BACKGROUND: Violence is an important public health problem and one of the main causes of deaths worldwide. The mental health consequences of surviving intimate partner violence (IPV) include depression, anxiety and post-traumatic stress disorder. Previous studies have identified that there is a relationship between depression and level of disability in female survivors of IPV. Estimating the direct, indirect or total effect of an exposure on an outcome makes it possible to identify mediating effects between a group of variables. Detecting mediation effects is useful for identifying casual pathways that generate a final outcome and provides a rationale for designing interventions to target the mediator, which in turn positively affects the outcome. The objective was to identify the mediating role of depressive symptoms on the relationship between IPV and disability.
METHODS: This was a cross-sectional study of 94 women over the age of 18 who were survivors of IPV by men. They were recruited from two public hospitals in Cali and Tuluá in southwest Colombia. An analysis of casual relationships was performed using structural equation modelling that was made up of: four exogenous observed variables (age, current relationship status [in a relationship or single], level of schooling, and history of an impairment), intermediate endogenous variables (violence and depressive symptoms), and the main endogenous variable (disability). The analyses were carried out in Stata14.2.
RESULTS: The direct effect of IPV severity on the level of disability was not statistically significant (β=0.09; P=0.63). However, the indirect effect of IPV severity on disability mediated by depressive symptoms was (β=0.39; P<0.01). The total effect of IPV severity on the level of disability was even greater (β=0.48; P=0.01).
CONCLUSIONS: This study found a complete mediating role of depressive symptoms on the relationship between the severity of IPV and the level of disability for the female participants in this study. The results of this research contribute to defining strategies to prevent and address intimate partner violence, depressive symptoms and disability in this population.

OBJECTIVE: This study aims to compare the effects of microscopic microdiscectomy and microendoscopic discectomy on pain, disability, fear of falling, kinesiophobia, anxiety, quality of life in patients with lumbar disc herniation (LDH).
METHODS: A total of 90 patients who underwent microscopic microdiscectomy (n = 40) and microendoscopic discectomy (n = 50) for LDH were included in this study. The patients\' pain, disability, fear of falling, kinesiophobia, anxiety, and quality of life were evaluated before the surgery, in the early postoperative period and three months after.
RESULTS: In patients who underwent microendoscopic discectomy, the results of pain, disability, fear of falling, kinesiophobia and anxiety were statistically decreased compared with the microscopic microdiscectomy in the early postoperative period and three months later (p < 0.05). Also, a statistically higher increase was observed in the general health perception of patients who underwent microendoscopic discectomy three months after the operation (p < 0.01).
CONCLUSIONS: Microendoscopic microdiscectomy, remains the most effective and widely applied method with advantages on pain, quality of life, and improved physical functions.
OBJECTIVE: Este estudio tiene como objetivo comparar los efectos de la microdiscectomía microscópica y la discectomía microendoscópica sobre el dolor, la discapacidad, el miedo a caer, la kinesiofobia, la ansiedad y la calidad de vida en pacientes con hernia de disco lumbar (LDH).
UNASSIGNED: Se incluyeron en este estudio un total de 90 pacientes sometidos a microdiscectomía microscópica (n = 40) y discectomía microendoscópica (n = 50) por LDH. Se evaluó el dolor, la discapacidad, el miedo a caer, la kinesiofobia, la ansiedad y la calidad de vida de los pacientes antes de la cirugía, en el postoperatorio temprano y tres meses después.
RESULTS: En los pacientes sometidos a discectomía microendoscópica, los resultados de dolor, discapacidad, miedo a caer, kinesiofobia y ansiedad disminuyeron estadísticamente en comparación con la microdiscectomía microscópica en el postoperatorio temprano y tres meses después (p < 0.05). Además, se observó un aumento estadísticamente mayor en la percepción de salud general de los pacientes sometidos a discectomía microendoscópica tres meses después de la operación (p < 0.01).
UNASSIGNED: La microdiscectomía microendoscópica sigue siendo el método más eficaz y ampliamente aplicado con ventajas sobre el dolor, la calidad de vida y la mejora de las funciones físicas.

BACKGROUND: For thirty years, Mexico has studied the burden of disease in order to inform health decisions.
OBJECTIVE: To analyze the burden of disease, injuries, and risk factors in Mexico between 1990 and 2021.
METHODS: Estimates from the Global Burden of Disease 2021 study were used to analyze mortality, years of life lost due to premature mortality, years lived with disability and disability-adjusted life years, as well as the burden attributable to risk factors by sex, age and state of the country.
RESULTS: Infant mortality decreased by 39.4% from 1990 to 2000 and by 49.0% from 2000 to 2013. At the national level, mortality decreased by 27.5% between 1990 and 2019, but increased in 2020 and 2021 across all states, especially in adults aged from 35 to 64 years due to the COVID-19 pandemic, which contributed with 24.3% of deaths in 2021. Significant differences in mortality were observed according to age and sex. The burden attributable to metabolic risk factors did increase, while alcohol and tobacco consumption decreased. Access to drinking water and sanitation showed improvements.
CONCLUSIONS: Assessing the burden of disease is crucial in order to design effective strategies to address current health needs and future healthcare challenges.
BACKGROUND: Desde hace treinta años, México ha estudiado la carga de la enfermedad para sustentar decisiones en salud.
OBJECTIVE: Analizar la carga de enfermedad, lesiones y factores de riesgo en México entre 1990 y 2021.
UNASSIGNED: Se utilizaron las estimaciones del Global Burden of Disease 2021 para analizar la mortalidad, los años de vida perdidos por muerte prematura, los años vividos con discapacidad y los años de vida saludable perdidos, así como la carga atribuible a los factores de riesgos por sexo, edad y entidad federativa.
RESULTS: La mortalidad infantil disminuyó 39.4 % de 1990 a 2000, y 49.0 % de 2000 a 2019. En el ámbito nacional, la mortalidad decreció 27.5 % entre 1990 y 2019, pero ascendió en 2020 y 2021 en todos los estados, especialmente en adultos de 35 a 64 años, debido a la pandemia de COVID-19, que contribuyó con 24.3 % de las defunciones en 2019. Se observaron diferencias significativas en la mortalidad según la edad y el sexo. La carga atribuible a los factores de riesgo metabólicos se incrementó, mientras que la atribuible el consumo de alcohol y tabaco disminuyó. El acceso al agua potable y saneamiento mejoró.
CONCLUSIONS: Evaluar la carga de enfermedad es crucial para diseñar estrategias eficaces para abordar las necesidades actuales y los futuros desafíos en salud.

Long covid is a health problem that will entail a high hidden cost attributable to the pandemic years after it because it affects the work capacity of many workers. Given the millions of covid-19 cases worldwide and current research showing that one in 7covid-19 patients remain symptomatic at 12 weeks, the number of long covid patients is likely to be substantial. Long covid is characterized by heterogeneous sequelae that often affect multiple systems, organs with an impact on the functioning and capacity of the worker. Workers with long covid symptoms can return to their occupation but this involves a complex individualized approach to the impact of symptoms on work, adjustments and modifications to the workplace. Patients with long covid typically report prolonged multisystem involvement and signicant disability. The psychological cost to the worker must also be addressed. A survey by the Community of Madrid (CCOO, SATSE, CSIF, AMYTS) in 2022 reveals that 24.5% of those affected by long covid were sick for more than 12 months; 30% of those affected by persistent covid need and adaption to their workplace. In Spain, more than 10million people infected with SARS-CoV-2 have been reported since the pandemic began, so it is estimated that there could be one million people with persistent covid. In 2021 alone there were more than 2.6 million sick leave due to covid-19 in Spain, the average duration of which was 10 days. One hundred million people around the world suffer from persistent covid, but few countries officially count them, nor do they help those affected with employment. In advanced countries, like the United States, long covid is treated as a disability,and the number of people with disabilities working or looking for work increased by 1.36 million, an increase of 23%, between January 2021 and January 2022. In the United Kingdom, some 200,000 people are not working or are not looking for work due to long-term health problems attributable to long covid, since the pandemic began.

OBJECTIVE: To determine the risk factors associated with disability in patients who had a stroke in northeastern Mexico.
METHODS: This was an observational, retrospective, cross-sectional study. SITE: Conducted at the Family Medicine Unit No. 33 of the Mexican Institute of Social Security in Reynosa, Tamaulipas, Mexico.
METHODS: One hundred and ninety-eight males and 146 females, above 18 years old, beneficiaries of the Mexican Institute of Social Security with a diagnosis of stroke between 2018 and 2021.
METHODS: The Barthel index that assesses the degree of dependence to perform basic activities of daily living was applied to the participants and sociodemographic, biological and anthropometric variables were collected from the digital medical record.
METHODS: A univariate, correlational and ordinal logistic regression statistical analysis was performed between independent and dependent variables to obtain measures of frequency, percentages, and associated risks.
RESULTS: The risk factors associated with disability were age (OR 1.03, CI 1.01-1.05), overweight (OR 1.81, CI 1.03-3.1), obesity grade I (OR 2.74, CI 1.46-5.1), obesity grade II (OR 4.38, CI 1.44-13), obesity grade III (OR 9.99, CI 2.12-47); type of stroke: ischemic (OR 4.60, CI 2.6-8) or thrombotic (OR 4.95, CI 1.57-15). The number of comorbidities was associated with disability when having one comorbidity (OR 2.80, CI 1.22-6.4), two comorbidities (OR 3.43, CI 1.37-8.5), three comorbidities (OR 2.71, CI 1.01-7.3), and with five comorbidities (OR 3.17, CI 1.01-9.9).
CONCLUSIONS: The risk factors found for disability were age, overweight, obesity, and type of ischemic and thrombotic stroke. Being cared for by a relative and/or spouse reduces the probability of disability.

BACKGROUND: Multiple sclerosis is a chronic, autoimmune, degenerative disease. Therapies targeting B-cells have been shown to be effective in its treatment; however, there are few studies evaluating their efficacy in the Mexican population.
OBJECTIVE: To evaluate the clinical impact of rituximab in patients with newly-diagnosed relapsing-remitting multiple sclerosis (RRMS).
METHODS: Real life, descriptive study, in which rituximab was evaluated as treatment for RRMS over a 24-month period. Pre- and post-treatment clinical variables were analyzed; a comparison was made between treatment-naïve and non-treatment-naïve patients.
RESULTS: Twenty-eight patients with RRMS were included. Mean age at diagnosis was 30.7 years, and 22 patients were treatment-naïve (78.5 %). After 24 months, there was a mean reduction of 1.8 points in the EDSS scale and a decrease in the number of active lesions on magnetic resonance imaging; a significant difference in both variables could be established (p < 0.05). However, the logistic regression model did not show a relationship between the variables for achieving NEDA-3 criteria. No serious adverse events were observed.
CONCLUSIONS: Treatment with rituximab resulted in significant clinical and radiological improvement in treatment-naïve and non-treatment-naïve Mexican patients with RRMS.
BACKGROUND: La esclerosis múltiple es una enfermedad crónica, autoinmune y degenerativa. Las terapias blanco contra los linfocitos B han probado ser efectivas en su tratamiento; sin embargo, existen pocos estudios que evalúen su eficacia en población mexicana.
OBJECTIVE: Evaluar el impacto clínico del rituximab en pacientes con esclerosis múltiple remitente recurrente (EMRR) de reciente diagnóstico.
UNASSIGNED: Estudio de vida real, descriptivo, en el que se evalúa rituximab como tratamiento de EMRR durante un periodo de 24 meses. Se analizaron variables clínicas pre y postratamiento; se realizó la comparación entre pacientes naïve y no naïve.
RESULTS: Se incluyeron 28 pacientes con EMRR. La edad media al diagnóstico fue de 30.7 años y 22 pacientes fueron naïve (78.5 %). Después de 24 meses, se observó una reducción media de 1.8 puntos en EDSS y en el número de lesiones activas por resonancia magnética. Aunque se logró establecer una diferencia significativa en ambas variables con p < 0.05, el modelo de regresión logística no mostró una relación entre las variables para alcanzar un NEDA-3. No se observaron eventos adversos graves.
CONCLUSIONS: El tratamiento con rituximab resultó en mejoría significativa clínica y radiológica en pacientes mexicanos con EMRR naïve y no-naïve.

Hereditary ataxia (HA) and hereditary spastic paraplegia (HSP) are rare diseases; as such, they are rarely managed in general neurology consultations. We present a set of brief, practical recommendations for the diagnosis and management of these patients, as well as a standardised procedure for comprehensive evaluation of disability. We provide definitions for HA and \"HA plus,\" and \"pure\" and \"complicated\" HSP; describe the clinical assessment of these patients, indicating the main complementary tests and clinical scales for physical and psychological assessment of the patients; and summarise the available treatments. These recommendations are intended to facilitate daily neurological practice and to unify clinical criteria and disability assessment protocols for patients with HA and HSP.

Emotion dysregulation has been consistently linked to psychopathology, and the relationship between disability and depressive symptomatology in old age is well-known.
To examine the mediational role of emotional dysregulation in the relationship between perceived disability and depressive symptomatology in older adults.
Two hundred eighty-three participants, aged 60-96 years (M±SD=74.22±8.69; 62.9% women; 29.0% with long-term care support [LTC-S] and 71.0% community residents without LTC-S), were assessed with the Geriatric Depression Scale-8 (GDS-8), the World Health Organization Disability Assessment Schedule-2 (WHODAS-2), and the Difficulties in Emotion Regulation Scale-16 (DERS-16).
A mediation model was established, which revealed: (1) a moderate association between WHODAS-2 and GDS-8 (β=0.20; p<.001); (2) DERS-16 partially and weakly mediated the relationship between WHODAS-2 and GDS-8 (β=0.003; p<.01). The model explained 31.9% of the variance of depressive symptoms. An inconsistent mediation model was obtained in the LTC-S group.
Globally, our findings indicate that disability has an indirect relationship with depressive symptomatology through emotional dysregulation (except for those in the LTC-S). Accordingly, we present suggestions for the treatment of depressive symptoms and for the inclusion of other emotion regulation variables in the study of the disability-depressive symptom link in future studies with older people in the LTC-S.

BACKGROUND: Mental disorders are among the leading causes of disability worldwide. Despite the fact that severe mental disorders (SMD) are associated with high disability, the impact of common mental disorders (CMD) is not negligible. In this work, we compare the disability measured with the WHODAS 2.0 scale of both diagnostic groups at the Mental Health Nurse facility.
METHODS: Sociodemographic data, clinical diagnosis and disability scores were collected, using the WHODAS 2.0 scale, of the patients attended by the Mental Health specialist nurse at the Infanta Elena de Valdemoro Hospital (Madrid) and disability was compared in patients with SMD and CMD, using the Student t test.
RESULTS: Our study sample consisted of 133 patients. Patients with CMD showed greater disability compared to patients with SMD. It was observed that the disability associated with CMD is higher, compared to SMD, this difference being significant for the domain of work (p < 0.001) and participation in society (p = 0.041).
CONCLUSIONS: In this study we showed that the level of disability associated with CMD was higher in certain areas compared to SMD, this difference was of special relevance for the «Work» and «Participation» domains. This may serve to adapt the interventions aimed at these people and improve their quality of life.

BACKGROUND: Functional impairment in schizophrenia is one of the main features of the disorder and implies a great impact on the patient\'s quality of life. The Brief Functioning Assessment Scale (FAST), originally validated in bipolar disorder, has also been validated for its application in other mental disorders. However, we only found one study on the reliability and validity of the Brazilian version in schizophrenia. The purpose of this study was to analyze the psychometric properties of the Spanish version of the FAST in patients diagnosed with schizophrenia.
METHODS: A total of 226 patients with a diagnosis of schizophrenia were evaluated by mean the FAST, the GAF and the self-care requirements scale (ERA). Scale properties were analyzed in terms of internal consistency, inter-observer agreement and test-retest reliability. Convergent validity with the GAF and ERA scales was also analyzed, as well as construct validity by means of a Confirmatory Factor Analysis (CFA).
RESULTS: For the total scale, the results showed high internal consistency (Cronbach\'s Alpha of, 87), as well as good inter-observer (ICC=,86) and test-retest (ICC=,77) agreement. Concurrent validity with the GAF scale was discrete (r=-,32; P<,001) and with the ERA scale was moderate (r=,50; P<,001). CFA showed an internal structure that matched the six factors proposed by the original scale, with a good level of item saturation for each factor.
CONCLUSIONS: The FAST scale showed good psychometric properties in terms of reliability and validity in its Spanish version for its application in patients with schizophrenia. It can be considered as a good tool to assess different areas of functional impairment in clinical practice and research.