E-Health Treatments for Dual Disorders on Pregnancy

Introduction Dual pathology during pregnancy, described as the co-occurrence of substance use and mental health problems, is one of the leading preventable causes of maternal and perinatal mortality and morbidity; however, effective and accessible treatments are lacking. Objectives As part of the WOMAP(Woman Mental Health and Addictions on Pregnancy) initiative, our study aimed to evaluate the effectiveness of an e-health-based psychotherapeutic program compared to enhanced usual care. Methods This effectiveness randomized clinical trial was conducted between 2016-2020 in 5 hospitals in the Madrid(Spain) metropolitan area. 2014 pregnant women under 26 weeks of pregnancy were screened. Eligible participants(n=120) were those who screened positive for co-occurring symptoms(AC-OK screener) and were not receiving specialized behavioral treatment. Participants were assessed in depth at baseline, 2,4,8 and 12 months(PHQ-9;GAD-7;PCL-5;AUDIT;DAST;Fagerström) and randomized to the usual care control group(n=38) or to two groups of a 10-session pregnancy-adapted psychotherapeutic program, one delivered by App/internet(n=41) and one by telephone(n=41). Intent-to-treat analyses assessed effectiveness. Results Statistically significant effects of the intervention were found for mental health symptoms in the telephone group as compared to the control and App/internet groups, with an improvement effect starting earlier(2 months) and lasting longer(figures 1-3). Regarding substance use, due to the lack of other substances consumption, only smoking and alcohol cessation rates were analyzed. Patients in the App/internet and telephone groups discontinued significantly more, earlier and for a longer period compared to the control group(figures 4-5). Conclusions E-health psychotherapeutic programs could benefit pregnant women with dual disorders. An App/internet implementation could only be useful if focused solely on substances.2021-2

Genetic and phenotypic characterisation of HIV-associated aggressive B-cell non-Hodgkin lymphomas, which do not occur specifically in this population: diagnostic and prognostic implications

The frequency of aggressive subtypes of B-cell non-Hodgkin lymphoma (B-NHL), such as high-grade B-cell lymphomas (HGBL) with MYC and BCL2 and/or BCL6 rearrangement (HGBL-DH/TH) or Burkitt-like lymphoma (BL) with 11q aberration, is not well known in the HIV setting. We aimed to characterise HIV-associated aggressive B-NHL according to the 2017 WHO criteria, and to identify genotypic and phenotypic features with prognostic impact. Seventy-five HIV-associated aggressive B-NHL were studied by immunohistochemistry (CD10, BCL2, BCL6, MUM1, MYC, and CD30), EBV-encoded RNAs (EBERs), and fluorescence in situ hybridisation (FISH) to evaluate the status of the MYC, BCL2, and BCL6 genes and chromosome 11q. The 2017 WHO classification criteria and the Hans algorithm, for the cell-of-origin classification of diffuse large B-cell lymphomas (DLBCL), were applied. In DLBCL cases, the frequencies of MYC and BCL6 rearrangements (14.9 and 27.7%, respectively) were similar to those described in HIV-negative patients, but BCL2 rearrangements were infrequent (4.3%). MYC expression was identified in 23.4% of DLBCL cases, and coexpression of MYC and BCL2 in 13.0%, which was associated with a worse prognosis. As for BL cases, the expression of MUM1 (30.4%) conferred a worse prognosis. Finally, the prevalence of HGBL-DH/TH and BL-like with 11q aberration are reported in the HIV setting. The phenotypic and genotypic characteristics of HIV-associated aggressive B-NHL are similar to those of the general population, except for the low frequency of BCL2 rearrangements in DLBCL. MYC and BCL2 coexpression in DLBCL, and MUM-1 expression in BL, have a negative prognostic impact on HIV-infected individuals.Peer reviewe

Disponibilidad y promoción de alcohol según la tipología de los locales y las condiciones socioeconómicas del área

Smoking and substance use during pregnancy are major preventable causes of mortality and morbidity, having a bidirectional and deleterious relationship with the mental health of the mother and child. As part of the WOMAP (Woman Mental Health and Addictions on Pregnancy) initiative, our study aimed to describe the prevalence of co-occurring mental illness and substance use problems, diagnoses and severity of those considered at risk and rates of treatment.A screening of 2,014 pregnant women was done using the AC-OK scale and they were asked about their smoking habits and services use for mental health/substance abuse. Of these, 170 women were considered at risk of co-occurring mental illness and substance use problems (≥ 2 positive responses to the AC-OK-Mental Health subscale, ≥ 1 positive response to the AC-OK-Substance Abuse subscale and/or smoking more than once a month and no use of specialized services) and were assessed with a more extensive battery of measures (Patient Health Questionnaire [PHQ-9], General Anxiety Disorder [GAD-7], Posttraumatic stress disorder [PTSD] Checklist for DSM-5 [PCL-5], Alcohol Use Disorders Identification Test [AUDIT], Drug Abuse Screening Test [DAST] and Fagerström).In the last year, 614 women (30.5%) smoked tobacco (42.5% daily) and 9.8% were positive for both substance use and mental illness per the AC-OK. Only 11.1% of them received specific treatment in the previous three months while another 13.6% were scheduled to attend services in the following month. From the subsample assessed in depth, 62(36.5%) endorsed at least moderate depression, 35(20.6%) endorsed at least moderate anxiety, 32(18.8%) endorsed PTSD on the PCL, and 37 out of 88 alcohol users scored above the threshold in AUDIT (≥ 3).In conclusion, high prevalence and low treatment rates suggest that effective detection mechanisms should be integrated into usual care, allowing for early interventions. ------------------------------------------------------------------ El tabaquismo y el consumo de sustancias durante el embarazo son importantes causas prevenibles de morbimortalidad, teniendo una relación bidireccional y deletérea con la salud mental de la madre y el niño. Como parte de la iniciativa WOMAP (Woman Mental Health and Addictions on Pregnancy), se estudiaron 2014 embarazadas buscando describir la prevalencia de trastornos mentales y por uso de sustancias concurrentes, las tasas de tratamiento y los diagnósticos y la gravedad. Las participantes fueron evaluadas con la escala AC-OK y se les preguntó sobre sus hábitos tabáquicos y uso de servicios de salud mental/sustancias. De las participantes, 170 mujeres resultaron positivas para un trastorno mental y por uso de sustancias concurrentes (≥ 2 positivos a la subescala AC-OK-Salud Mental, ≥ 1 positivos a la subescala AC-OK-Sustancias y/o fumar más de una vez al mes y no estar en tratamiento) y fueron evaluadas en profundidad mediante una batería de escalas (Patient Health Questionnaire [PHQ-9], General Anxiety Disorder [GAD-7], Post-traumatic stress disorder Checklist [PCL-5], Alcohol Use Disorders Identification Test [AUDIT], Drug Abuse Screening Test [DAST] y Fagerström). En el último año, 614 mujeres (30,5 %) fumaron tabaco (42,5 % diariamente) y el 9,8 % fueron positivas para problemas por uso de sustancias y salud mental según la AC-OK. Solo el 11,1 % había recibido tratamiento en los tres meses previos y solo un 13,6 % tenía una cita en el siguiente mes. De las 170 pacientes evaluadas secundariamente, 62(36,5 %) presentaron al menos depresión moderada, 35(20,6 %) al menos ansiedad moderada, 32(18,8 %) fueron positivas a la PCL-5, y 37 de las 88 que reconocieron uso de alcohol puntuaron por encima del umbral en AUDIT (≥ 3). En conclusión, la combinación de una prevalencia significativa junto con bajas tasas de tratamiento, remarcan la necesidad de mecanismos de detección efectivos en la atención habitual, permitiendo una intervención temprana.2020-2

Addictive and wonderful : the experience of reading the Harry Potter series

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Plan gallego de hospitalización a domicilio. Estrategia HADO 2019-2023

Documento estratéxico que pretende potenciar e consolidar a hospitalización a domicilio como un modelo asistencial do Servizo Galego de Saúde e garantir o seu desenvolvemento nos próximos seis anos, establecendo criterios homoxéneos de atención coa finalidade de normalizar os modelos asistenciais, carteira de servizos e fluxos de traballo para asegurar una asistencia sanitaria de calidadeDocumento estratégico que pretende potenciar y consolidar la hospitalización a domicilio como un modelo asistencial del Servicio Gallego de Salud y garantizar su desarrollo en los próximos seis años, estableciendo criterios homogéneos de atención con la finalidad de normalizar los modelos asistenciales, cartera de servicios y flujos de trabajo para asegurar una asistencia sanitaria de calida

High-flow nasal cannula and non-invasive mechanical ventilation in pediatric asthma exacerbation: two-year prospective observational study in intensive care

Background: Asthma is a common cause of admission to the pediatric intensive care unit (PICU). We described and analyzed the therapies applied to children admitted to a tertiary PICU because of asthma. Later, we evaluated high-flow nasal cannula (HFNC) use in these patients and compared their evolution and complications with those who received non-invasive ventilation. Methods: We conducted a prospective observational study (October 2017-October 2019). Collected data: epidemiological, clinical, respiratory support therapy needed, complementary tests, and PICU and hospital stay. Patients were divided into three groups: (1) only HFNC; (2) HFNC and non-invasive mechanical ventilation (NIMV); and (3) only NIMV. Results: Seventy-six patients were included (39 female). The median age was 2 years and 1 month. The median pulmonary score was 5. The median PICU stay was 3 days, and the hospital stay was 6 days. Children with HNFC only (56/76) had fewer PICU days (p = 0.025) and did not require NIMV (6/76). Children with HFNC had a higher oxygen saturation/fraction of inspired oxygen ratio ratio (p = 0.025) and lower PCO2 (p = 0.032). In the group receiving both therapies (14/76), NIMV was used first in all cases. No epidemiologic or clinical differences were found among groups. Conclusion: HFNC was a safe approach that did not increase the number of PICU or hospital days. On admission, normal initial blood gases and the absence of high oxygen requirements were useful in selecting responders to HFNC. Further randomized and multicenter clinical trials are needed to verify these data

Anales de Edafología y Agrobiología Tomo 24 Número 5-6

Níquel en los·suelos de la provincia de La Coruña, por T. Carballas Fernández, M. Muñoz ,Taboadela y F. Guitián Ojea.-- Estudio comparativo de varios métodos no químicos de extracción de fósforo asimilable, por F. Lucena Conde y T. Crisanto Herrero.-- Estudio del grado de evolución de dos suelos de la provincia de Cáceres, por A. García Rodríguez .y M . Sánchez Camazano .-- Nuevo índice fisiológico en las relaciones suelo planta agua, por Angel Ortuño Martínez y María Parra Gilabert.--Evolución anual de nutrientes en hojas de frutales .IV. Vid (parral), por M. G. Guillén, F. G. Fernández y M. Caro.--Los sistemas agropecuarios, por Pedro Montserrat-Recoder.—Notas. III Reunión Internacional de Micromorfología del suelo. Madrid, 1961 (Primera circular).-- C. S. l. C. Plan de Desarrollo Económico y Social, 1964.-- .Curso sohre Micromorfología de Suelo.-- Conferencia del Dr. Vink.-- Comferencia del Dr. Goosen.--Conferencia del Prof. Rutter.-- Conferencia de D. José M. del Moral.-- Conferencia del Prof. Duvigneaud.-- Conferencia del Prof. Wain.-- Ciclo de conferencias sobre Hidrología superficial y subterránea, en Barcelona.-- Congresos, reuniones internacionales y Qecas.-- Nombramientos.-- Invitaciones a profesores extranjeros.-- Problemas de nutrición animal.--Instituto de Orientación y Asistencia Técnica de Levante.—Bibliografía.Estudio Agrobiológíco de la Provincia de Cádiz (Gonzalo Bilbao Agejas).-- Potassium (n relation to Grassland Production (P. Sánéhez Conde)Peer reviewe

Documentos de apoyo para la elaboración de las programaciones didácticas : Educación infantil. Educación Primaria. Educación Secundaria Obligatoria y Bachillerato

Las programaciones docentes deben ser el reflejo documental del plan de trabajo en cada área o materia, fruto de la reflexión conjunta de los miembros del equipo docente o departamento, que desde la reforma operada por la LOMCE deben recoger los nuevos elementos del currículo, como las competencias clave y los estándares de aprendizaje.Esta publicación se concibe como un documento de apoyo para los equipos de ciclo y departamentos, así como para los equipos directivos, en esta tarea de elaboración de las programaciones docentes anuales y contiene unas orientaciones generales, elementos de que debe constar, responsables y normativa de referencia. El documento se centra, de manera diferenciada en la Educación Infantil, en la Educación Primaria y en la Educación Secundaria Obligatoria y Bachillerato.ES

Genetic and phenotypic characterisation of HIV-associated aggressive B-cell non-Hodgkin lymphomas, which do not occur specifically in this population : diagnostic and prognostic implications

Altres ajuts: acord transformatiu CRUE-CSICAltres ajuts: Gilead Sciences S.L. (GLD19/00121); Josep Carreras International Foundation; "la Caixa" FoundationThe frequency of aggressive subtypes of B-cell non-Hodgkin lymphoma (B-NHL), such as high-grade B-cell lymphomas (HGBL) with MYC and BCL2 and/or BCL6 rearrangement (HGBL-DH/TH) or Burkitt-like lymphoma (BL) with 11q aberration, is not well known in the HIV setting. We aimed to characterise HIV-associated aggressive B-NHL according to the 2017 WHO criteria, and to identify genotypic and phenotypic features with prognostic impact. Seventy-five HIV-associated aggressive B-NHL were studied by immunohistochemistry (CD10, BCL2, BCL6, MUM1, MYC, and CD30), EBV-encoded RNAs (EBERs), and fluorescence in situ hybridisation (FISH) to evaluate the status of the MYC, BCL2, and BCL6 genes and chromosome 11q. The 2017 WHO classification criteria and the Hans algorithm, for the cell-of-origin classification of diffuse large B-cell lymphomas (DLBCL), were applied. In DLBCL cases, the frequencies of MYC and BCL6 rearrangements (14.9 and 27.7%, respectively) were similar to those described in HIV-negative patients, but BCL2 rearrangements were infrequent (4.3%). MYC expression was identified in 23.4% of DLBCL cases, and coexpression of MYC and BCL2 in 13.0%, which was associated with a worse prognosis. As for BL cases, the expression of MUM1 (30.4%) conferred a worse prognosis. Finally, the prevalence of HGBL-DH/TH and BL-like with 11q aberration are reported in the HIV setting. The phenotypic and genotypic characteristics of HIV-associated aggressive B-NHL are similar to those of the general population, except for the low frequency of BCL2 rearrangements in DLBCL. MYC and BCL2 coexpression in DLBCL, and MUM-1 expression in BL, have a negative prognostic impact on HIV-infected individuals