The smartphone in research: The instant messenger as an ally to reduce trial drop-outs

El permanente avance de la telefonía móvil en la vida diaria puede traducirse en beneficios para los investigadores, especialmente en el campo de la salud. Hay varios motivos para ello: la reducción de gastos derivados de las llamadas telefónicas, del SMS, así como del tiempo dedicado a la puesta en contacto con los sujetos; puede ser una herramienta de anonimato perfecta, asociando un código a un número de teléfono; se tiene constancia del momento en que el sujeto ha leído la información suministrada por el investigador y además permite una mayor cercanía entre el participante y el investigador

Evaluation of the screening in current diagnosis of prostatic cancer. New development of urinary biomarkers

El cáncer de próstata (CaP) es el tumor maligno no cutáneo más frecuente en el hombre, y supone la segunda causa de muerte por cancer en hombres en EEUU, sólo superado por el cáncer de pulmón. Constituye unos de los problemas sanitarios más importantes en nuestro medio, tanto en términos de morbimortalidad, como de impacto social, económico o sobre la calidad de vida. Sin embargo a pesar de tratarse de un cáncer muy prevalente el screening del cáncer de próstata es aún controvertido. Las principales técnicas utilizadas en la evaluación inicial del cáncer de próstata son el examen digito-rectal, antígeno prostático específico (PSA) sérico, y la ecografía transrectal de próstata. El PSA, es considerado actualmente, el biomarcador más importante para la detección y monitorización del CaP, sin embargo carece de especificidad. Esto ha llevado a la búsqueda de biomarcadores tanto urinarios como en sangre, que supongan una alternativa, para superar esa falta de especificidad. Recientemente se han propuesto una serie de marcadores biológicos alternativos en distintos tipos de tumores, entre los que se encuentra el CaP.Prostate cancer (PCa) tumor is the most common non-cutaneous malignancy in men, and is the second leading cause of cancer death in men in the U.S, exceeded only by lung cancer. It is one of the most important health problems in our environment, both in terms of morbidity and mortality, as social, economic or quality of life. But despite being a highly prevalent cancer screening for prostate cancer remains controversial. The main techniques used in the initial evaluation of prostate cancer are finger-rectal examination, serum prostatic specific antigen (PSA), prostate transrectal ultrasound. The PSA is considered the most important biomarker for the detection and monitoring of prostate cancer, however it lacks specificity. This has led to the search for biomarkers in both urine and blood, which constitute an alternative to overcome this lack of specificity. Have recently proposed a series of alternative biological markers in different types of tumors, including PCa found

Breastfeeding and cognitive development; interference evaluation by "5 digits test"

Introducción y objetivo: Numerosos estudios han intentado demostrar que la duración de la lactancia materna se relaciona con un mejor desarrollo cognitivo en la edad escolar. En el pre- sente estudio se evalúa el potencial efecto beneficioso a largo plazo de la alimentación con leche materna durante los prime- ros meses de vida, no sólo sobre el desarrollo cognitivo, sino también como posible prevención del déficit de atención e hipe- ractividad. Esta valoración resulta de especial interés en la so- ciedad actual en la que se han incrementado de forma muy nota- ble los déficits de atención en la infancia, unidos o no a trastornos de hiperactividad. Material y Métodos: Un total de 103 niños, escolarizados en primer curso de Educación Primaria, 6 años de edad, (47 niños y 56 niñas), fueron reclutados en diferentes colegios de la provin- cia de Granada de áreas urbanas, semiurbanas y rurales. Se analizó la velocidad de procesamiento cognitivo y la capacidad de enfocar la atención y reorientarla tras un suceso de distrac- ción, mediante el test de los cinco dígitos (5-DGT), variante del test de interferencia de Stroop. Resultados: Los datos demuestran una correlación lineal en- tre una mayor duración de la lactancia materna y mejores resul- tados en todas las pruebas del test. Resultan altamente significa- tivas (P ≤ 0,001) las comparaciones para las pruebas de lectura y alternancia, entre aquellos niños que fueron alimentados con le- che materna durante 6 meses frente a los que sólo recibieron es- ta alimentación durante su primer mes de vida. Conclusión: El estudio valida la hipótesis inicial, demostrando una mayor velocidad de resolución y una menor interferencia en el grupo de niños alimentados con pecho al menos durante los 6 primeros meses. Los datos obtenidos deberían refrendarse en un posterior estudio, con una mayor muestra, ya que resulta de su- ma importancia reforzar el consejo de lactancia materna duran- te al menos los 6 primeros meses de vida ante neonatos con sospe- cha clínica de posible desarrollo de TDAH.Background and objective: Different publications have analyzed the possible correlation between breastfeeding length and a better cognitive development during school age. The present study evaluates the possible long term beneficial effects of breastfeeding during the first months of life on the cognitive development, as well as its possible role on the attention deficit and hyperactivity prevention. Currently this evaluation is of special interest considering the increasing number in western societies of childhood attention deficits, with or without, hyper - activity disorders. Material and methods: 103 children, during the first year of elementary education, 6 years of age (47 boys and 56 girls), were recruited in different schools of the Granada province, inclu- ding urban, semi-urban and rural areas. The speed of cognitive processing and the ability to focus attention and reorient after an incident of distraction, using the five digits test (5-DGT), - variant of the Stroop interference test- were analyzed. Results: Data show a linear correlation between longer breastfeeding and better scores in the test. Particularly signifi- cant (P ≤ 0.001) are the reading and alternation tests for chil- dren who were breastfed for 6 months when compared with those that only received this nutrition during their first month of life. Conclusion: This study validates the initial hypothesis, showing faster resolution speed and less interference in the group of children breastfed, at least during the first 6 months of life. Further well designed studies are necessary for reinforced breastfeeding recommendation, at least during the first 6 months of life, for children underclinical suspicion of possible ADHD development

Acute and chronic stress increase salivary cortisol: a study in the real-life setting of a national examination undertaken by medical graduates

Spanish medical graduates who apply for a medical specialty training position (MIR) must take an examination that will shape their future personal and professional lives. Preparation for the test represents an important stressor that persists for several months. The aim of this study was to elucidate the stress pattern of this group and evaluate possible changes in the circadian rhythm of cortisol release in medical graduates preparing for this test. A repeated-measures longitudinal study was performed, measuring the salivary cortisol concentrations in 36 medical graduates (13 males and 23 females; mean age of 24.2 years) on five sampling days. Five cortisol samples were collected from 07:00 to 21:00 h in order to monitor changes in the circadian rhythm. On all sampling days (except on the day of the official examination), anxiety and psychological stress were evaluated with the Spanish versions of the State-Trait Anxiety Inventory (STAI) and the Perceived Stress Scale (PSS). During the study period, participants showed higher levels of anxiety than the Spanish reference population as well as a progressive increase in self-perceived stress. A significant increase in salivary cortisol concentration was observed in both chronic (study and examination preparation) and acute (examinations) situations. Our results suggest that the cortisol awakening response (CAR) may be a good indicator of anticipatory stress but is unaffected by long-term examination preparation. Comparison of results between the official examination day and the mock examination days yielded evidence that learning may modulate the behavior of the hypothalamic–pituitary–adrenal axis

Riesgos psicosociales y estrés como predictores del burnout en médicos internos residentes en el Servicio de Urgencias.

To study the stress, the psychosocial risks associated to the job and the burnout, in a group of junior doctors working at the emergency ward; and to analyze what of those variables could predict and are better related with burnout. Cross-sectional study, with a sample of 42 junior doctors which are on duty in the emergency ward of the University Hospital San Cecilio, Granada (Spain). The Spanish adapted version of the Perceived Stress Scale was used to evaluate stress, the Maslach Burnout Inventory (MBI) to evaluate the professional burnout and the adapted and scaled questionnaire for the self-evaluation of psychosocial risks at work (CopSoQ-ISTAS21). 78% of the junior doctors are in the unfavorable or intermediate range for all CopSoQ-ISTAS21 dimensions, being particularly relevant that 90% of them display unfavorable score in psychological demands. In addition, MBI results show that 45% of our population presents high emotional exhaustion simultaneously to high depersonalization. ISTAS21 psychological demands dimensions (ß = 0.393; p Junior doctors develop its professional activity under adverse circumstances probably due to the high psychosocial risk associated to the job. Psychological demands are suggested as the main predicting factor of burnout. These results indicate the need of psychological and structural interventions in order to improve the professional performance of junior doctors at the emergency ward

Comments about psychosocial risks at work: an evaluative approach

Sr. Editor. A propósito del artículo publicado en su revista en el número 2 del año 2012, titulado “Riesgos psicosociales en el trabajo y salud ocupacional” (1) consideramos oportuno, dada su relevancia, contribuir al mismo. Queremos resaltar que es tan importante hacer una descripción teórica sobre los riesgos psicosociales como aproximarse a ellos empíricamente

Gender influence on health related quality of life among resident physicians working in an Emergency Department

The high emotional burden of physicians working in emergency departments may affect their quality of life perception. Aim: To evaluate health related quality of life among resident physicians performing shifts at an emergency department. Material and Methods: Seventy one physicians aged 26,3 ± 1,7 years (47 women), working as residents in an emergency department, answered the short version of the Short-Form Health Survey Questionnaire (SF-36®). This questionnaire analyses eight domains: physical function, body pain, general health, vitality, social function, emotional role and mental health. Results: Women had a significantly worse perception than a reference population in four dimensions of the SF-36, especially mental health and social functioning. Men had scores similar to the reference population. Among women, vitality is the best predictor of mental health and social functioning. Conclusions: Women working as residents in an emergency department have a worse perception of their quality of life than men performing the same job