Andrés Catena

Introduction: A magnetic resonance image (MRI) study recently described greater improvements in gray matter volume and cortical thickness in post‐stroke patients with upper‐limb spasticity treated with surgery versus botulinum toxin‐A (BoNT‐A). Objective: To compare changes in the white matter of these patients after surgical versus BoNT‐A treatment and to relate findings to upper‐limb function and quality‐of‐life. Methods: In a two‐arm randomized controlled clinical trial, 30 post‐stroke patients (>12 months) with spastic upper limbs were recruited and randomly assigned (1:1) to surgery or BoNT‐A treatment (controls). Functional and quality‐of‐life parameters were studied at baseline (pre‐intervention) and at 6 months, while brain MRI scans of the white matter were taken at the same time points using a Siemens 3T Prisma MRI scanner. Although baseline MRI scans were obtained in all 30 participants, complete longitudinal MRI data were available for only 14 participants because of contraindications or refusal of follow‐up imaging. Therefore, the imaging analyses were considered only exploratory and hypothesis‐generating. Results: Increased post‐ versus pre‐surgery fractional anisotropy (FA) values were associated with Carer Burden and House functional scale scores, and decreased FA values with Ashworth, Fugl‐Meyer, pain visual analogue scale, and SF‐36 scores. Reduced mean diffusivity (MD) values for inferior fronto‐occipital fasciculus, cingulum parahippocampal parietal, uncinate fasciculus, and reticular tract were associated with improvements in Fugl‐Meyer motor recovery scores. Conclusion: The post–pre increase in FA of white matter tracts in the experimental versus control group may suggest differences in white matter microstructure between treatment groups, potentially reflecting neuroplastic changes. These findings suggest that changes in white matter microstructure might be associated with improvements in motor function, independence, and caregiver burden. However, given the small longitudinal MRI sample, the tract‐specific findings should be considered hypothesis‐generating and require confirmation in larger studies.

Background: In acute coronary syndrome the time elapsed between the start of symptoms and the moment the patient receives treatment is an important determinant of survival and subsequent recovery. However, many patients do not receive treatment as quickly as recommended, mostly due to substantial prehospital delays such as waiting to seek medical attention after symptoms have started. Objective: To conduct a systematic review with meta-analysis of the relationship between nine frequently investigated psychological and cognitive factors and prehospital delay. Design: A protocol was preregistered in PROSPERO [CRD42018094198] and a systematic review was conducted following PRISMA guidelines. Data sources: The following databases were searched for quantitative articles published between 1997 and 2019: Medline (PubMed), Web of Science, Scopus, Psych Info, PAIS, and Open grey. Review methods: Study risk of bias was assessed with the NIH Quality Assessment Tool for Observational, Cohort, and Cross-Sectional Studies. A best evidence synthesis was performed to summarize the findings of the included studies. Results: Forty-eight articles, reporting on 57 studies from 23 countries met the inclusion criteria. Studies used very diverse definitions of prehospital delay and analytical practices, which precluded meta-analysis. The best evidence synthesis indicated that there was evidence that patients who attributed their symptoms to a cardiac event (n = 37), perceived symptoms as serious (n = 24), or felt anxiety in response to symptoms (n = 15) reported shorter prehospital delay, with effect sizes indicating important clinical differences (e.g., 1.5–2 h shorter prehospital delay). In contrast, there was limited evidence for a relationship between prehospital delay and knowledge of symptoms (n = 18), concern for troubling others (n = 18), fear (n = 17), or embarrassment in asking for help (n = 14). Conclusions: The current review shows that symptom attribution to cardiac events and some degree of perceived threat are fundamental to speed up help-seeking. In contrast, social concerns and barriers in seeking medical attention (embarrassment or concern for troubling others) may not be as important as initially thought. The current review also shows that the use of very diverse methodological practices strongly limits the integration of evidence into meaningful recommendations. We conclude that there is urgent need for common guidelines for prehospital delay study design and reporting

Background Individuals with cancer often experience stress throughout the cancer trajectory and have a high risk of experiencing depression.Objective The aim of this study was to examine the relationship between allostatic load (AL), a measure of cumulative stress-related physiologic dysregulation of different body systems, and symptoms of depression in cancer survivors.Methods Participants were 294 adult cancer survivors from the US National Health and Nutrition Examination Survey (NHANES 2007-2018). Allostatic load was measured using 14 indicators representing cardiometabolic risk, glucose metabolism, cardiopulmonary functioning, parasympathetic functioning, and inflammation. Depressive symptoms were measured with the Patient Health Questionnaire-9. The relationship between AL and depressive symptoms was investigated using multiple regression adjusted for diverse sociodemographic and diagnosis variables.Results Higher AL was associated with higher depressive symptom scores. The higher risk of depression was concentrated among those survivors in the highest AL quartile, with 21% (95% confidence interval, 11%-32%) of survivors presenting a high risk of depression compared with 8% to 11% of survivors in the lower quartiles. In exploratory analyses, the relationship between AL and depressive symptoms was only significant among survivors with a lower income. In contrast, in survivors in the highest income group, depressive symptoms were lower and unrelated to AL.Conclusion High AL is associated with more depressive symptoms among cancer survivors.Implications for Practice Nurses have an important role in identifying psychological distress in cancer patients and survivors. Further research is needed to investigate the usefulness of AL as a marker in the context of cancer follow-up care and screening for psychological distress.

Objective: People's beliefs about cancer can affect the actions they take to prevent and detect the disease. We investigated socio‐economic inequalities in beliefs about cancer and its causes in the general population.Methods: We analyzed data from the representative probabilistic Spanish Oncobarometer survey (N = 4769, 2020) and the non‐probabilistic weight‐corrected Spanish Cancer Awareness Survey (N = 1029, 2022). Beliefs about cancer, recognition of cancer symptoms, and recognition of risk factors were measured with the Awareness and Beliefs about Cancer questionnaire. Endorsement of mythical causes was measured with the CAM‐Mythical Causes questionnaire. The effects of socio‐economic status (SES) were investigated in multiple regression analyses adjusted for age, sex, and personal and family cancer history.Results: Individuals with lower SES were more likely to endorse pessimistic beliefs (e.g., “cancer is a death sentence”), and less likely to endorse optimistic beliefs about cancer (e.g., “people with cancer continue with normal activities”). Individuals with lower SES also recognized fewer cancer symptoms and risk factors and endorsed more mythical causes of cancer. The gap in knowledge regarding cancer causes was wider among people with low SES, who were more likely to endorse several mythical causes than some established risk factors included in cancer prevention recommendations.Conclusions: Socio‐economic inequalities in beliefs about cancer are robust and multidimensional and indicate worse preparedness to act against the disease among lower socio‐economic groups. Differences in beliefs about disease outcomes and causes are likely one of the multiple contributors to cancer disparities and should be targeted and monitored in prevention efforts.

Autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD) are the most prevalent neurodevelopmental disorders. There is a growing body of literature investigating factors affecting quality of life in families (FQoL) with a child with these disorders. However, there are no studies that trace their knowledge anatomy. Thus, we conducted a scientometric analysis to describe this literature, detect certain variables that could be related to FQoL, and identify tendencies and open questions for future research. A literature search in the Web of Science, PubMed, and Scopus was run and identified 3281 publications published between 1975 and 2022. The results suggest an increase in the quantity of publications on FQoL in ASD and ADHD over the last few years (14% and 12%, respectively). For both research fields, the USA published the highest number of documents, showing that the production related to ADHD and FQoL is concentrated in just a few countries. Thematic analysis revealed several clusters, considering quality of life and children as core themes that are still setting trend lines. Moreover, it would be worthwhile to describe and analyze FQoL not only during the childhood of children with ASD and ADHD but also during their adolescence. Impact Although the relationship between family quality of life and neurodevelopmental disorders could be considered novel, there is a growing interest from an interdisciplinary perspective. Family quality of life should be monitored not only during the childhood of children with ASD and ADHD, but also during their adolescence and adulthood. The analysis of the family quality of life in first-degree relatives and its relationship with protective factors (e.g., resilience and social support) should be explored in future studies.

Background. The main purpose of this study was to determine the effects of a high-intensity interval training (HIIT) intervention in the context of moderate alcohol consumption on cognitive performance in healthy young adults. Methods. We conducted a 10-week HIIT program along with four types of beverages with/without alcohol content. A total of 75 healthy adults (18–40 years old; 46% female) were allocated to either a control Non-Training group or an HIIT program group (2 days/week). Using block randomization, participants in the HIIT group were further allocated to an HIIT-Alcohol group (alcohol beer or sparkling water with vodka added, 5.4%) or an HIIT-NonAlcohol group (sparkling water or non-alcohol beer, 0.0%). The control group was instructed to maintain an active lifestyle but did not undergo any regular training. A comprehensive neuropsychological battery was used to evaluate cognitive performance (i.e., memory, working memory, processing speed, inhibitory control, and verbal fluency). Changes from baseline to week 10 were included in the main analyses. Results. All groups improved in all neuropsychological measures (all p ≤ 0.001), independent of sex and alcohol consumption, with no statistical differences between groups (all p > 0.05). Furthermore, larger increases in maximal oxygen uptake were associated with greater improvements in processing speed, inhibitory control, and verbal fluency (all p < 0.050). Conclusions. Although the improvements found in cognitive performance cannot be attributed to the HIIT intervention, no significant impairments in cognitive functions were noted due to moderate alcohol intake. Furthermore, our results confirmed that exercise-induced physical fitness improvements were associated with cognitive performance enhancements in young healthy adults.

Objectives: To examine the relationship between sleep and subcortical brain structures using a shape analysis approach. Methods: A total of 98 children with overweight/obesity (10.0 ± 1.1 y, 59 boys) were included in the cross-sectional analyses. Sleep behaviors (i.e., wake time, sleep onset time, total time in bed, total sleep time, sleep efficiency, and wakening after sleep onset) were estimated with wrist-worn accelerometers. The shape of the subcortical brain structures was acquired by magnetic resonance imaging. A partial correlation permutation approach was used to examine the relationship between sleep behaviors and brain shapes. Results: Among all the sleep variables studied, only total time in bed was significantly related to pallidum and putamen structure, such that those children who spent more time in bed had greater expansions in the right and left pallidum (211–751 voxels, all p’s p = 0.03). Conclusions: These findings suggest that more time in bed was related to expansions on two subcortical brain regions in children with overweight/obesity.

The aim of this study was to analyze the long-term marginal bone level (MBL) of implants supporting fixed full-arch restoration in patients who had previously lost their dentition due to severe periodontitis. This retrospective study included 35 patients in whom 342 implants with internal tapered conical connections were placed. MBL was analyzed radiographically over time and a long-term estimation of MBL was calculated. A mixed linear model with abutment height, graft, diameter and location (maxilla/mandible) as factors and gender, age, implant length and prosthetic variables as covariates was used to evaluate the influence on MBL. MBL in these patients showed an estimator of predictions at 4108 days after loading of −0.307 mm, SE = 0.042. Only 0.15% of implants were radiographically affected with MBL of 3 mm or more. The mixed linear model results showed a main effect of the type of opposing dentition, gender, implant diameter, and abutment height. Particularly, an abutment height of 1 mm had associated larger MBL than the remaining heights. Thus, it can be concluded that dental implants restored with fixed segmented full-arch rehabilitation in patients with a history of severe periodontal disease do not suffer important marginal bone loss if some specific factors are considered, mainly the use of long transmucosal abutments (≥2 mm).