Random Changes of Accommodation Stimuli: An Automated Extension of the Flippers Accommodative Facility Test

Postprint (author's final draft

Diagnóstico ecográfico en un caso clínico de quiste paraprostático canino

El artículo describe el diagnóstico ecográfico de un caso clínico de quiste paraprostático en un perro, discutiendo la importancia de la imagen en el diagnóstico de afecciones prostáticas y mostrando imágenes radiológicas y ecográficas.This paper describes the ultrasonographic diagnosis in a case of paraprostatic cyst in a dog. Importance of imaging diagnostic methods in prostatic diseases are discussed. Radiologic and ultrasound images are shown

An automated and objective cover test to measure heterophoria

Postprint (published version

Alberta Stroke Program Early CT Score applied to CT angiography source images is a strong predictor of futile recanalization in acute ischemic stroke

The final publication is available at Springer via http://dx.doi.org/10.1007/s00234-016-1652-7Introduction Reliable predictors of poor clinical outcome despite successful revascularization might help select patients with acute ischemic stroke for thrombectomy. We sought to determine whether baseline Alberta Stroke Program Early CT Score (ASPECTS) applied to CT angiography source images (CTA-SI) is useful in predicting futile recanalization. Methods Data are from the FUN-TPA study registry (ClinicalTrials.gov; NCT02164357) including patients with acute ischemic stroke due to proximal arterial occlusion in anterior circulation, undergoing reperfusion therapies. Baseline non-contrast CT and CTA-SI-ASPECTS, timelapse to image acquisition, occurrence, and timing of recanalization were recorded. Outcome measures were NIHSS at 24 h, symptomatic intracranial hemorrhage, modified Rankin scale score, and mortality at 90 days. Futile recanalization was defined when successful recanalization was associated with poor functional outcome (death or disability). Results Included were 110 patients, baseline NIHSS 17 (IQR 12; 20), treated with intravenous thrombolysis (IVT; 45 %), primary mechanical thrombectomy (MT; 16 %), or combined IVT+MT (39 %). Recanalization rate was 71 %, median delay of 287 min (225; 357). Recanalization was futile in 28 % of cases. In an adjusted model, baseline CTA-SI-ASPECTS was inversely related to the odds of futile recanalization (OR 0.5; 95 % CI 0.3–0.7), whereas NCCT-ASPECTS was not (OR 0.8; 95 % CI 0.5–1.2). A score ≤5 in CTA-SIASPECTS was the best cut-off to predict futile recanalization (sensitivity 35 %; specificity 97 %; positive predictive value 86 %; negative predictive value 77 %). Conclusions CTA-SI-ASPECTS strongly predicts futile recanalization and could be a valuable tool for treatment decisions regarding the indication of revascularization therapie

Intravenous thrombolytic treatment in the oldest old

Background and Purpose. Intravenous thrombolysis using tissue plasminogen activator is safe and probably effective in patients >80 years old. Nevertheless, its safety has not been specifically addressed for the oldest old patients (≥85 years old, OO). We assessed the safety and effectiveness of thrombolysis in this group of age. Methods. A prospective registry of patients treated with intravenous thrombolysis. Patients were divided in two groups (<85 years and the OO). Demographic data, stroke aetiology and baseline National Institute Health Stroke Scale (NIHSS) score were recorded. The primary outcome measures were the percentage of symptomatic intracranial haemorrhage (SICH) and functional outcome at 3 months (modified Rankin Scale, mRS). Results. A total of 1,505 patients were registered. 106 patients were OO [median 88, range 85–101]. Female sex, hypertension, elevated blood pressure at admission, cardioembolic strokes and higher basal NIHSS score were more frequent in the OO. SICH transformation rates were similar (3.1% versus 3.7%, P = 1.00). The probability of independence at 3 months (mRS 0–2) was lower in the OO (40.2% versus 58.7%, P = 0.001) but not after adjustment for confounding factors (adjusted OR, 0.82; 95% CI, 0.50 to 1.37; P = 0.455). Three-month mortality was higher in the OO (28.0% versus 11.5%,P < 0.001). Conclusion. Intravenous thrombolysis for stroke in OO patients did not increase the risk of SICH although mortality was higher in this groupThis work is part of the Spanish collaborative research network RENEVAS (Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación, RD06/0026/008, RD07/0026/2003

Guía itinerario formativo tipo (GIFT) "Anestesiología, reanimación y terapéutica del dolor"

Guía del itinerario formativo de los residentes en el servicio de Anestesiología, reanimación y terapéutica del dolor del Complejo Hospitalario Universitario de FerrolGuía do itinerario formativo dos residentes no servizo de Anestesioloxía, reanimación e terapéutica da dor do Complexo Hospitalario Universitario de Ferro

Mental Health Problems and Related Factors in Ecuadorian College Students

Although the mental health problems of college students have been the subject of increasing research, there are no studies about its prevalence in Ecuadorian college students. The aim of this study was to determine the mental health problems and their associated factors in Ecuadorian freshmen university students. A sample of 1092 students (53.7% women; mean age = 18.3 years) were recruited from the Technical Particular University of Loja (Ecuador). Socio-demographic, academic, and clinical characteristics were gathered, as well as information on the participants’ mental health through a number of mental health screens. Prevalence of positive screens was 6.2% for prevalence of major depressive episodes, 0.02% for generalized anxiety disorders, 2.2% for panic disorders, 32.0% for eating disorders, 13.1% for suicidal risk. Mental health problems were significantly associated with sex, area of study, self-esteem, social support, personality and histories of mental health problems. The findings offer a starting point for identifying useful factors to target prevention and intervention strategies aimed at university studentsThis study was funded by grant PY250 from the Universidad Técnica Particular de Loja (Ecuador)S

A brief problem-solving indicated-prevention intervention for prevention of depression in nonprofessional caregivers

Background: Despite depression being a common problem among nonprofessional caregivers, no studies of prevention of depression targeting this population exist in the literature. The studies of indicated prevention of depression aim of this study was to assess the efficacy of a problem-solving intervention in preventing clinical depression in a sample of female caregivers. Method: A controlled randomized trial was conducted among 173 participants (mean age 53.9 years), 89 of whom were randomized to the intervention group and 84 (controls) to usual care. The intervention comprised five weekly 90-minute group sessions. Results: At post-treatment, depression symptoms in the intervention group had remitted significantly more than in the control group, with a large effect size (d = 1.54). The proportion of participants showing clinically significant improvement was significantly larger in the intervention group (80.9% vs. 11.9% among controls), and fewer intervention-group participants had progressed to clinical depression during the study period (4.5% vs. 13.1% among controls). The intervention group also exhibited a significantly greater reduction in emotional distress and caregiver burden than the control group. Conclusions: These findings attest to the short-term efficacy of the interventionUna intervención breve de solución de problemas para la prevención indicada de la depresión en cuidadoras. Antecedentes: a pesar que la depresión es un problema frecuente en los cuidadores no profesionales, en la literatura no hay estudios de prevención indicada de la depresión en esta población. Se evaluó la eficacia de una intervención de solución de problemas para prevenir la depresión clínica en una muestra de cuidadoras. Método: se realizó un ensayo controlado aleatorizado entre 173 participantes (edad promedio 53,9 años), 89 de las cuales fueron asignadas al azar al grupo de intervención y 84 (controles) a atención habitual. La intervención constó de cinco sesiones aplicadas semanalmente en formato grupal de una duración de 90 minutos cada una. Resultados: en el postratamiento, los síntomas depresivos en el grupo de intervención disminuyeron significativamente más que en el grupo control, con un tamaño del efecto d grande de 1,54. La proporción de participantes con mejoría clínicamente significativa fue significativamente mayor en el grupo de intervención (80,9% frente a 11,9% entre los controles); y menos participantes del grupo de intervención progresaron a una depresión clínica durante el período del estudio (4,5% frente a 13,1% entre los controles). El grupo de intervención también tuvo una reducción significativamente mayor en malestar emocional y sobrecarga del cuidador que el grupo control. Conclusiones: estos hallazgos demuestran la eficacia de la intervención a corto plazoThis study was supported by grant 2007/PN017 from the Ministry of Labour and Social Affairs of Spain. This research was also supported from Ministry of Labour and Welfare (Xunta de Galicia)S

Protocol for a randomized controlled dismantling study of a brief telephonic psychological intervention applied to nonprofessional caregivers with symptoms of depression

Background Although depression is a common problem in caregivers and there are effective cognitive-behavioral interventions for its prevention, the ability of caregivers to attend these treatments is often limited by logistics. Furthermore, the efficacy of the components of these interventions is unknown. The objectives of this study are to (a) evaluate the efficacy of a telephone-administered cognitive-behavioral intervention to prevent depression with all its components (cognitive and behavioral) and only with behavioral activation, and to (b) analyze the mediators of the change in depressive symptoms. Methods/Design A randomized controlled clinical trial was designed to dismantle the components of a cognitive-behavioral intervention. Caregivers with elevated depressive symptoms will be randomly assigned to a cognitive-behavioral intervention, an intervention with only the behavioral activation component, or a usual care control group. Each condition will consist of approximately 60 participants. The two interventions will consist of five sessions lasting 90 min each, applied to groups of about 5 participants at a time via conference call. Trained interviewers, blind to the experimental conditions, will conduct the assessments at the pre-treatment, post-treatment and 1-, 3-, 6- and 12-month follow-ups. Discussion This study will provide evidence of the efficacy of a cognitive-behavioral intervention to prevent depression in caregivers with elevated depressive symptoms administered via conference call, and on the impact of the behavioral activation component on the overall efficacy of the program. If we find favorable results, it would mean that we have developed a program of prevention of depression of higher clinical utility and efficacy than those currently available, which would make it possible for a large number of caregivers to have access to such resourcesThis study was funded by grant 2012-PN162 (PSI2012-37396) from the Ministry of Economy and Competitiveness of Spain. We wish to thank support from Ministry of Labor and Welfare (Xunta de Galicia)S