Enfermedad inflamatoria intestinal: depresión y estrategias de afrontamiento

Los objetivos de esta investigación fueron evaluar las estrategias de afrontamiento del estrés que utilizan los enfermos de Crohn y Colitis Ulcerosa una vez diagnosticada las enfermedad y relacionar estas estrategias con el estado de ánimo (depresivo - no depresivo), con el fin de determinar qué estrategias de afrontamiento son las que más están influyendo en el estado de ánimo del enfermo. La muestra estuvo formada por 40 pacientes, a los que se les administró un cuestionario demográfico, el Inventario de Depresión de Beck y el Cuestionario de Estrategias de Afrontamiento de Lazarus y Folkman. Los datos de este estudio reflejan que un alto porcentaje de enfermos de Crohn y Colitis Ulcerosa (45%) se encuentra deprimido, y que las diferencias en cuanto al sexo y la situación laboral son estadísticamente significativas, siendo las mujeres y aquellos pacientes que se encuentran desempleados, jubilados o que se dedican a sus labores los que mayor puntuación en depresión obtienen. Asimismo, la estrategia de afrontamiento que mejor predice un estado de ánimo depresivo es la de huida.The objectives of this research were to evaluate the stress coping strategies that Crohn and Ulcerative Colitis patients use once the illness is diagnosed and to relate these strategies with the mood (depressive - not depressive), with the aim of determining which coping strategies are influencing more in the patient mood. The sample was formed by 40 patients. They completed a demographic questionnaire, the Beck Depression Inventory and the Coping Strategies Questionnaire by Lazarus and Folkman. The data of this study reflect that a high percentage of Crohn and Ulcerative Colitis patients (45%) are depressed, and differences relating the sex and employed situation are statistically significant, being women and unemployed, retired or housewife patients who got a higher score in depression. Likewise, the coping strategy that better predicts the mood depression state is the avoidance

Utilización de infusores elastoméricos de antibióticos en hospitalización a domicilio

[Abstract] Objective: To describe the avoided costs and to analyze the effectiveness of intravenous antibiotic treatment in continuous perfusion in patients at Hospital at Home Units (HHU) administered using elastomeric infusion pumps (EIP) prepared in a Hospital Pharmacy Service (HPS). Methods: Retrospective observational study of the number and type of EIP prepared in the HPS and of the treated patients. Study period: January 2017-December2018. Analyzed data: demographic data of patients, location of infection, responsible microorganism, medication and type of EIP, dose and duration of treatment and its effectiveness in terms of cure or non-cure or patient's death. Economic valuation considering: costs of EIP, nursing time needed for preparation and cost of HHU care. Results: A total of 1,688 EIP to treat 102 patients resulted in 106 episodes of outpatient treatment of parenteral antibiotic therapy (OPAT) for 1,409 days, thereby avoiding 1,409 days of hospital admission. A total of 59.8% of the patients were men and the mean age was 70.5 ± 17 years. A 31.1% and 68.9% of the cases were empirical and pathogen-directed treatments, respectively. The most used antimicrobials were piperacillin/tazobactam (42.7%), ceftazidime (24.5%), meropenem (19.8%), ceftolozane/tazobactam (2.8%), and cloxacillin (1.9%). Mean duration of treatment was 13.29 ± 8.60 days. Location of infection: respiratory (42.5%), urinary (17.9%), skin and soft tissue (12.3%), bacteraemia (11.3%), osteomyelitis (7.5%), abdominal (3.8%) and 4.7% in other locations. The cure rate was 84%. Total avoided cost: 580,788.28€ in the 24 months studied. Conclusions: This program represents very important economic savings for the health system, and the effectiveness of the antibiotic treatment has not been compromised.[Resumen] Objetivo. Describir los costes evitados y analizar la efectividad del tratamiento con antibióticos por vía intravenosa en perfusión continua en pacientes en unidades de Hospitalización a Domicilio (HD) administrados con bombas de infusión elastoméricas (BIE) preparadas en un Servicio de Farmacia Hospitalaria (SFH). Método. Estudio observacional retrospectivo del número y tipo de BIE preparados en el SFH y pacientes tratados entre enero 2017 y diciembre 2018. Los datos analizados fueron: datos demográficos de pacientes, localización de la infección, microorganismo, medicación y tipo de BIE, dosis y duración del tratamiento y efectividad en términos de curación o no curación o muerte. Valoración económica: coste de BIE, tiempo de enfermería necesario para la preparación y coste de la atención en HD. Resultados. Se analizaron 1.688 BIE preparados para tratar 102 pacientes que resultaron en 106 episodios de tratamiento ambulatorio durante 1.409 días, evitando así 1.409 días de ingreso hospitalario. El 59,8% de los pacientes eran hombres y la edad media 70,5±17 años. El 31,1% de los tratamientos fueron empíricos versus 68,9% dirigidos por patógeno. Los antimicrobianos más empleados fueron piperacilina-tazobactam (42,7%), ceftazidima (24,5%), meropenem (19,8%), ceftolozano-tazobactam (2,8%) y cloxacilina (1,9%). La duración media del tratamiento fue de 13,29 ± 8,60 días. Localización de la infección: respiratorias (42,5%), urinarias (17,9%), piel y partes blandas (12,3%), bacteriemias (11,3%), osteomielitis (7,5%), abdominales (3,8%) y un 4,7% en otras localizaciones. La tasa de curación del 84%. El coste total evitado fue de 580.788,28€ durante los 24 meses de estudio. Conclusiones. Este programa representa un ahorro económico muy importante para el sistema de salud, y la efectividad del tratamiento con antibióticos no se ha visto comprometida

Saberes para el buen vivir en la cultura digital desde el Sur Global

El presente trabajo busca dar visibilidad al lugar de enunciación de las personas mayores en la cultura digital desde el Sur Global. Tiene como base un estudio investigativo de corte biográfico que se interroga por el lugar de las tecnologías de comunicación e información en el desarrollo de posibilidades de creación de sí y de las luchas por el buen vivir de hombres y mujeres mayores, que en contextos precarizados y de creciente desigualdad como el colombiano, configuran rutas y trayectorias de encuentro con las TICs. A lo largo del texto se reconocen posicionamientos que se imponen a los guiones de la vejez del orden global, outsiders del sistema moderno capitalista, colonial y patriarcal, dibujando un ecosistema integrado de saberes y experiencias cultivados en lo cotidiano que ofrecen una matriz civilizatoria alternativa, articulada en temporalidades, espacialidades, prácticas de cuidado, autonomía, formas de estar juntos, que invitan a repensar la cultura digital más allá de jerarquías epistémicas

Ehlers–Danlos Syndrome Type Arthrochalasia: A Systematic Review

Ehlers–Danlos syndrome type arthrochalasia (aEDS) is a rare genetic disease characterized by severe generalized joint hypermobility, bilateral congenital hip dislocation, skin hyperextensibility, muscle hypotonia, and mild dysmorphic features. It is an autosomal dominant connective tissue disease causing defects in collagen, associated with two genes, COL1A1 or COL1A2. Only about 42 cases have been published worldwide. Treatment is currently symptomatic and focuses on increasing the quality of life of these patients, as there is no curative treatment. The main objective of the review was to update information on Ehlers–Danlos syndrome type arthrochalasia from scientific publications. The review report was carried out in accordance with the criteria of the Preferred Reporting Items for Systematic reviews and MetaAnalyses (PRISMA) review protocol, by searching Orphanet, OMIM, PubMed, and Scopus, as well as free sources. A total of 20 articles were analyzed, which, after analysis, provide an updated report that aims to establish a solid starting point for future lines of research

Validity of Virtual Reality Body Exposure to Elicit Fear of Gaining Weight, Body Anxiety and Body-Related Attentional Bias in Patients with Anorexia Nervosa

Fear of gaining weight (FGW), body image disturbances, associated anxiety and body-related attentional bias are the core symptoms of anorexia nervosa (AN) and play critical roles in its development and maintenance. The aim of the current study is to evaluate the usefulness of virtual reality-based body exposure software for the assessment of important body-related cognitive and emotional responses in AN. Thirty female patients with AN, one of them subclinical, and 43 healthy college women, 25 with low body dissatisfaction (BD) and 18 with high BD, owned a virtual body that had their silhouette and body mass index. Full-body illusion (FBI) over the virtual body was induced using both visuo-motor and visuo-tactile stimulation. Once the FBI was induced, the FBI itself, FGW, body anxiety and body-related attentional bias toward weight-related and non-weight-related body areas were assessed. One-way analyses of covariance (ANCOVA), controlling for age, showed that AN patients reported higher FGW, body anxiety and body-related attentional bias than healthy controls. Unexpectedly, patients with AN reported significantly lower FBI levels than healthy participants. Finally, Pearson correlations showed significant relationships between visual analog scales and body-related attentional bias measures, compared to other eating disorder measures. These results provide evidence about the usefulness of virtual reality-based body exposure to elicit FGW and other body-related disturbances in AN patients. Thus, it may be a suitable intervention for reducing these emotional responses and for easing weight recovery

AN-VR-BE. A randomized controlled trial for reducing fear of gaining weight and other eating disorder symptoms in anorexia nervosa through virtual reality-based body exposure

In vivo body exposure therapy is considered an effective and suitable intervention to help patients with anorexia nervosa (AN) reduce their body image disturbances (BIDs). However, these interventions have notable limitations and cannot effectively reproduce certain fears usually found in AN, such as the fear of gaining weight (FGW). The latest developments in virtual reality (VR) technology and embodiment-based procedures could overcome these limitations and allow AN patients to confront their FGW and BIDs. This study aimed to provide further evidence of the efficacy of an enhanced (by means of embodiment) VR-based body exposure therapy for the treatment of AN. Thirty-five AN patients (16 in the experimental group, 19 in the control group) participated in the study. FGW, BIDs, and other body-related and ED measures were assessed before and after the intervention and three months later. The experimental group received treatment as usual (TAU) and five additional sessions of VR-based body exposure therapy, while the control group received only TAU. After the intervention, ED symptoms were clearly reduced in both groups, with most of the changes being more noticeable in the experimental group. Specifically, after the intervention and at follow-up, significant group differences were found in the FGW and BIDs, with the experimental group showing significantly lower values than the control group. The current study provides new insights and encouraging findings in the field of exposure-based therapies in AN. VR technology might improve research and clinical practice in AN by providing new tools to help patients confront their core fears (i.e., food- or weight-related cues) and improve their emotional, cognitive, and behavioral responses to their body image

Early identification of golimumab-treated patients with higher likelihood of long-term retention

BackgroundThe early identification of patients’ profiles most likely to respond to and maintain long-term therapy with a biological drug can have clinical and cost-effectiveness implications.ObjectivesTo evaluate the utility of an innovative approach for early identification of patient profiles associated with long-term persistence of golimumab, a tumour necrosis factor inhibitor, in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (SpA) under real-world conditions.DesignRetrospective non-interventional database analysis.MethodsKaplan-Meier curves of golimumab retention over 8 years from the BIOBADASER registry, overall and by indication, were analysed using a novel approach (a two-phase decay model) to identify the point at which the golimumab retention curve shifted from rapid (indicating high golimumab discontinuation rate) to slow decay (low discontinuation rate). Factors associated with golimumab retention at these time points were identified using Cox regression, and retention rates for different patient profiles were calculated.Results885 patients were included. The golimumab retention curve shifted from rapid to slow decay at month 10 for the overall population (retention rate: 73.4%), at month 24 for RA patients (retention: 45.0%), and at month 8 for SpA, including axial SpA and PsA (81.6%). Factors associated with golimumab discontinuation at these early points were, overall, similar to those previously identified at year 8 (RA diagnosis, golimumab as second- or third-line of biological therapy, disease activity over the median and treatment with corticosteroids at golimumab initiation, advanced age [in RA], and female gender [in SpA]).ConclusionWith this novel approach, the factors associated with long-term retention were identified in the initial period of rapid discontinuation of golimumab

PM060184, a new tubulin binding agent with potent antitumor activity including P-glycoprotein over-expressing tumors

PM060184 belongs to a new family of tubulin-binding agents originally isolated from the marine sponge Lithoplocamia lithistoides. This compound is currently produced by total synthesis and is under evaluation in clinical studies in patients with advanced cancer diseases. It was recently published that PM060184 presents the highest known affinities among tubulin-binding agents, and that it targets tubulin dimers at a new binding site. Here, we show that PM060184 has a potent antitumor activity in a panel of different tumor xenograft models. Moreover, PM060184 is able to overcome P-gp mediated resistance in vivo, an effect that could be related to its high binding affinity for tubulin. To gain insight into the mechanism responsible of the observed antitumor activity, we have characterized its molecular and cellular effects. We have observed that PM060184 is an inhibitor of tubulin polymerization that reduces microtubule dynamicity in cells by 59%. Interestingly, PM060184 suppresses microtubule shortening and growing at a similar extent. This action affects cells in interphase and mitosis. In the first case, the compound induces a disorganization and fragmentation of the microtubule network and the inhibition of cell migration. In the second case, it induces the appearance of multipolar mitosis and lagging chromosomes at the metaphase plate. These effects correlate with prometaphase arrest and induction of caspase-dependent apoptosis or appearance of cells in a multinucleated interphase-like state unrelated to classical apoptosis pathways. Taken together, these results indicate that PM060184 represents a new tubulin binding agent with promising potential as an anticancer agent.This work was supported by grants BIO2010-16351 (JFD), CAM S2010/BMD-2457 (JFD), CAM S2010/BMD-2353 (JMA), BFU2011-23416 (JMA) and PharmaMar-CSIC contracts. BP had a contract from Comunidad de Madrid

El rol del alumno-profesor: trabajando competencias transversales y elaboración de materiales docentes

[ES] La experiencia innovadora que se describe en la presente comunicación tuvo como objetivos generales aumentar la motivación por el aprendizaje y fomentarlo en su modalidad autónoma, consolidando la adquisición y desarrollo de competencias de los alumnos de la optativa de Derecho penal de cuarto curso del Grado en Derecho impartido en la ULe. Los objetivos específicos, articulados a través de elementos propios de modelos pedagógicos innovadores, como el aprendizaje-servicio, el aula invertida o el aprendizaje colaborativo, obedecieron a este fin general. Con ocasión del Día Internacional de la eliminación de la violencia contra la Mujer y tras la aprobación de la Ley Orgánica de garantía integral de la libertad sexual, los días 23, 24 y 25 de noviembre de 2022, el GID DP-ULe y el Grupo de Investigación Derecho Penal de la ULe organizaron el seminario «El Derecho penal en la prevención y castigo de las violencias sexuales», en el que los alumnos participaron: preparando y efectuando la contextualización de cada una de las mesas; comunicando los resultados del estudio de alguno de los delitos tratados; moderando las sesiones del seminario; y grabando y editando un vídeo para su proyección en el seminario y para su utilización como material docente en el curso 2023/2024. Aunque sea pronto para hablar de todos los resultados y extraer conclusiones definitivas, en las fases ya realizadas del proyecto es palpable el desarrollo de ciertas competencias por parte de los estudiantes, mostrándose las actividades organizadas como adecuadas para alcanzar los objetivos planteados y los alumnos satisfechos y motivados con la experiencia

Combined dietary administration of Chlorella fusca and ethanol-inactivated Vibrio proteolyticus modulates intestinal microbiota and gene expression in Chelon labrosus

The use of functional feeds in aquaculture is currently increasing. This study aimed to assess the combined impact of dietary green microalgae Chlorella fusca and ethanol-inactivated Vibrio proteolyticus DCF12.2 (CVP diet) on thick-lipped grey mullet (Chelon labrosus) juvenile fish. The effects on intestinal microbiota and the transcription of genes related to metabolism, stress, and the immune system were investigated after 90 days of feeding. Additionally, the fish were challenged with Aeromonas hydrophila and polyinosinic–polycytidylic acid (poly I:C) to evaluate the immune response. Microbiota analysis revealed no significant differences in alpha and beta diversity between the anterior and posterior intestinal sections of fish fed the control (CT) and CVP diets. The dominant genera varied between the groups; Pseudomonas and Brevinema were most abundant in the CVP group, whereas Brevinema, Cetobacterium, and Pseudomonas were predominant in the CT group. However, microbial functionality remained unaltered. Gene expression analysis indicated notable changes in hif3α, mhcII, abcb1, mx, and tnfα genes in different fish organs on the CVP diet. In the head kidney, gene expression variations were observed following challenges with A. hydrophila or poly I:C, with higher peak values seen in fish injected with poly I:C. Moreover, c3 mRNA levels were significantly up-regulated in the CVP group 72 h post-A. hydrophila challenge. To conclude, incorporating C. fusca with V. proteolyticus in C. labrosus diet affected the microbial species composition in the intestine while preserving its functionality. In terms of gene expression, the combined diet effectively regulated the transcription of stress and immune-related genes, suggesting potential enhancement of fish resistance against stress and infections