Impact of discontinuing non-pharmacological interventions on cognitive impairment in dementia patients by COVID-19 lockdown. A pilot observational, longitudinal, retrospective study carried out in an adult day center in Spain during the COVID-19 pandemic

[EN] Background: The lockdown imposed during the COVID-19 pandemic led to social isolation and prevented patients with dementia from receiving a suite of non-pharmacological interventions (NPIs) that prevent cognitive decline. This discontinuation of NPIs could substantially affect the mental health status of people with dementia in social care settings, such as adult day care centers (ADCs). Propose: The study aimed to evaluate the effects of the COVID-19 lockdown on mental health and cognitive impairment in patients with dementia who could not attend their usual ADCs and did not receive our NPIs, based on World Health Organization (WHO) Guidelines. Methods: Observational, longitudinal, retrospective study carried out in an adult day center in Spain and reported it in accordance with the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) statement. Cognitive status was assessed using the Mini-Mental State Examination (MMSE) in 80 patients attending the ADC of the “Leonese Association of Dementia Patients” (León, Spain), who had been evaluated with this instrument before the COVID-19 lockdown. Results: We observed a 0.4-point decrease in MMSE score/month (IQR = 1.4) during lockdown versus a 0.1-point decrease/month (IQR = 0.3) before this period (p = 0.038). Notably, this translated to >10-point decreases in MMSE score/ year in 33.8% of participants during lockdown versus 5.5% earlier (p < 0.001). No statistically significant associations (p < 0.05) were found between the individual characteristics of the caregivers and the occurrence of the event. Conclusion: The reported declines in MMSE scores reveal a significant acceleration of cognitive decline during the period of inactivity. This could suggest that our NPIs, focused on slowing cognitive decline, are beneficial and, therefore, necessary in patients with dementia.SIDepartment of Education of the Government of Castilla y León and European Regional Development Fund (grant nos. VA005P17 and VA002G18

Prescribed Burning and Clear-Cutting Effects on Understory Vegetation in a Pinus canariensis Stand (Gran Canaria)

[EN] Prescribed fires are a powerful tool for reducing fire hazards by decreasing amounts of fuel. The main objective is to analyze the effects of prescribed burning on the understory vegetation composition as well as on the soil characteristics of a reforested stand of Pinus canariensis. The study attempts to identify the effects of the preburning treatment of cutting understory vegetation on the floristic parameters of the vegetation community. This study was carried out for two years following a prescribed fire in a Canarian pine stand. Cutting and burning treatment affected species composition and increased diversity. Burnt and cut plots were characterized by a diverse array of herbaceous species and by a lower abundance of Teline microphylla (endemic legume), although burning apparently induced its germination. Cut treatment was more consistently differentiated from the control plots than burnt treatment. Soil K decreased after both treatments, pH slightly decreased after cutting, while P and Ca increased after fire. From an ecological point of view, prescribed burning is a better management practice than cutting the woody species of the understory. However, long-term studies would be necessary to evaluate the effects of fire intensity, season and frequency in which the prescribed burning is appliedSIConsejería de Medio Ambiente y Emergencias (Gran Canaria Council), especially UOFF and PRESA, for granting permission to work in Pinus canariensis forest, carrying out the prescribed fire, and partially supporting this study (CI02380503). They also thank the Ministerio de Educación y Ciencia (MEC) of the Spanish Government, which provided financial support by granting C. García a FPU (Formación de Profesorado Universitario, AP2005- 4736) predoctoral fellowshi

Una Experiencia de aprendizaje basado en proyectos utilizando herramientas colaborativas de desarrollo de software libre

En este artículo se describe la experiencia desarrollada en el ámbito de una asignatura optativa sobre programación declarativa en la que se han utilizado herramientas colaborativas habituales en el desarrollo de software libre. Se ha creado un proyecto común entre todos los estudiantes, con el objetivo de facilitar un aprendizaje basado en proyectos

La escala Strength and Difficulties Questionnaire (SDQ) como predictora del TDAH: comportamiento de los índices SDQ respecto a las dimensiones “hiperactividad/Impulsividad” e “inatención” en una muestra clínica.

Introduction: Strength and Difficulties Questionnaire (SDQ) is an international screening tool widely used for research and clinical practice on child and adolescents. Objective: The aim of this study was to explore the relationship between SDQ indices and “Hyperactivity/Impulsivity" and "inattention" domains of specific ADHD scale. Method: The SDQ and ADHD-RS-IV were administered to parents and teachers of a sample of 212 children aged between 6 and 16 years old with a prior diagnosis of ADHD. Results: A significant relationship between "Hyperactivity/inattention" Scale (SDQ) and "hyperactivity/impulsivity" and "inattention" ADHD dimensions was confirmed. However, other SDQ scales were also related, depending of informant and ADHD domain. For the family, "hyperactivity/impulsivity" domain was related with high scores on "behavior problems" scale, while the "inattention" was related with "emotional symptoms" scale. Conclusions: This results suggest the possibility of to take into account rating scores on SCT scales to increase the sensitivity of the scale to discriminate ADHD clinical subtypes.Introducción: La escala Strength and Difficulties Questionnaire (SDQ) es una herramienta de cribado clínico para  infancia y adolescencia ampliamente utilizada internacionalmente en la clínica y en la investigación.  Objetivo: El objetivo de este estudio es explorar la relación entre los diferentes índices de la escala SDQ y la puntuación en las dimensiones “Hiperactividad/Impulsividad” e “inatención” en una escala específica de TDAH. Método: Padres y profesores/as de una muestra de 212 niños/as de entre 6 y 16 años con un diagnóstico previo de TDAH, completaron las escalas SDQ y ADHD-RS-IV. Resultados: Se confirmó la relación significativa entre la dimensión “Hiperactividad” de la escala SDQ y ambas dimensiones del TDAH. Sin embargo, otros índices de la escala SDQ mostraron también relación con ambas dimensiones, diferenciando esta relación según el informador y la dimensión clínica. Para la familia, la “hiperactividad/impulsividad” estaba también relacionada con puntuaciones elevadas en el índice “Problemas de conducta”, mientras que la “inatención” lo estaba con “síntomas emocionales”. Conclusiones: Estos resultados sugieren la posibilidad de valorar las puntuaciones en otros índices de la escala SCT para aumentar la sensibilidad de la escala a los diferentes perfiles clínicos del TDAH

Colchicine treatment in children with periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome: A multicenter study in Spain

Objective: To evaluate the efficacy of colchicine therapy in pediatric patients with PFAPA syndrome who present with an incomplete response to the standard treatment or with frequent episodes (an interval of less than 14 days between two disease flares). Methods: A multicenter cohort study of children diagnosed with PFAPA syndrome and treated with colchicine was performed in three separate hospitals located in Spain. The patients clinical and laboratory data were reviewed by accessing their medical records. Response to colchicine was evaluated after 12 months of treatment for frequency, duration, and intensity of PFAPA episodes. Results: A total of 13 children were included in our study, 43% of whom were boys. Median age of the colchicine therapy initiation was 6 years (interquartile range (IQR)=3-9.5). Following a 12-month period of colchicine therapy (median dosage of 0.02 mg/kg/day; IQR=0.02-0.03), a significant decrease in the median number of flares (median 8; IQR=7-14 vs 3; IQR=2-4; p=0.005) and the duration of disease episodes (median 4 days; IQR=3.25-5.125 vs 1 day; IQR=1-2; p=0.003) was observed. Furthermore, the highest degree of fever during disease flares was reduced from median 40ºC (IQR=39.5-40) to 38.5ºC (IQR=37.7-38.9) (p=0.002). Conclusion: Colchicine therapy decreased the frequency and intensity of PFAPA. The use of colchicine could be an effective treatment in pediatric patients with PFAPA syndrome who present with frequent or severe relapses

Intergroup conflict and rational decision making

The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved in an in-group deliberative discussion. Results of a laboratory experiment support the idea that intergroup conflict ¿associated with indicators of the activation of negative feelings (negative affect state and heart rate)¿ has a negative effect on the aforementioned rationality over time and on both group and individual decision making. Although intergroup conflict leads to sub-optimal decision making, rationality improves when groups and individuals subjected to intergroup conflict make decisions after an in-group deliberative discussion. Additionally, the increased rationality of the group decision making after the deliberative discussion is transferred to subsequent individual decision making

Transcanalicular laser dacryocystorhinostomy in the treatment of primary acquired nasolacrimal infrasacal duct obstruction

Primary acquired nasolacrimal infrasacal duct obstruction (PANDO) is a common disorder in middle aged an older patients leading to chronic epiphora and blepharitis as well as recurring or chronic dacryocystitis./nIn the treatment of PANDO, external dacryocystorhinostomy (DCR) is still considered to be "the gold standard " with success rates above 85%./nHowever in recent years external DCR is considered an invasive procedure that puts at risk the medial structures of the eyelid including the physiological canalicular pump mechanism and leave patient with an uncosmetic scar./nThese risks are potentially avoidable by performing less invasive techniques or choosing an endonasal approach (endoscopic or laser modified)./nOne disadvantage of laser modified surgery is the economic inversion because of the high cost of the equipment and maintenance.La obstrucción primaria adquirida infrasacal del ducto nasolagrimal es una entidad bastante frecuente en pacientes de edad media y avanzada que origina epífora y blefaritis así como dacriocistitis crónica y/o recurrente./nEn el tratamiento de esta patología se sigue considerando, aunque cada vez menos, la dacriocistorrinostomía (DCR) externa como "el gold standard" con unas tasas de éxito que se sitúan alrededor del 85%./nSin embargo, en la actualidad, es considerada como una opción "invasiva", que pone en riesgo estructuras como el mecanismo de bomba canalicular y puede generar una cicatriz poco cosmética./nEstos riesgos potenciales se pueden evitar con técnicas menos invasivas (DCR endoscópica y la DCR transcanalicular con láser diodo modificada)./nLa principal desventaja que puede presentar la técnica quirúrgica de dacriocistorrinostomía con láser diodo es la inversión económica por el alto coste del aparataje y su mantenimient

Position statement on infection screening, prophylaxis, and vaccination in pediatric patients with rheumatic diseases and immunosuppressive therapies, part 2: infection prophylaxis

This study aims to provide practical recommendations on prophylaxis for infection in pediatric patients with immune-mediated rheumatic diseases receiving/scheduled to receive immunosuppressive therapy. A qualitative approach was applied. A narrative literature review was performed via Medline. Primary searches were conducted using MeSH terms and free text to identify articles that analyzed data on infections and vaccinations in pediatric patients with immune-mediated rheumatic diseases receiving immunosuppressive therapy. The results were presented and discussed in a nominal group meeting comprising a committee of 12 pediatric rheumatologists from the Prevention and Treatment of Infections Working Group of the Spanish Society of Pediatric Rheumatology. Several recommendations were generated. A consensus procedure was implemented via a Delphi process that was extended to members of the Spanish Society of Pediatric Rheumatology and the Vaccine Advisory Committee of the Spanish Association of Pediatrics. Participants produced a score ranging from 0 (completely disagree) to 10 (completely agree). Agreement was considered to have been reached if at least 70% of participants voted ≥ 7. The literature review included more than 400 articles. Overall, 63 recommendations were generated (23 on infection prophylaxis) and voted by 59 pediatric rheumatologists and other pediatric specialists, all of whom achieved the pre-established level of agreement. The recommendations on prophylaxis of infection cover vaccination and prophylaxis against varicella zoster virus, tuberculosis, Pneumocystis jiroveccii, and invasive fungal infections in pediatric patients with immune-mediated rheumatic diseases receiving/scheduled to receive immunosuppressive therapy. Conclusion: Based on current evidence and a Delphi process, we provided consensus and updated recommendations on prophylaxis and treatment of infections to guide those caring for pediatric rheumatology patients.Funding for open access charge: Universidad de Málaga/CBU

Metoprolol in Critically Ill Patients With COVID-19.

Severe coronavirus disease-2019 (COVID-19) can progress to an acute respiratory distress syndrome (ARDS), which involves alveolar infiltration by activated neutrophils. The beta-blocker metoprolol has been shown to ameliorate exacerbated inflammation in the myocardial infarction setting. The purpose of this study was to evaluate the effects of metoprolol on alveolar inflammation and on respiratory function in patients with COVID-19-associated ARDS. A total of 20 COVID-19 patients with ARDS on invasive mechanical ventilation were randomized to metoprolol (15 mg daily for 3 days) or control (no treatment). All patients underwent bronchoalveolar lavage (BAL) before and after metoprolol/control. The safety of metoprolol administration was evaluated by invasive hemodynamic and electrocardiogram monitoring and echocardiography. Metoprolol administration was without side effects. At baseline, neutrophil content in BAL did not differ between groups. Conversely, patients randomized to metoprolol had significantly fewer neutrophils in BAL on day 4 (median: 14.3 neutrophils/µl [Q1, Q3: 4.63, 265 neutrophils/µl] vs median: 397 neutrophils/µl [Q1, Q3: 222, 1,346 neutrophils/µl] in the metoprolol and control groups, respectively; P = 0.016). Metoprolol also reduced neutrophil extracellular traps content and other markers of lung inflammation. Oxygenation (PaO2:FiO2) significantly improved after 3 days of metoprolol treatment (median: 130 [Q1, Q3: 110, 162] vs median: 267 [Q1, Q3: 199, 298] at baseline and day 4, respectively; P = 0.003), whereas it remained unchanged in control subjects. Metoprolol-treated patients spent fewer days on invasive mechanical ventilation than those in the control group (15.5 ± 7.6 vs 21.9 ± 12.6 days; P = 0.17). In this pilot trial, intravenous metoprolol administration to patients with COVID-19-associated ARDS was safe, reduced exacerbated lung inflammation, and improved oxygenation. Repurposing metoprolol for COVID-19-associated ARDS appears to be a safe and inexpensive strategy that can alleviate the burden of the COVID-19 pandemic.Mr Clemente-Moragón is supported by a fellowship from the Ministerio de Ciencia e Innovación (FPU2017/01932). The CNIC is supported by the ISCIII, the Ministerio de Ciencia e Innovación, and the Pro CNIC Foundation. Dr Ibáñez is supported by the European Commission (ERC-CoG grant No 819775) and by the Spanish Ministry of Science and Innovation (MCN; “RETOS 2019” grant No PID2019- 107332RB-I00). Dr Oliver is supported by funds from the Comunidad de Madrid Programa de Atracción de Talento (2017-T1/BMD-5185). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.S