Design considerations of a randomized clinical trial on a cognitive behavioural intervention using communication and information technologies for managing chronic low back pain

Background: Psychological treatments have been successful in treating chronic low back pain (CLBP). However, the effect sizes are still modest and there is room for improvement. A way to progress is by enhancing treatment adherence and self-management using information and communication technologies (ICTs). Therefore, the objective of this study was to design a trial investigating the short- and long-term efficacy of cognitive behavioural treatment (CBT) for CLBP using or not ICTs. A secondary objective of this trial will be to evaluate the influence of relevant variables on treatment response. Possible barriers in the implementation of CBT with and without ICT will also be investigated. Methods: A randomised controlled trial with 180 CLBP patients recruited from specialised care will be conducted. Participants will be randomly assigned to three conditions: Control group (CG), CBT, and CBT supported by ICTs (CBT + ICT). Participants belonging to the three conditions will receive a conventional rehabilitation program (back school). The CBT group program will last six sessions. The CBT + ICT group will use the internet and SMS to practice the therapeutic strategies between sessions and in the follow-ups at their homes. Primary outcome variables will be self-reported disability and pain intensity. Assessment will be carried out by blinded assessors in five moments: pretreatment, post-treatment and 3-, 6-, and 12-month follow-ups. The influence of catastrophizing, fear-avoidance beliefs, anxiety and depression in response to treatment in the primary outcomes will also be analysed. Discussion: This study will show data of the possible benefits of using ICTs in the improvement of CBT for treating CLBP

Pressure-Driven Isostructural Phase Transition in InNbO4: In Situ Experimental and Theoretical Investigations

"This document is the Accepted Manuscript version of a Published Work that appeared in final form in Inorganic Chemistry, copyright © American Chemical Society after peer review and technical editing by the publisher. To access the final edited and published work see http://pubs.acs.org/page/policy/articlesonrequest/index.html"[EN] The high-pressure behavior of technologically important visible-light photocatalytic semiconductor In.NbO4, adopting a monoclinic wolframite-type structure at ambient conditions, was investigated using synchrotron-based X-ray diffraction, Raman spectroscopic measurements, and first-principles calculations. The experimental results indicate the occurrence of a pressure-induced isostructural phase transition in the studied compound beyond 10.8 GPa. The large volume collapse associated with the phase transition and the coexistence of two phases observed over a wide range of pressure shows the nature of transition to be first-order. There is an increase in the oxygen anion coordination number around In and Nb cations from six to eight at the phase transition. The ambient-pressure phase has been recovered on pressure release. The experimental pressure volume data when fitted to a Birch-Murnaghan equation of states yields the value of ambient pressure bulk modulus as 179(2) and 231(4) GPa for the low and high-pressure phases, respectively. The pressure dependence of the Raman mode frequencies and Gruneisen parameters was determined for both phases by experimental and theoretical methods. The same information is obtained for the infrared modes from first-principles calculations. Results from theoretical calculations corroborate the experimental findings. They also provide information on the compressibility of interatomic bonds, which is correlated with the macroscopic properties of InNbO4.This research was supported by the Spanish Ministerio de Economia y Competitividad (MINECO), the Spanish Research Agency (AEI), and the European Fund for Regional Development (FEDER) under Grant Nos. MAT2013-46649-004-01/02/03-P, MAT2016-75586-C4-1/2/3-P, and MAT2015-71070-REDC (MALTA Consolider). J.A.S. acknowledges financial support through the Ramon y Cajal Fellowship.Garg, AB.; Errandonea, D.; Popescu, C.; Martínez-García, D.; Pellicer Porres, J.; Rodríguez-Hernández, P.; Muñoz, A.... (2017). Pressure-Driven Isostructural Phase Transition in InNbO4: In Situ Experimental and Theoretical Investigations. Inorganic Chemistry. 56(9):5420-5430. https://doi.org/10.1021/acs.inorgchem.7b00437S5420543056

Tratamiento cognitivo conductual en pacientes con dolor lumbar en salud pública: Estudio piloto

Low back pain is a major public health problem due to the physical limitations it produces and the comorbidity with mental problems. The aim of this study was to apply a cognitive behavioral group treatment of six sessions in a public health rehabilitation service, to test its effects on pain, disability, anxiety, depression, fear and avoidance beliefs, catastrophizing, and pain coping strategies. The sample consisted of 5 patients from a public hospital in Valencia diagnosed with low back pain (M = 57 years), who had been suffering pain for an average of 5.9 years. The results showed a reduction of disability, of the use of maladaptive strategies and fear-avoidance beliefs, indicating that psychological aspects have a great impact on low back pain and that it is possible to apply psychological interventions for this condition in the public health system in Spain.El dolor lumbar constituye un grave problema de salud pública por las limitaciones físicas que produce y las psicopatologías asociadas. El objetivo de este estudio fue aplicar un tratamiento cognitivo conductual grupal de seis sesiones en un servicio de rehabilitación de sanidad pública, para comprobar sus efectos sobre: dolor, discapacidad, ansiedad, depresión, creencias sobre miedo y evitación, catastrofización y estrategias de afrontamiento ante el dolor. La muestra consistió en 5 pacientes de un hospital público de Valencia diagnosticados de dolor lumbar (M = 57 años), que habían padecido dolor lumbar durante una media de 5.9 años. Los resultados muestran una reducción en discapacidad, uso de estrategias desadaptativas y creencias de miedo-evitación, lo que indica que los aspectos psicológicos tienen gran impacto en el dolor lumbar y que es posible aplicar terapia psicológica para esta dolencia en el sistema de salud pública en el sistema de salud público español.

Evaluación de los diferentes tipos de membranas de hemodiálisis

La pluralidad de membranas utilizadas en la fabricación de dializadores, contribuye a que se presente en el mercado gran número de ellos, más de 400 en el ámbito de la EDTA, con características muy diferentes, tanto en lo relativo a sus prestaciones funcionales como a su "biocompatibilidad" y su precio. La trascendencia clínica y económica del uso de uno u otro tipo de dializador ha sido objeto de multitud de publicaciones y considerable debate que no ha llegado a materializarse en un cuerpo de doctrina universalmente aceptado, que sitúe con precisión la contribución relativa de cada tipo de dializador al resultado clínico del tratamiento en diálisis de la insuficiencia renal; y, consecuentemente, la efectividad y eficiencia de este elemento, fundamental en dicho tratamiento. El objeto del presente informe es proporcionar información respecto de dichas cuestiones, desde una perspectiva global, ponderando el valor relativo de los diferentes criterios en juego que afectan a: efectividad clínica, funcionalidad, biocompatibilidad y precio.Presentación, Abreviaturas, Informe de síntesis, Tratamiento de IRCT: Desarrollo actual y resultados, Objetivos y fundamentos de la técnica, Biocompatibilidad, Clasificación de membranas. Criterios y parámetros, Diálisis adecuada, Morbi-mortalidad asociada a diálisis Uso de las diferentes categorías de membranas, Consideraciones económicas, Conclusiones, Hemodiálisis: Evolución histórica y consideraciones generales, Morbilidad asociada a la diálisis Evolución de la técnica y diálisis adecuada, Criterios de clasificación de las membranas, Valoración clínica de las diferentes categorías de membranas, Extensión del uso de las diferentes categorías de membranas Aspectos económicos del tratamiento, Anexos

Diacylglycerol transport by Arabidopsis Synaptotagmin 1 at ERplasma membrane contact sites under abiotic stress.

Bulk lipid transport between membranes within cells involves vesicles, however membrane contact sites have recently been discovered as mediators of non-vesicular lipid transfer. ER-PM contact sites are conserved structures defined as regions of the endoplasmic reticulum (ER) that tightly associate with the plasma membrane (PM). Our recent data suggest that the constitutively expressed Arabidopsis Synaptotagmin 1 (SYT1) and the cold-induced homolog AtSYT3 are proteins located in these ER-PM contact sites that are essential for the tolerance various abiotic stresses. Arabidopsis SYTs proteins are integral membrane proteins that contain multiple Ca2+-binding C2 domains and a synaptotagmin-like mitochondrial lipid-binding protein (SMP) domain that contains a hydrophobic groove. In mammals, several SMP proteins are responsible for the inter-organelle transport of glycerophospholipids. Our experiments have demonstrated that there is a recruitment of AtSYT1 and AtSTYT3 to ER-PM contact sites under stress conditions and it requires phosphatidylinositol 4- phosphate, PI(4)P in the PM, in opposition to the recruitment of PI(4,5)P2 in mammals. Moreover, our recent high-resolution lipidome analysis suggest that saturated diacylglycerols (DAGs) are the lipids that AtSYT1 is transferring between the PM and ER. Additionally, we have identified AtDGK2 (diacylglycerol kinase 2) as a key interactor of AtSYT1. Generally, in response to a stress stimulus, a phospholipase C (PLC), hydrolyses PIP2 after the elevation of cytosolic Ca2+, generating DAGs which immediately can be converted to phosphatidic acid (PA) by DGKs.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. The authors acknowledge the support by the Plan Propio from University of Malaga, Campus de Excelencia Internacional de Andalucía and by the Redes of Excelencia (BIO2014-56153-REDT) and BIO2017-82609-R, RYC-2016-21172 & PGC2018-098789 of the Ministerio de Economía, Industria y Competitividad

Synaptotagmins at the endoplasmic reticulum-plasma membrane contact sites maintain diacylglycerol homeostasis during abiotic stress

Endoplasmic Reticulum-Plasma Membrane contact sites (ER-PM CS) play fundamental roles in all eukaryotic cells. Arabidopsis mutants lacking the ER-PM protein tether synaptotagmin1 (SYT1) exhibit decreased plasma membrane (PM) integrity under multiple abiotic stresses such as freezing, high salt, osmotic stress and mechanical damage. Here, we show that, together with SYT1, the stress-induced SYT3 is an ER-PM tether that also functions in maintaining PM integrity. The ER-PM CS localization of SYT1 and SYT3 is dependent on PM phosphatidylinositol-4-phosphate and is regulated by abiotic stress. Lipidomic analysis revealed that cold stress increased the accumulation of diacylglycerol at the PM in a syt1/3 double mutant relative to WT while the levels of most glycerolipid species remain unchanged. Additionally, SYT1-GFP preferentially binds diacylglycerol in vivo with little affinity for polar glycerolipids. Our work uncovers a SYT-dependent mechanism of stress adaptation counteracting the detrimental accumulation of diacylglycerol at the PM produced during episodes of abiotic stress

CIBERER: Spanish national network for research on rare diseases: A highly productive collaborative initiative

13 páginas,1 figura, 3 tablas, 1 apéndice. Se extraen los autores pertenecientes a The CIBERER network que trabajan en Centros del CSIC del Appendix ACIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research.This study has been funded by Instituto de Salud Carlos III (ISCIII) and Spanish Ministry of Science and InnovationPeer reviewe

Estudio multifactorial del tratamiento con hemodiálisis periódicas del fracaso renal crónico

Tesis doctoral original inédita, leída el 19 de diciembre de 1979 en la Universidad de Autonoma de Madrid, Facultad de Medicin