DE. Artículos del Departamento de Enfermería y Fisioterapia

Effects of minimalist footwear on postural stability, plantar footprint, and safety in healthy adults: a single-blind randomized clinical trial

2026-08-31T00:02:02Z

This study evaluated the long-term changes induced by wearing minimalist footwear (MF) during activities of daily living (ADLs) on the plantar footprint and postural stability in healthy adults. In this randomized clinical trial, a total of 95 healthy adults were recruited; 90 participants completed the protocol and were analyzed in either an experimental group (EG, n = 45), which wore MF for at least 5 h per day over a 6-month period, or a passive control group (CG, n = 45). Plantar pressure distribution (forefoot, rearfoot, and total contact areas), static stability (center of pressure (CoP) displacement under open-eyes and closed-eyes conditions), and dynamic stability (forward reach test) were assessed using a force platform at baseline and post-intervention. A self-reported questionnaire and an adverse event record were also completed by the EG. Statistical analysis was carried out using a repeated-measures analysis of variance (ANOVA) and a paired Student’s t-test; statistical significance level was set at p < 0.05. The Group × Time interaction analysis revealed no statistically significant between-group differences across the evaluated parameters. However, within-group analysis showed a significant increase in CoP displacement under the open-eye condition in the CG (𝑝=0.037), indicating a decline in baseline postural efficiency, whereas the EG maintained structural and posturographic stability. Regarding user feedback, comfort (44.4%) was highlighted as the primary advantage, aesthetics (77.8%) was the main drawback, and 70% of the participants intended to continue using MF. Only two minor, transient adverse events were recorded. In conclusion, a 6-month program of MF use during ADLs did not produce any statistically significant changes in plantar footprint or stability in healthy adults.

Neuromuscular electrical stimulation protocols for glycaemic control in adults with type 2 diabetes mellitus: a systematic review

2026-08-31T00:01:59Z

Neuromuscular electrical stimulation (NMES) has emerged as a potential alternative or adjunctive intervention for individuals with type 2 diabetes mellitus (T2DM) who experience barriers to conventional exercise participation. This systematic review aimed to synthesise NMES protocols and evaluate their effects on glycaemic outcomes in adults with T2DM. A systematic review was conducted according to PRISMA 2020 recommendations and registered in PROSPERO (CRD420251006814). PubMed/MEDLINE, EMBASE, CENTRAL, Scopus and Google Scholar were searched from inception to January 2026. Interventional studies evaluating NMES-induced skeletal muscle contractions and reporting glycaemic outcomes in adults with T2DM were included. Because of substantial clinical and methodological heterogeneity, findings were synthesised without meta-analysis using a structured Synthesis Without Meta-analysis (SWiM)-informed approach. Ten studies involving 163 participants met the eligibility criteria. Acute NMES interventions consistently attenuated postprandial or short-term CGM-derived glucose responses, whereas chronic effects on fasting glucose and HbA1c were more variable. Favourable outcomes were more frequently observed in studies using stimulation of large lower-limb muscle groups and greater cumulative exposure. NMES was generally safe, well tolerated and associated with high adherence. NMES may improve glycaemic regulation in adults with T2DM; however, adequately powered sham-controlled trials with standardised protocols remain necessary.

Effects of physical exercise, cognitive stimulation, and their combination on mobility, cognitive function, and psychosocial well-being in older adults residing in long-term care: protocol for a randomised controlled trial

2026-08-27T00:02:32Z

Background/Objectives: Older adults residing in long-term care frequently experience multimorbidity, low habitual activity, mobility decline, executive dysfunction, and reduced quality of life. Evidence separating the effects of exercise, cognitive stimulation, and their combination remains limited. The primary objective of this trial is to determine whether a 12-week combined physical exercise plus cognitive stimulation programme improves executive function, functional mobility, and health-related quality of life compared with usual care. Secondary objectives are to estimate the effects of each single-component programme, compare the combined programme with each component, and examine maintenance at six months. Methods: This is a four-arm, parallel-group, assessor-blinded randomised controlled trial in Portuguese long-term care facilities. A total of 140 residents aged 65 years or older, residing in long-term care for at least three months and able to provide informed consent, will be allocated 1:1:1:1 to supervised multicomponent exercise, group cognitive stimulation, combined exercise plus cognitive stimulation, or usual care. Active programmes will be delivered three times weekly for 12 weeks. Assessments are planned at baseline, post-intervention, and six-month follow-up according to the prespecified schedule. Primary outcomes are the Stroop interference score, Timed Up and Go time, and EQ-5D-5L index value at 12 weeks. Analyses will follow the intention-to-treat principle using mixed-effects models; multiplicity across the three primary endpoints will be controlled using Holm’s procedure, and interaction analyses will be exploratory and hypothesis-generating. Results: Recruitment and data collection had not started at manuscript submission; therefore, no participant data are reported. Conclusions: The trial will estimate the effects of the combined programme versus usual care and provide exploratory comparative evidence on the single-component programmes in real-world long-term care.

Central sensitization in psoriatic arthritis: prevalence, clinical correlates, and association with therapeutic refractoriness in an unselected cohort excluding fibromyalgia

2026-08-27T00:02:34Z

Background: Central sensitization (CS) contributes to persistent pain in psoriatic arthritis (PsA), yet its prevalence, independent predictors, and association with therapeutic refractoriness remain incompletely characterized across disease phenotypes. Objectives: To evaluate CS prevalence and clinical correlates in unselected PsA patients excluding fibromyalgia, with emphasis on predictors, multidimensional pain phenotypes, and the association between CS and therapeutic refractoriness. Design: Cross-sectional observational study. Methods: A total of 228 consecutive PsA patients were recruited from April to November 2025 at a single tertiary center. Patients with fibromyalgia (2016 modified ACR criteria, systematically screened) were excluded. CS was assessed using the Central Sensitization Inventory (CSI ⩾40). Disease activity, functionality, pain phenotypes (PAIN DETECT questionnaire (PDQ)), sleep quality (Pittsburgh Sleep Quality Index), depression and anxiety (Hospital Anxiety and Depression Scale), and physical activity (International Physical Activity Questionnaire) and therapeutic refractoriness were systematically measured. Binary and linear regression analyses identified independent predictors of CS. Results: CS was present in 35.1% of patients. CS was associated with higher disease activity indices (Clinical Disease Activity Index for Psoriatic Arthritis: 14 vs 9.8, p = 0.001; Ankylosing Spondylitis Disease Activity Score with C-reactive protein: 4.8 vs 1.8, p = 0.007), greater functional disability (Health Assessment Questionnaire—Disability Index: 0.8 vs 0.2, p = 0.001), increased neuropathic pain (55.6% vs 8.2%, p = 0.001), and notably higher prevalence of therapeutic refractoriness (61.5% vs 6.8%, p = 0.003). Independent predictors of CS presence were depression severity (HADS-D: odds ratio (OR) = 1.32, p = 0.01), poor sleep quality (Pittsburgh Sleep Quality Index: OR = 1.21, p = 0.001), and PDQ (OR = 1.07, p = 0.03). Depression, sleep quality, and fatigue explained 47% of CS variance in linear regression. Conclusion: Approximately one-third of unselected PsA patients experience CS, which independently contributes to therapeutic refractoriness despite inflammatory control. Psychosocial factors—particularly sleep dysfunction and depression—emerge as robust predictors of CS. These findings support systematic CS screening in PsA patients with inadequate symptomatic response and highlight the need for integrated biopsychosocial interventions addressing both inflammatory and non-inflammatory pain mechanisms.

The role of morphology and function of intrinsic foot muscles in young handball players with chronic ankle instability

2026-07-31T00:01:28Z

Background Strong evidence shows the importance of intrinsic foot muscles (IFMs) in balance and foot and ankle biomechanics; despite this, not much research has been published regarding the role of IFMs on chronic ankle instability. The aim of the study was to compare IFMs morphology and function between young handball players with and without chronic ankle instability. The secondary objective was to assess the association between the morphology or function of the IFMs and the foot morphology. Methods Cross-sectional case-control study. A sample of 100 young handball players were recruited and divided into athletes with chronic ankle instability (case group, n = 50) and without (control group, n = 50). Main outcome measures: morphology and function of abductor hallucis, abductor digiti minimi, flexor hallucis brevis, flexor digitorum brevis and quadratus plantae, which were assessed with ultrasound examination at rest and in active contraction. Foot Posture Index-6 was used to analyze foot morphology. Results Significant differences were only found in the abductor hallucis morphology (case group CSA 2.14cm2, control group CSA 1.84cm2, p 0.013) and in the flexor hallucis brevis morphology (case group thickness 1.31 cm, control group thickness 1.41 cm, p 0.005). A significant but weak positive correlation was found between foot morphology and abductor hallucis function (r = 0.32, p = 0.025). Conclusions Between-groups differences were only found in abductor hallucis and flexor hallucis brevis morphology; no differences were found in the rest of IFMs morphology and function outcomes. A significant positive association was only found between foot morphology and AbH function in young athletes with CAI.

Assessment of muscle function decline and cachexia-related biomarkers in hospitalized oncology patients: study protocol

2026-07-11T00:01:50Z

[ENG]Background: Cancer cachexia and sarcopenia are highly prevalent complications affecting up to 50% of patients with cancer and are associated with increased treatment toxicity, poorer functional outcomes, and reduced survival. Early identification of muscle deterioration during hospitalization remains challenging. Objective: To evaluate the change in dominant-hand handgrip strength between hospital admission and discharge in hospitalized oncology patients. Methods: This prospective longitudinal study will evaluate hospitalized adults with confirmed malignancy and an expected hospital stay of ≥5 days. Daily handgrip strength and sEMG assessments will be performed as exploratory secondary measures to characterize temporal patterns of muscle function during hospitalization. Baseline and discharge evaluations will additionally include bioelectrical impedance analysis, validated patient-reported outcome measures (SARC-F, EORTC QLQ-C30, PSQI), and serum biomarkers related to inflammatory and nutritional status. Linear mixed models will be used to evaluate longitudinal changes and associations between functional, electrophysiological, and biochemical parameters. Expected results: The study aims to characterize trajectories of muscle function decline during hospitalization, identify candidate biomarker signatures for cachexia detection, and evaluate neuromuscular fatigue patterns using sEMG. Conclusions: This protocol proposes a feasible multimodal framework for monitoring skeletal muscle deterioration during acute oncology hospitalization and may inform future interventional strategies targeting cancer-related cachexia and sarcopenia.

Massage-Related changes in cortical activity and cerebral oxygenation in healthy term infants: an exploratory EEG-fNIRS study with sex-specific observations

2026-07-11T00:01:47Z

[ENG]Background: Central nervous system development is a rapid and highly plastic process during the first years of life. Tactile stimuli have been shown to induce cortical changes, but potential sex-related differences remain unexplored. This study aimed to investigate sex-specific differences in cortical activity and cerebral oxygenation in response to tactile stimulation via body massage. Methods: Four healthy full-term infants (two females and two males), all aged 11 weeks, were included in this prospective exploratory study. Each infant received a standardized 5 min massage protocol. Cortical activity and cerebral oxygenation were assessed using an 8-channel electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS) before, during, and after the intervention, with a 5 min pre-intervention resting period used as the baseline. Results: EEG analysis focused on a single spectral band (4 Hz–30 Hz). This range was selected to capture the main cortical oscillations in infants, including theta, alpha, and beta activity, while delta activity below 4 Hz was partially excluded to reduce movement and physiological artifacts. Standard infant EEG bands were considered when defining this range. Data shows for the female subject an average PSD of −6.726 (± −4.075), and for the male subject, −12.594 (± −10.741). Although babies are of the same gestational age, they exhibited distinct basal cortical activity, which prevented comparisons from being made. Nevertheless, massage induced similar activity patterns in all subjects with increased cortical electrical activity in the left parietal region relative to baseline. fNIRS data showed that comparable HbO concentration patterns between participants were observed only during the second minute of recording. Relative to baseline, pre-intervention HbO responses displayed an opposite distribution, and the effects of the intervention differed by sex. The female participant exhibited a slight reduction in activation in the right hemisphere accompanied by a modest increase in the most ventral region of the left hemisphere. Conversely, the male participant showed an inverse response pattern, characterized by a marked increase in right hemispheric activation and a pronounced decrease in the left hemisphere during the intervention period. Conclusions: These preliminary observations suggest the presence of early variations in cortical processing that warrant further investigation in larger samples, although they cannot be considered conclusive. While baseline response patterns differed between participants, both showed increased left parietal activity during tactile stimulation. The inversion of HbO responses between the pre-intervention and intervention phases points to potential sex-related differences in hemodynamic trajectories. Nevertheless, these results remain preliminary, and larger, well-powered studies are required to determine whether these patterns reflect stable, sex-dependent developmental changes.

Prevalence and predictors of kinesiophobia in psoriatic arthritis: the role of central sensitization and comorbidities

2026-07-11T00:01:44Z

[ENG]Background – Kinesiophobia (excessive fear of movement due to belief of injury) is highly prevalent in rheumatologic diseases, yet its prevalence and associations in psoriatic arthritis (PsA) remain unexplored. Objective – To determine the prevalence of kinesiophobia in PsA and examine its associations with central sensitization (CS), demographic characteristics, disease activity, physical function, and patient-reported outcomes. Methods – Cross-sectional study of 246 consecutive PsA patients. Kinesiophobia was assessed using the Tampa Scale of Kinesiophobia-11. CS was measured by Central Sensitization Inventory (CSI). Disease activity, functional status, physical activity, sleep quality, anxiety, depression, and fatigue were systematically evaluated. Univariate and multivariable analyses (logistic and linear regression) were performed. Results – Kinesiophobia was present in 45.5% (112/246) of patients. Patients with kinesiophobia demonstrated significantly higher CSI scores (41.5 vs. 29; p < 0.001), reduced physical activity (1619.5 vs. 2, 970 MET-minutes/week; p = 0.01), greater disease activity (cDAPSA: 13 vs. 11; p = 0.001), functional impairment (HAQ-DI; p = 0.001), and increased comorbid anxiety and depression (p = 0.001). A significant correlation existed between kinesiophobia and CSI (r = 0.39; p < 0.001). In multivariable logistic regression, central sensitization (OR: 1.03; 95% CI: 1.00–1.05; p = 0.02) and sleep quality (PSQI; OR: 1.09; 95% CI: 1.00–1.1; p = 0.03) emerged as independent predictors, explaining 20% of kinesiophobia variance. In linear regression, these variables accounted for 12% of variance (R2 = 0.12). Conclusion – Kinesiophobia functions as an amplifier of pain perception and functional disability, particularly in patients with symptom-inflammation discordance. A bidirectional pathophysiologic relationship between kinesiophobia and CS likely perpetuates chronic pain and disability. Multidimensional interventions may enhance clinical outcomes in kinesiophobic PsA patients, especially those with high perceived impact despite adequate inflammatory control.

Obstructive sleep apnea in psoriatic arthritis: clinical characteristics and comorbidities

2026-07-11T00:01:41Z

[ENG]Background: Obstructive sleep apnea (OSA) is increasingly recognized in chronic inflammatory diseases, yet its prevalence and clinical correlates in psoriatic arthritis (PsA) remain poorly characterized. Objective: The objective of this study was to evaluate OSA prevalence and its relationship with disease activity, functional impairment, and comorbidities in PsA patients. Methods: A cross-sectional analysis of 247 consecutive PsA patients was conducted. OSA diagnosis was determined through medical record review. Disease activity was assessed using cDAPSA and ASDAS-CRP. Functional disability was measured using HAQ-DI and BASFI. Sleep quality (PSQI) and psychological symptoms (HADS) were evaluated. Inflammatory markers included CRP, IL-6, and TNF-α. Multivariable logistic regression identified independent predictors of OSA. Results: OSA prevalence was found to be 8.9% (22/247). OSA+ patients had significantly higher median age (58.0 vs. 54.0 years, p = 0.02), tender joint count (2.0 vs. 1.0, p = 0.002), functional disability (1.1 vs. 0.3, p = 0.001), fatigue (30.5 vs. 38.0, p = 0.04), anxiety (7.5 vs. 5.0, p = 0.03), depression (7.0 vs. 3.0, p = 0.004), and worse sleep quality (11.5 vs. 7.0, p = 0.001). Notably, no significant differences in inflammatory markers (CRP, swollen joints) were found between groups despite substantially higher pain burden in OSA+ patients. Female sex and greater tender joint count emerged as independent predictors of OSA. Conclusions: OSA occurs in ~9% of unselected PsA patients and is independently associated with functional disability, psychological distress, and elevated tender joint counts despite comparable inflammatory markers. This dissociation suggests that OSA drives pain amplification through non-inflammatory mechanisms. These findings support the use of systematic OSA screening in PsA patients with pain or disability disproportionate to inflammatory burden, particularly in those with psychological comorbidities.

Traumatic symptoms among syrian refugees in host countries: a comparative study of Jordan and Spain

2026-07-11T00:01:37Z

Background: Displaced individuals endure challenges, including conflict, forced migration, family separation, human rights violations, limited access to essential services, and increased exposure to violence and abuse. These hardships significantly impact their mental health, often leading to heightened trauma-related symptoms. Methods: We used a cross-sectional correlational design in refugee camps, homes, and centers across Jordan and Spain. 200 refugees with confirmed status in the past ten years were recruited. Demographic data were collected via a demographic form, the PTSD-8 Inventory assessed traumatic symptoms, and data analysis included descriptive statistics, independent t-tests, one-way ANOVA, and Chi-square tests. Results: Most participants had a secondary education, were unemployed, and had low incomes. PTSD symptoms were prevalent, with rates of recurrent thoughts (63.5%), re-experiencing events (57.5%), nightmares (50.5%), sudden reactions (56.5%), activity avoidance (53.5%), avoidance of specific thoughts or feelings (56.5%), jumpiness (53.5%), hypervigilance (53.5%), feeling on guard (41.5%), and general avoidance (43.5%) rated from rarely to most of the time. All symptoms were significantly more frequent among refugees in Jordan than in Spain. Conclusions and Recommendations: Intrusive thoughts were more frequent among females, urban residents, and unemployed individuals. Avoidance behaviors were higher in married and unemployed individuals. Hypervigilance was more prevalent among females, married individuals, and those with lower incomes. Regionally, females and married individuals in Jordan exhibited more intrusive thoughts and avoidance. In Spain, intrusive thoughts and hypervigilance were more common among females and the unemployed. The findings highlight the urgent need for targeted mental health interventions, particularly in refugee camps like those in Jordan, where PTSD symptom rates were significantly higher. Programs should prioritize trauma-focused therapies, such as Cognitive Behavioral Therapy, while adopting gender-sensitive approaches to address the heightened vulnerability of women and unemployed individuals. Given the strong link between unemployment and symptom severity, livelihood support and vocational training should be integrated into psychosocial care. Policymakers in host countries like Jordan could benefit from adopting integration strategies similar to Spain’s, which may contribute to lower PTSD prevalence. Additionally, community-based awareness initiatives could improve early symptom recognition and access to care. Future research should explore longitudinal outcomes to assess the long-term impact of displacement and resettlement conditions on mental health.

Loneliness in patients with cancer: Associations with perceived social support, functional Independence, and psychological distress in a cross-sectional study

2026-06-24T00:00:49Z

[EN] Background: Loneliness has emerged as a psychosocial issue in oncology, with implications for emotional well- being, social and daily functioning, and adaptation to illness. However, its relationship with perceived social support and functional independence in patients with cancer remains insufficiently characterized. Objective: To analyze loneliness in patients with cancer and its association with sociodemographic, psychosocial, and functional variables. Methods: We conducted a cross-sectional study in 153 adults with cancer recruited from the onco-haematology day hospital at the Complejo Asistencial Universitario de Salamanca, Spain. Global loneliness was assessed with the UCLA Loneliness Scale, and emotional and social loneliness with the De Jong Gierveld Loneliness Scale. Perceived social support was evaluated with the Duke-UNC Functional Social Support Questionnaire, quality of life with the EORTC QLQ-C30, functional independence with the Barthel Index, and anxiety and depressive symptoms with the Hospital Anxiety and Depression Scale (HADS). Correlation analyses and multivariable linear and logistic regression models were performed. Results: The median UCLA loneliness score was 36 (range 20–79), indicating variability in perceived loneliness. Higher loneliness was associated with lower perceived social support, greater depressive and anxiety symptoms, and lower functional independence. In multivariable analyses, perceived social support and functional independence remained independently associated with lower loneliness, while depressive symptoms were associated with higher loneliness only in the linear model. Conclusions: Loneliness was more closely associated with psychosocial and functional than sociodemographic variables. These findings support loneliness assessment in comprehensive cancer care and suggest that social support and functional status may be key loneliness correlates. [ES] Antecedentes: La soledad ha emergido como un problema psicosocial en oncología, con implicaciones en el bienestar emocional, el funcionamiento social y diario, y la adaptación a la enfermedad. Sin embargo, su relación con el apoyo social percibido y la independencia funcional en pacientes con cáncer sigue sin estar suficientemente caracterizada. Objetivo: Analizar la soledad en pacientes con cáncer y su asociación con variables sociodemográficas, psicosociales y funcionales. Métodos: Se realizó un estudio transversal en 153 adultos con cáncer reclutados en el hospital de día de oncohematología del Complejo Asistencial Universitario de Salamanca, España. La soledad global se evaluó con la Escala de Soledad de la UCLA, y la soledad emocional y social con la Escala de Soledad de De Jong Gierveld. El apoyo social percibido se evaluó con el Cuestionario de Apoyo Social Funcional Duke-UNC, la calidad de vida con el EORTC QLQ-C30, la independencia funcional con el Índice de Barthel, y los síntomas de ansiedad y depresión con la Escala de Ansiedad y Depresión Hospitalaria (HADS). Se realizaron análisis de correlación y modelos de regresión lineal y logística multivariante. Resultados: La mediana de la puntuación de soledad de la UCLA fue de 36 (rango 20–79), lo que indica variabilidad en la soledad percibida. Una mayor soledad se asoció con un menor apoyo social percibido, mayores síntomas de depresión y ansiedad, y una menor independencia funcional. En los análisis multivariantes, el apoyo social percibido y la independencia funcional se mantuvieron asociados de forma independiente con una menor soledad, mientras que los síntomas depresivos se asociaron con una mayor soledad solo en el modelo lineal. Conclusiones: La soledad se asoció más estrechamente con las variables psicosociales y funcionales que con las sociodemográficas. Estos hallazgos respaldan la evaluación de la soledad en la atención integral del cáncer y sugieren que el apoyo social y el estado funcional pueden ser correlatos clave de la soledad.

Neuroprotective potential of the Flavonoids Quercetin and Epicatechin in a C. elegans Tauopathy Model

2026-05-29T00:02:28Z

The prevalence of cognitive disorders such as Alzheimer's disease (AD) is increasing due to the global rise in longevity. The accumulation of amyloid β (Aβ) deposits and hyperphosphorylated Tau protein (p-Tau) are considered the main hallmarks of AD. A growing body of evidence suggests that the regular intake of flavonoid-rich foods could reduce the risk of developing AD or mitigate its progression. This study explores the potential of quercetin (Q) and epicatechin (EC) as effective molecules against AD-like pathology, using the Caenorhabditis elegans BR5270 strain, which expresses the pro-aggregant F3DK280 fragment of the human Tau protein. The results showed that after exposure to 150 µM of EC or Q, worms exhibited increased lifespan, improved chemotaxis, and delayed age-related decline in locomotion. To explore the molecular mechanisms involved, the expression of genes associated with the inhibition of p-Tau proteotoxicity were measured by RT-qPCR. It was found that Q and EC significantly increased the expression levels of autophagy-related genes and of a key gene for de novo synthesis of α- tubulin. EC and Q delay neurodegeneration in the C. elegans tauopathy model, suggesting their potential to reduce the risk of AD progression.

The effects of polyphenols against oxidative stress in Caenorhabditis elegans are determined by coexisting bacteria

2026-05-29T00:02:25Z

[ENG]Introduction: Increasing evidence supports the role of gut microbiota in many aspects of human health, including immune, metabolic and neurobehavioral traits. Several studies have focused on how different components of the diet, such as polyphenols, can modulate the composition and function of the gut microbiota leading to health benefits. Methods: The effects on the resistance against thermally induced oxidative stress of C. elegans grown in the presence of flavonoids (quercetin or epicatechin) and fed different probiotic strains, namely Lactobacillus plantarum CLC17, Bifidobacterium longum NCIMB 8809 and Enterococcus faecium CECT 410, were explored. Results: Feeding C. elegans with the assayed bacteria in the absence of flavonoids did not significantly affect body size and fertility of the worms neither improve their resistance against oxidative stress compared to E. coli controls. However, increased resistance to stress was found when C. elegans was cultivated in the presence of both L. plantarum and flavonoids, but not with B. longum or E. faecium. An exploratory study revealed the presence of glycosylated and sulfated metabolites together with the aglycone in worms treated with quercetin and fed any of the different assayed LAB strains. However, in the assays with epicatechin a differential metabolite, tentatively identified as 5-(4′-hydroxyphenyl)-γ-valerolactone 3′-O-glucoside, was detected in the worms fed L. plantarum but not with the other bacteria. Conclusion: The obtained results indicated that the interactions bacteria/polyphenol play a key role in the effects produced in C. elegans regarding resistance against oxidative stress, although those effects cannot be only explained by the ability of bacteria to metabolize polyphenols, but other mechanisms should also be involved.

Sociodemographic determinants of Alzheimer’s disease in primary care: evidence from the province of Salamanca (Spain)

2026-06-04T06:27:29Z

Abstract Background Alzheimer’s disease (AD) is the most prevalent form of dementia worldwide, representing a growing public health concern as populations age. While biological mechanisms have been extensively studied, less is known about how sociodemographic determinants - such as residence, education, and socioeconomic context - affect the onset and distribution of AD in Spain. This study explores the association between sociodemographic factors and AD diagnosis among patients in primary health care centers in the province of Salamanca. Methods A cross-sectional, observational, and retrospective study was conducted using data from the Medora 4 electronic health records system of the Castilla y León Regional Health Service (SACYL). A total of 760 patients with a confirmed diagnosis of AD between 2009 and 2019 were randomly selected from an initial cohort of 1,623 individuals (95% confidence level, 2.59% margin of error). Variables analyzed included age, sex, place of residence (urban/rural), educational level, occupation, depressive symptoms, and family history of dementia. Data were analyzed with descriptive and inferential statistics using chi-square and Kruskal–Wallis tests (p < 0.05). Results Conclusion Among the 760 participants, 70% were women (n = 535) and 30% men (n = 225), with a mean age above 65 years. AD prevalence was significantly higher among urban residents (50.8%) than rural residents (49.2%) (p = 0.016). Women were disproportionately affected in both environments, especially in rural areas (74.1% vs. 66.1% in urban areas). Depression was recorded in 40.3% of patients, more frequently among women, though no significant association was observed with AD onset. Advanced age and female sex were confirmed as predominant risk factors. This study reveals a significant urban – rural disparity in AD prevalence in Salamanca, Spain, and confirms the higher vulnerability of older women. The findings underscore the need for targeted prevention and early detection strategies within primary care, particularly in urban settings where prevalence is higher. Understanding these sociodemographic determinants is crucial for designing equitable, community-based dementia care policies.

Proyecto ERCAV. Papel relevante de la enfermería en la toma de decisiones sobre el acceso vascular en pacientes renales. Resultados del estudio piloto

2026-05-12T00:01:37Z

Introducción: La negativa a la fístula arteriovenosa es un reto en hemodiálisis. La intervención enfermera es determinante en la toma de decisiones compartidas. Objetivo: Evaluar el impacto de una intervención multidisciplinar estructurada para abordar la negativa de pacientes con enfermedad renal crónica a la creación de una fístula arteriovenosa. Material y Método: Estudio piloto prospectivo y multicéntrico dividido en cuatro grupos según su situación respecto al acceso vascular. La intervención incluyó educación visual, formación del equipo en habilidades comunicativas y ecografía. Se analizaron variables demográficas, clínicas y de intervención. El estudio contó con aprobación ética y consentimiento informado. Análisis mediante pruebas paramétricas (t-Student, ANOVA) y no paramétricas (U de Mann-Whitney, Kruskal-Wallis). Resultados: Se incluyeron 51 pacientes con una edad media de 67,4±13,4 años (68,6% hombres). Tras la intervención, el 68,6% optó por fístula arteriovenosa. Enfermería lideró el 100% de las primeras consultas (media 30±12,7 minutos). La aceptación fue total en el grupo ERCA (100%) y alta en incidentes (78%), frente al 35% en prevalentes con CVC>6 meses (p<0,001). Las consultas sucesivas multidisciplinares aumentaron significativamente la aceptación frente a consultas solo de enfermería (p<0,05). Las principales barreras fueron miedo a la cirugía (54%) y comodidad del catéter (46%). Quienes aceptaron la fístula fueron más jóvenes (p<0,05). Conclusiones: La enfermería lidera positivamente la toma de decisiones mediante un enfoque estructurado y empático. La consulta ERCA es clave para la planificación anticipada, mientras que en portadores de catéter de larga duración se requieren intervenciones más tempranas.

Effectiveness of a multiple health-behaviour-change intervention in increasing adherence to the Mediterranean Diet in adults (EIRA study): a randomized controlled hybrid trial

2026-04-28T00:02:59Z

[ENG]The present study describes the effectiveness of a complex intervention that addresses multiple lifestyles to promote healthy behaviours in increasing adherence to the Mediterranean diet (MD). METHODS: Cluster-randomised, hybrid clinical trial controlled with two parallel groups. The study was carried out in 26 primary Spanish healthcare centres. People aged 45-75 years who presented at least two of the following criteria were included: smoker, low adherence to the MD or insufficient level of physical activity. The intervention group (IG) had three different levels of action: individual, group, and community, with the aim of acting on the behaviours related to smoking, diet and physical activity at the same time. The individual intervention included personalised recommendations and agreements on the objectives to attain. Group sessions were adapted to the context of each healthcare centre. The community intervention was focused on the social prescription of resources and activities performed in the environment of the community of each healthcare centre. Control group (CG) received brief advice given in the usual visits to the doctor's office. The primary outcome was the change, after 12 months, in the number of participants in each group with good adherence to the MD pattern. Secondary outcomes included the change in the total score of the MD adherence score (MEDAS) and the change in some cardiovascular risk factors. Three thousand sixty-two participants were included (IG = 1,481, CG = 1,581). Low adherence to the MD was present in 1,384 (93.5%) participants, of whom 1,233 initiated the intervention and conducted at least one individual visit with a healthcare professional. A greater increase (13.7%; 95% CI, 9.9-17.5; p < 0.001) was obtained by IG in the number of participants who reached 9 points or more (good adherence) in the MEDAS at the final visit. Moreover, the effect attributable to the intervention obtained a greater increase (0.50 points; 95% CI, 0.35 to 0.66; p < 0.001) in IG. A complex intervention modelled and carried out by primary healthcare professionals, within a real clinical healthcare context, achieved a global increase in the adherence to the MD compared to the brief advice. ClinicalTrials.gov Identifier: NCT03136211. Retrospectively registered on 02/05/2017 https://clinicaltrials.gov/ct2/show/NCT03136211.