-specific mortality by 23% (RR, 0.77; 95% CI: 0.66 to 0.93). Prediagnosis PA reduced the risk of BC by 18% (RR, 0.82; 95% CI: 0.74 to 0.91). Conclusion: This systematic review with meta-analysis shows that recreational PA can be an interesting therapeutic tool to protect against recurrence of BC in female survivors.
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    Nintendo Wii Balance Board therapy for postural control in children with cerebral palsy: a systematic review and metaanalysis
    (WILEY, 2021-11) Montoro-Cárdenas, Desirée; Cortés-Pérez, Irene; Zagalaz-Anula, Noelia; Osuna-Pérez, María Catalina; Obrero-Gaitán, Esteban; Lomas-Vega, Rafael
    Aim: To analyse the efficacy of Nintendo Wii therapy (NWT) on functional balance in children with cerebral palsy (CP). Method: A systematic review with meta-analysis (PROSPERO identification number CRD42020169510) was performed using randomized controlled trials (RCTs) that examined the effect of NWT on functional, dynamic, and static balance in children with CP, assessed with the Pediatric Balance Scale, the Timed Get Up and Go Test, and the One Leg Stance Test respectively. The pooled effect was calculated using the Cohen's standardized mean difference (SMD). Results: Eleven RCTs with 270 children (when sex was reported: 43% females, 57% males) with CP (mean age [SD] 10y 1mo [1y 1mo], range 5-16y) were included. On functional balance, we found very low-quality evidence with a large effect of NWT compared with no intervention (SMD 0.95, 95% confidence interval [CI] 0.02-1.89) and moderate-quality evidence for using NWT plus conventional physical therapy (CPT) versus CPT (SMD 0.78, 95% CI 0.20-1.35) in sessions of approximately 30 minutes (SMD 0.86, 95% CI 0.20-1.52) and interventions lasting longer than 3 weeks (SMD 1.03, 95% CI 0.58-1.47). For dynamic balance, very low-quality evidence for a medium effect for using NWT plus CPT versus CPT (SMD 0.70, 95% CI 0.12-1.29) was found. Interpretation: NWT can be considered an effective treatment for improving functional and dynamic balance in children with CP, especially when combined with CPT in 30-minute sessions with interventions lasting longer than 3 weeks. What this paper adds Moderate-quality evidence with a large effect of Nintendo Wii therapy (NWT) on functional balance, compared with conventional physical therapy (CPT). Moderate-quality evidence with medium effect of NWT plus CPT on functional and dynamic balance, compared with CPT. Appropriate NWT sessions should be equal to or slightly less than 30 minutes. NWT interventions must be longer than 3 weeks.
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    Transcultural Adaptation and Validation of the Fonseca Anamnestic Index in a Spanish Population with Temporomandibular Disorders
    (MDPI, 2020-10-09) Sánchez-Torrelo, Carmen María; Zagalaz-Anula, Noelia; Alonso-Royo, Roger; Ibáñez-Vera, Alfonso Javier; López-Collantes, Jesús; Rodríguez-Almagro, Daniel; Obrero-Gaitán, Esteban; Lomas-Vega, Rafael
    Background: The Fonseca Anamnestic Index (FAI) offers a simple method to screen temporomandibular disorders (TMD). This study aimed to validate the Spanish version of the FAI in patients with TMD. Methods: The sample consisted of 125 subjects (66 TMD and 59 controls) aged over 18 years. Construct validity, internal consistency, test-retest reliability, concurrent validity and capacity to discriminate between TMD and healthy subjects were analyzed. Results: The Spanish version of the FAI showed a structure formed by three factors. Cronbach's alpha was 0.826. The reliability of the items varied between substantial to almost perfect and was excellent for the total score (intraclass correlation coefficient = 0.937). The standard error of measurement (SEM) was 6.52, with a minimum detectable change (MDC) of 12.78. FAI score showed a significant correlation with headache, neck pain and vertigo measurements. A cut-off point >35 showed a sensitivity = 83.33% and a specificity = 77.97% in differentiating between healthy and TMD patients, with an area under the curve (AUC) = 0.865. Conclusions: The Spanish version of the FAI is a valid and reliable instrument for diagnosing people with TMD, with appropriate general clinimetric properties. Discrimination between patients with and without TMD is excellent.
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    Corrective exercise-based therapy for adolescent idiopathic scoliosis: Systematic review and meta-analysis.
    (SAGE, 2022) Gámiz-Bermúdez, Francisca; Obrero-Gaitán, Esteban; Zagalaz-Anula, Noelia; Lomas-Vega, Rafael
    Abstract Objective: to analyse the efficacy of Corrective exercise-based therapy in the improvement of deformity and quality of life in adolescent idiopathic scoliosis. Data Sources: PubMed Medline, Scopus, Web of Science, Physiotherapy Evidence Database, CINAHL Complete and SciELO, until June 2021. Review methods: Randomized controlled trials was selected, including participants diagnosed with adolescent idiopathic scoliosis, in which the experimental group received Corrective exercise-based therapy. Two authors independently searched the scientific literature in the data sources, extracted the data and assessed the risk of bias. A pairwise meta-analysis using the random-effects model was performed. Results: Eight randomized controlled trials providing data from 279 adolescent idiopathic scoliosis patients were included. Seven randomized controlled trials including 236 patients showed moderate-quality evidence for a medium effect (SMD=-0.52, 95% CI -0.96 to -0.1), favouring corrective exercise-based therapy for spinal deformity reduction. Corrective exercise-based therapy was better than no intervention (SMD=-0.59, 95% CI -1.18 to -0.01) but similar to other intervention (SMD=-0.2, 95% CI -0.67 to 0.27), and a medium effect was found (SMD=-0.51, 95% CI -0.89 to -0.13) when corrective exercise-based therapy was used with other therapies. Four studies including 151 patients showed low-quality evidence of a large effect of Corrective exercise-based therapy on Scoliosis Research Society measurement (SRS-22) total score improvement (SMD=1.16, 95% CI 0.36 to 1.95). Conclusion: In mild and moderate adolescent idiopathic scoliosis patients, corrective exercise-based therapy could be used to reduce spinal deformity and to improve quality of life as isolated treatment or as coadjuvant treatment combined with other therapeutic resources.
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    Intracellular signaling pathways involved in the cell growth inhibition of glioma cells by melatonin.
    (American Association for Cancer Research, 2006) Martín-Fernández, Vanesa; Carrera-González, Pilar; Antolín, Isaac; Rodríguez-Sánchez, María Carmen; García-Santos, Guillermo; Rodríguez-Blanco, Jezabel; Herrera-García, Federico
    Melatonin is an indolamine mostly produced in the pineal gland, soluble in water, and highly lipophilic, which allows it to readily cross the blood-brain barrier. Melatonin possesses antioxidant properties and its long-term administration in rodents has not been found to cause noteworthy side effects. In the present work, we found that millimolar concentrations of this indolamine reduced cell growth of C6 glioma cells by 70% after 72 hours of treatment, inhibiting cell progression from G1 to S phase of the cell cycle. Intraperitoneal administration of 15 mg/kg body weight of melatonin to rats previously injected in the flank with C6 glioma cells reduces tumor growth by 50% 2 weeks after the implant. Inhibition of cell growth does not depend on melatonin membrane receptor activation whereas it seemingly relates to the reduction of intracellular basal free radical levels by 30%. Increase of basal redox state of the cells and constitutive activation of tyrosine kinase receptor [receptor tyrosine kinase (RTK)] pathways, including the extracellular signal-regulated kinase 1/2 (ERK1/2) and the Akt and protein kinase C (PKC) signaling pathways, contribute to the progression of the gliomas leading to the constitutive activation of the redox-dependent survival transcription factor nuclear factor KB (NF-KB). The antioxidant effect of melatonin in C6 cells is associated to inhibition of NFKB and Akt, but not of ERK1/2. The antiproliferative effect of the indolamine on these cells is partially abolished when coincubated with the PKC activator 12-O-tetradecanoylphorbol-13-acetate, thus indicating that the ability of melatonin to change cellular redox state may be inactivating the pathway RTK/PKC/Akt/NF-KB.