Differentiation between negative and depressive symptomatology in schizophrenia and schizoaffective disorder. a literature review

36 p.La clasificación de los trastornos psicóticos ha evolucionado desde las primeras divisiones de Kahlbaum y Kraepelin hasta modelos multidimensionales más recientes, motivados por la complejidad de síntomas como los negativos y depresivos en la esquizofrenia. Estos últimos comparten ciertas manifestaciones clínicas, lo que dificulta su diferenciación y evaluación precisa. Este trabajo tiene como objetivo contextualizar los modelos actuales de esquizofrenia, recopilar las principales escalas históricamente empleadas para medir síntomas negativos y depresivos, y analizar su eficacia psicométrica tanto en la identificación de éstos como en su diferenciación. A través de una revisión sistemática de la literatura, se observa que la Calgary Depression Scale for Schizophrenia (CDSS) es la herramienta más específica y fiable para evaluar depresión en pacientes con esquizofrenia, mostrando un solapamiento mínimo con los síntomas negativos. Por otro lado, escalas como HAMD, MADRS o BDI-II presentan menor especificidad en contextos psicóticos. En cuanto a los síntomas negativos, destacan la Brief Negative Symptom Scale (BNSS) y la Self-evaluation of Negative Symptoms (SNS), adaptadas al modelo de cinco dimensiones y con buen rendimiento psicométrico. La CAINS, aunque menos consistente internamente, no correlaciona con escalas depresivas, lo que refuerza su especificidad. La inclusión de pacientes con trastorno esquizoafectivo en las muestras no parece incrementar el solapamiento entre escalas. En conjunto, los hallazgos subrayan la importancia de emplear instrumentos específicos para mejorar el diagnóstico diferencial y la planificación terapéutica, y señalan la necesidad de seguir investigando en esta dirección.The classification of psychotic disorders has evolved from the early divisions proposed by Kahlbaum and Kraepelin to more recent multidimensional models, driven by the complexity of symptoms such as negative and depressive symptoms in schizophrenia. These symptoms share certain clinical manifestations, making their differentiation and accurate assessment challenging. This study aims to contextualize current models of schizophrenia, compile the main scales historically used to measure negative and depressive symptoms, and analyze their psychometric effectiveness both in identifying these symptoms and in differentiating between them. Through a systematic review of the literature, it was found that the Calgary Depression Scale for Schizophrenia (CDSS) is the most specific and reliable tool for assessing depression in patients with schizophrenia, showing minimal overlap with negative symptoms. In contrast, scales such as HAMD, MADRS, and BDI-II demonstrate lower specificity in psychotic contexts. Regarding negative symptoms, the Brief Negative Symptom Scale (BNSS) and the Self-evaluation of Negative Symptoms (SNS) stand out for being aligned with the five-domain model and for their strong psychometric performance. The CAINS, although less consistent internally, does not correlate with depressive scales, which reinforces its specificity. The inclusion of patients with schizoaffective disorder in the samples does not appear to increase overlap between scales. Overall, the findings highlight the importance of using specific and psychometrically sound instruments to improve differential diagnosis and therapeutic planning, and point to the need for further research in this area.Grado en Medicin

Baseline Functional and Psychological Status as Predictors of Toxicity and Survival in Car-T Cell Therapy for Hematologic Malignancies

41 p.Background: Chimeric Antigen Receptor T-cell (CAR-T) therapy represents a significant advancement for patients with relapsed or treatment-resistant hematologic cancers. However, it is frequently associated with severe side effects, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), along with deteriorations in quality of life (QOL). While patient-reported outcomes (PROs) are gaining recognition in oncology, there remains limited evidence on how baseline PROs relate to CAR-T treatment results. Methods: We carried out a secondary data analysis of a longitudinal cohort study involving 100 adults aged 18 and over with relapsed or refractory blood cancers treated with CAR-T at a single academic institution. Evaluations included QOL (Functional Assessment of Cancer Therapy–General), psychological distress (Hospital Anxiety and Depression Scale), and physical symptoms (Edmonton Symptom Assessment System- revised) recorded at baseline. From the electronic health records, we retrieved: (1) initial response to CAR-T, (2) incidence and severity of CRS and ICANS, (3) hospital length of stay (LOS), and (4) mortality or last follow-up date. We explored the association between baseline PROs and outcomes such as overall survival (OS), presence of moderate-to-severe CRS, ICANS occurrence, and LOS. Statistical approaches included both univariate and multivariable modeling to account for clinical and patient-related variables. All PROs were analyzed as continuous measures.Antecedentes: La terapia con células CAR-T ha supuesto un gran avance en el tratamiento de las neoplasias hematológicas en recaída o refractarias, aunque a menudo se acompaña de toxicidades como el síndrome de liberación de citocinas (CRS), el síndrome de neurotoxicidad asociado a células inmunes (ICANS) y deterioro en la calidad de vida. Aunque en oncología se valora cada vez más la información proporcionada por los propios pacientes sobre su estado físico y emocional antes del tratamiento, todavía existen pocos estudios que analicen cómo estos factores se relacionan con los resultados clínicos tras la terapia CAR-T. Métodos: Realizamos un análisis sobre datos previamente recogidos en un estudio longitudinal con 100 adultos mayores de 18 años con neoplasias hematológicas en recaída o refractarias tratados con CAR-T en un único centro académico. Se evaluaron al inicio del tratamiento la calidad de vida (mediante el cuestionario FACT-G), el estado de ánimo (HADS) y la carga de síntomas físicos (escala ESAS-r). A partir de la historia clínica electrónica, se extrajeron los siguientes datos: 1) mejor respuesta al tratamiento CAR-T, 2) tasas y grados de CRS e ICANS, 3) duración del ingreso hospitalario (LOS), y 4) fecha de fallecimiento o última visita. Se analizó la relación entre las variables psicológicas basales y la supervivencia global (OS), el desarrollo de CRS grado ≥2, la aparición de ICANS y la duración del ingreso, mediante modelos univariables y multivariables ajustados por distintos factores clínicos. Todos los PROs fueron tratados como variables continuas.Grado en Medicin

Microeconomic Losses Due to Intimate Partner Violence Against Women (IPVAW): Three Scenarios Based on Accounting Methodology Approach

This article thoroughly examines the multidimensional consequences of intimate partner violence against women (IPVAW) and estimates the monetary costs associated with this kind of violence in Spain for 2022. Based on the accounting model approach, three alternative scenarios are proposed to quantify the direct tangible costs of IPVAW from a microeconomic perspective. Each scenario considers the out-of-pocket expenditures and the opportunity cost of lost income due to IPVAW, borne by the survivor women, their families and relatives, the public sector, and the private organizations. The study utilizes microdata from the latest Spanish Macro-survey on Violence Against Women, conducted in 2019 by the Government Office against Gender-Based Violence (Spanish Government). Results show the costs ranging from EUR 1.38 billion (the most conservative estimate) to EUR3.01billion (the highest estimate). Further research is needed to deepen understanding of the mechanisms by which violence affects the various domains and agents of society

Abordaje del shock hemorrágico en el contexto bélico actual en Europa

41 p.El shock hemorrágico supone un gran problema de salud en el contexto del politraumatismo, y en ambientes militares es la primera causa de muerte prevenible. Su adecuado manejo es determinante para la vida del paciente y requiere un enfoque multifactorial, rápido y adaptado al entorno, siendo la primera hora un periodo crítico. En la guerra actual, la atención temprana se ve comprometida, así como el acceso a recursos sanitarios, debido a la complejidad para mantener una adecuada cadena logística. Su abordaje se basa en la evidencia científica, que apoya la administración de ácido tranexámico (ATX) de forma precoz y la transfusión prehospitalaria dirigida; no obstante, debido a la flexibilidad y adaptabilidad de la Sanidad Militar, nuevas estrategias que se están probando a raíz del presente conflicto armado en Europa pueden ser clave en los próximos años, como por ejemplo la incorporación de calcio o la transfusión de sangre completa, contribuyendo tanto a la elaboración de nuevas guías de actuación como al desarrollo de la sanidad civil.Hemorrhagic shock represents a major health issue in the context of polytrauma, and in military settings, it is the leading cause of preventable death. Its proper management is crucial for the patient’s survival and requires a multifactorial, rapid, and environment- adapted approach, with the first hour being a critical period. In modern warfare, early medical care is often compromised, as is access to healthcare resources, due to the challenges of maintaining an effective logistical chain. For this reason, management is based on scientific evidence, which supports the early administration of TXA and targeted prehospital transfusion. However, due to the flexibility and adaptability of Military Healthcare, new strategies being tested in the current conflict may prove to be key in the coming years—such as the incorporation of calcium or whole blood transfusion— contributing not only to the development of new clinical guidelines but also to the advancement of civilian healthcare.Grado en Medicin

Aging-related hyperphosphatemia triggers the release of TNF-alfa from macrophages, promoting indicators of sarcopenia through the reduction of IL-15 expression in skeletal muscle.

Aims: The association between aging-related hyperphosphatemia and sarcopenia has been documented, and evidence suggests that inflammaging is involved in the manifestation of sarcopenia. The present study investigates whether hyperphosphatemia triggers inflammation, thereby inducing the appearance of sarcopenia along with the cytokines involved in these processes. Materials and methods: RAW 264.7 macrophages were incubated with beta-glycerophosphate (BGP), as a phosphate donor, at different time intervals, to assess the production of proinflammatory markers. Conditioned medium from macrophages was collected and added to cultured C2C12 myoblasts to analyse whether proinflammatory molecules, released by macrophages, modified myogenic differentiation, cell senescence or myokine IL-15 expression. A neutralising antibody anti-TNF-alpha and recombinant IL-15 were added to evaluate the role of these cytokines in the observed effects. Additionally, TNF-alpha, IL-15, serum phosphate, and sarcopenia signs were evaluated in 5-month-old mice, 24-month-old mice and 24-month-old mice fed with a hypophosphatemic diet. Key findings: BGP increased TNF-alpha expression in macrophages through NFkB activation. Conditioned medium from BGP-treated macrophages impaired myogenic differentiation in differentiating myoblasts and promoted cellular senescence and reduced IL-15 expression in undifferentiated myoblasts. These effects were mediated by TNF-alpha. Old mice displayed reduced expression of muscle IL-15 and elevated circulating TNF-alpha, along with increased serum phosphate levels, which correlated with the appearance of sarcopenia indicators. The hypophosphatemic diet prevented these changes in old mice. Significance: Hyperphosphatemia induces TNF-alpha production in macrophages, which contributes to the reduced expression of muscular IL-15. This mechanism may play a role in inducing sarcopenia in elderly mice

Preventable risk factors in the development of eating disorders in elite athletes. implications in their performance

33 p.Introducción. Los Trastornos del Comportamiento Alimenticio (TCA) son uno de los problemas psiquiátricos más importantes en la población, siendo su prevalencia subestimada. Tienen un gran impacto en los aspectos físico y psíquico de los individuos. A través de este estudio, se tiene como objetivo conocer los factores de riesgo que contribuyen a que los deportistas de élite desarrollen un TCA, su impacto y el carácter prevenible de los mismos. Material y métodos. Se ha realizado una revisión bibliográfica narrativa a través del metabuscador PubMed, Psycinfo y Web of Science, conllevando al resultado, una vez aplicados los criterios de inclusión y exclusión, a la obtención de 26 artículos en total. Resultados. Se ha observado que hay factores de riesgo modificables y no modificables que influyen en la aparición de un TCA en los individuos. En el caso de los deportistas, son factores de riesgo prevenibles y por tanto modificables el entorno del deportista, entrenadores, información nutricional óptima y recuperación de lesiones entre otros. Se ha comprobado que los trastornos de la salud mental de los atletas no son diagnosticados de forma específica y a tiempo, bien sea por el propio estigma que albergan los atletas o los mismos equipos deportivos. De esto último, se ha observado una menor capacidad de control de manejar la salud mental de los deportistas, de modo que ésta pueda ayudarles a tener un mayor rendimiento en sus respectivos deportes. Discusión. Se ha detectado que, ante la falta de estudios de alta calidad realizados en este área, es necesario un estudio más profundo y conciso del tema tratado.Introduction: Eating disorders (ED) are one of the most important psychiatric problems in the population, being their prevalence underestimated. They have a great impact, not only physical, but also mental in the individuals. Through this study, it´s objective is to analyse the different risk factors which contribute to an ED, it´s mental health impact and determine which one of these are preventable or not, as to their impact, since the athlete´s performance not only resides in their physical health, but also their mental one. Material and methods. A bibliographic review has been done in this project, through the information acquired in different meta based webs, such as PubMed, Psycinfo and Web of Science. The valid articles, once exclusion and inclusion criteria were applied, were a total of 26. Results. Modifiable and non-modifiable risk factors have been observed that influence in the appearance of an ED in individuals. In case of the athletes, risk factors which are preventable and therefore modifiable are the environment, coaches, optimal nutritional information and recovery from injuries between others. It´s been proved that athletes mental health issues are not specifically diagnosed and on time of being able to be prevented, due to the own athletes stigma or the one from their own teams. It´s a fact then that due to the less capacity of the athletes to manage their own mental health, there´s a problem in their sport performance, so if this is improved, their efficiency will be enhanced. Discussion. Due to the lack of high quality studies in this area, a more profound and specific study is necessary.Grado en Medicin

Opinion and training of teachers in linguistc classrooms for immigrants students without knowledge of Spanish

Las aulas de acogida (AA en adelante) se consideran la medida más importante en lo que concierne a la acogida de alumnado inmigrante con dificultad lingüística. Se han implementado con el propósito de facilitar el aprendizaje de la lengua vehicular del centro al nuevo estudiantado, y, como consecuencia, fomentar su inclusión en el centro educativo de primaria y secundaria (el presente estudio se centra en secundaria). No obstante, muchos estudios señalan que esta medida, en las diferentes comunidades españolas, no cumple con los objetivos marcados en un principio, y concluyen, asimismo, que la formación del profesorado es mejorable. Por eso, el presente estudio se propone conocer la valoración que los docentes de las aulas de referencia tienen de esta medida, y analizar la formación específica (en atención a la diversidad y en educación intercultural) que tienen aquellos que ejercen en las AA. de la Región de Murcia. Para conseguirlo, en este estudio se encuesta a la totalidad del cuerpo docente que imparte clases a los discentes alófonos escolarizados en centros que cuentan con AA., concretamente a un total de 204. Las conclusiones generales de este estudio evidencian, por un lado, la escasa formación específica que han recibido aquellos que ejercen en las AA., y por otro, la muy positiva valoración que tienen los profesores del centro respecto a esta medida.The welcome classrooms (hereafter referred to as WW. CC.) are considered to be the most important measure for the reception of immigrant students with language difficulties. They have been implemented with the purpose of facilitating the learning of the school’s vehicular language for new students, and, as a consequence, fostering their inclusion in primary and secondary schools (the present study focuses on secondary schools). However, many studies point out that this measure, in the different Spanish Communities, does not meet the objectives originally set, and also conclude that there is room for improvement in teacher training. For this reason, this study aims to find out how teachers in the reference classrooms assess this measure, and to analyse the specific training (in attention to diversity and intercultural education) of those who work in WW. CC. of the Region of Murcia. To achieve this, in this study we surveyed all the teaching staff who work with allophone students in schools where there are WW. CC. The general conclusions of this study show, on the one hand, the low level of specific training received by those working in the WW. CC. and, on the other, the very positive assessment of this measure by the school teachers

CCN2 Activates Cellular Senescence Leading to Kidney Fibrosis in Folic Acid-Induced Experimental Nephropathy

Cellular communication network factor 2 (CCN2, also known as CTGF) is a complex protein that regulates numerous cellular functions. This biomolecule exhibits dual functions, depending on the context, and can act as a matricellular protein or as a growth factor. CCN2 is an established marker of fibrosis and a well-known mediator of kidney damage, involved in the regulation of inflammation, extracellular matrix remodeling, cell death, and activation of tubular epithelial cell (TECs) senescence. In response to kidney damage, cellular senescence mechanisms are activated, linked to regeneration failure and progression to fibrosis. Our preclinical studies using a total conditional CCN2 knockout mouse demonstrate that CCN2 plays a significant role in the development of a senescence phenotype after exposure to a nephrotoxic agent. CCN2 induces cell growth arrest in TECs, both in the early phase and in the chronic phase of folic acid nephropathy (FAN), associated with cell-death/necroinflammation and fibrosis, respectively. Renal CCN2 overexpression was found to be linked to excessive collagen accumulation in tubulointerstitial areas, microvascular rarefaction, and a decline in renal function, which were observed three weeks following the initial injury. All these findings were markedly diminished in conditional CCN2 knockout mice. In the FAN model, injured senescent TECs are associated with microvascular rarefaction, and both were modulated by CCN2. In primary cultured endothelial cells, as previously described in TECs, CCN2 directly induced senescence. The findings collectively demonstrate the complexity of CCN2, highlight the pivotal role of cellular senescence as an important mechanism in renal injury, and underscore the critical function of this biomolecule in kidney damage progression

Viejas historias de Graus y Ribagorza ; Excursiones pirenaicas

727 p.Vicente Castán Gil (1855-1922) fue un farmacéutico que durante cuatro décadas, a partir de 1883, se dedicó a escribir crónicas y a sacar fotografías de la vida cotidiana y popular de su pueblo, Graus, y de su comarca, la Ribagorza, en Huesca. Con el sueño, que no vio cumplido, de hacer una publicación. Se interesó sobre todo por las clases más populares, los oficios más marginados, las fiestas de tipo carnavalesco. Y por las conversaciones cotidianas (“charradetas”), que transcribió con sutileza y profusión, de él con los paisanos y de los paisanos entre sí. Su enfoque no tiene prácticamente parangón en la etnografía española e hispánica del siglo XIX y de gran parte del siglo XX, y se adelanta en décadas a lo que la antropología posterior ha denominado “observación participante”, “descripción densa”, “autoetnografía”, “conocimiento local”, “microetnografía”, “antropología visual”, “etnografía del paseo” “etnografía de la conversación”, etc. Una parte de ese asombroso legado de textos y fotografías, la más atenta a la cultura popular, emerge ahora como una de las primeras y más valiosas etnografías de las que han sido urdidas en España. Tras el lapsus de más de un siglo en que ha estado bajo la custodia de su familia, en especial de su biznieto Venancio Díaz Castán, la obra del farmacéutico de Graus reclama por fin una posición de relieve en los anales de nuestras ciencias humanas

Restauración ecológica en espacios mineros: plan de acción para la gravera Tranzones en Ciempozuelos

82 p.El objetivo principal de este Trabajo Fin de Máster es diseñar un plan de acción para aumentar la biodiversidad y los servicios ecosistémicos en la gravera Tranzones, situada en Ciempozuelos (Madrid), dentro del Parque Regional del Sureste. Este espacio, afectado durante décadas por la actividad minera, fue restaurado inicialmente por Holcim España, empresa que actualmente tiene un Acuerdo de Custodia del Territorio con la Fundación Internacional para la Restauración de Ecosistemas (FIRE). El trabajo parte de una reconstrucción de la historia ambiental reciente del enclave, seguida del diagnóstico de una línea base de biodiversidad mediante inventarios de vegetación leñosa, aves, mamíferos, herpetofauna e invertebrados. A partir del diagnóstico, se proponen acciones concretas para favorecer la restauración ecológica del espacio: control de especies exóticas invasoras, enriquecimiento botánico con especies autóctonas, creación de refugios para la fauna silvestre y mejora o introducción de elementos del paisaje. Uno de los pilares del diseño es la creación de un sistema agrosilvopastoril basado en los principios de agricultura regenerativa, que incluye rotaciones de cultivos, integración de árboles y setos vivos, manejo ganadero y prácticas para el mantenimiento de la fertilidad y la resiliencia ecológica. Además, se ha elaborado un plan de uso público centrado en el voluntariado ambiental y la instalación de carteles interpretativos, con el fin de promover la educación ambiental, la implicación social y el valor pedagógico del enclave restaurado. Este trabajo constituye un ejemplo de restauración ecológica multifuncional y replicable, con integración de conocimiento técnico, acción y colaboración entre la universidad, una ONG y el sector privado. Sienta las bases para consolidar un modelo de restauración aplicada que combina conservación, producción sostenible y participación ciudadana en antiguos espacios degradados por la mineríaThe main objective of this Master's Thesis is to design an action plan to enhance biodiversity and ecosystem services in the Tranzones gravel pit, located in Ciempozuelos (Madrid), within the Southeast Regional Park. This site, degraded for decades by mining activity, was initially restored by Holcim España, a company that currently holds a Land Stewardship Agreement with the International Foundation for Ecosystem Restoration (FIRE). The work begins with a reconstruction of the site's recent environmental history, followed by the establishment of a biodiversity baseline through field inventories of woody vegetation, birds, mammals, herpetofauna, and invertebrates. Based on this diagnosis, concrete actions are proposed to foster the ecological restoration of the area, including the control of invasive alien species, botanical enrichment with native species, the creation of wildlife refuges, and the improvement or introduction of landscape elements. A key component of the proposed design is the development of an agrosilvopastoral system grounded in the principles of regenerative agriculture, incorporating crop rotations, tree and hedgerow integration, managed grazing, and soil fertility enhancement practices to strengthen ecological resilience. In addition, a public use plan has been developed, focused on environmental volunteering and the installation of interpretive signage to promote environmental education, social engagement, and the pedagogical value of the restored site. This thesis presents a replicable model of multifunctional ecological restoration that integrates technical knowledge, practical action, and collaboration between academia, a non-governmental organization, and the private sector. It lays the foundation for a comprehensive approach to restoration that combines conservation, sustainable production, and citizen participation in formerly mined landscapes.Máster Universitario en Restauración de Ecosistemas (M194