Psicopatología en pacientes hospitalizados en un hospital general

Despite its importance for diagnosis, treatment and cost of attention, few studies have tried to determine the prevalence of psychophatological symptoms in patients hospitalized for medical reasons. We present a study designed to detect psychopatological symptoms in patients of the Hospital del Salvador of Santiago, using the twelve-items version of the General Health Questionnaire (GHQ-12). A team of interviewers assesed the psychological consequences of child trauma and obtained sociodemographic data of patients hospitalized in Internal Medicine, General Surgery, Ophthalmology, Otolaryngology, neurology, urology, traumatology and gynecology during a weekend in August 2001. Total sample consisted of 362 patients, of which 297 agreed to participate, 61.5% of the participants were females. Mean age for men was 57.8 years and 52.7 years for women. The prevalence of psychopatological symptoms (a score of at least 5 in the GHQ-12) was 46.4%. No correlation was observed between a higher score in the GHQ-12 and civil status, ocuppation or type of facility (medical or surgical). The high prevalence of comorbidity found confirms the importance of the detection and adequate care of the emotional disturbances in medical patients

Prolonged Door-to-Balloon Time Leads to Endothelial Glycocalyx Damage and Endothelial Dysfunction in Patients with ST-Elevation Myocardial Infarction

Damage to the endothelial glycocalyx (eGC) has been reported during acute ischemic events like ST-elevation myocardial infarction (STEMI). In STEMI, a door-to-balloon time (D2B) of p p 60 min led to significantly higher serum concentrations of eGC components (syndecan-1: p p p 60 min led to the pronounced loss of eGC height/stiffness (both, p p p p < 0.01). An increased D2B led to severe eGC shedding, with endothelial dysfunction in a temporal context. eGC components and pro-inflammatory mediators correlated with a prolonged D2B, indicating a time-dependent immune reaction during STEMI, with a decreased NO concentration. Thus, D2B is a crucial factor for eGC damage during STEMI. Clinical evaluation of the eGC condition might serve as an important predictor for the endothelial function of STEMI patients in the future

Depression and Psychological Trauma: An Overview Integrating Current Research and Specific Evidence of Studies in the Treatment of Depression in Public Mental Health Services in Chile

In the last two decades, different research has demonstrated the high prevalence of childhood trauma, including sexual abuse, among depressive women. These findings are associated with a complex, severe, and chronic psychopathology. This can be explained considering the neurobiological changes secondary to early trauma that can provoke a neuroendocrine failure to compensate in response to challenge. It suggests the existence of a distinguishable clinical-neurobiological subtype of depression as a function of childhood trauma that requires specific treatments. Among women with depression and early trauma receiving treatment in a public mental health service in Chile, it was demonstrated that a brief outpatient intervention (that screened for and focused on childhood trauma and helped patients to understand current psychosocial difficulties as a repetition of past trauma) was effective in reducing psychiatric symptoms and improving interpersonal relationships. However, in this population, this intervention did not prevent posttraumatic stress disorder secondary to the extreme earthquake that occurred in February 2010. Therefore in adults with depression and early trauma, it is necessary to evaluate prolonged multimodal treatments that integrate pharmacotherapy, social support, and interpersonal psychotherapies with trauma focused interventions (specific interventions for specific traumas)

http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-102375 Impact of IL28B-Related Single Nucleotide Polymorphisms on Liver Transient Elastography in Chronic Hepatitis C Infection

Background and Aims: Recently, several genome-wide association studies have revealed that single nucleotide polymorphisms (SNPs) in proximity to IL28B predict spontaneous clearance of hepatitis C virus (HCV) infection as well as outcome following pegylated interferon and ribavirin therapy among genotype 1 infected patients. Additionally the presence of the otherwise favorable IL28B genetic variants in the context of HCV genotype 3 infection reportedly entail more pronounced liver fibrosis and steatosis. The present study aimed to evaluate the impact of IL28B SNP variability on liver stiffness as accessed by transient elastography. Methods: Seven hundred and seventy-one Swedish HCV infected patients sequentially undergoing liver stiffnes

Percepción de funcionalidad familiar y trauma infantojuvenil: un estudio cualitativo

Se comparan las características de quince mujeres hospitalizadas en un hospital general publico en Santiago de Chile, que recuerdan más de tres experiencias traumáticas antes de los 16 años, con 15 casos que no recuerdan ninguno. En los 30 casos se estudian características socio-demográficas, y se aplican las siguientes escalas: Acontecimientos Traumáticos de Perry (TAI), las escalas de percepción familiar de Valdés y Cols (CTF-CSF) y la Escala Abreviada de Conductas de Riesgo (ECRA). Se comparan ambos grupos, constatándose una mayor frecuencia de dificultades en las relaciones interpersonales, disfuncionalidad familiar y conductas de riesgo en las mujeres con antecedentes anamnésticos de polipsicotrauma antes de los 16 años. Se concluye insistiendo en la importancia de la prevención de la violencia intrafamiliar y de los tratamientos adecuados para las víctima

Endothelial Glycocalyx and Cardiomyocyte Damage Is Prevented by Recombinant Syndecan-1 in Acute Myocardial Infarction

The outer layer of endothelial cells (ECs), consisting of the endothelial glycocalyx (eGC) and the cortex (CTX), provides a protective barrier against vascular diseases. Structural and functional impairments of their mechanical properties are recognized as hallmarks of endothelial dysfunction and can lead to cardiovascular events, such as acute myocardial infarction (AMI). This study investigated the effects of AMI on endothelial nanomechanics and function and the use of exogenous recombinant syndecan-1 (rSyn-1), a major component of the eGC, as recovering agent. ECs were exposed in vitro to serum samples collected from patients with AMI. In addition, in situ ECs of ex vivo aorta preparations derived from a mouse model for AMI were employed. Effects were quantified by using atomic force microscopy-based nanoindentation measurements, fluorescence staining, and histologic examination of the mouse hearts. AMI serum samples damaged eGC/CTX and augmented monocyte adhesion to the endothelial surface. In particular, the anaphylatoxins C3a and C5a played an important role in these processes. The impairment of endothelial function could be prevented by rSyn-1 treatment. In the mouse model of myocardial infarction, pretreatment with rSyn-1 alleviated eGC/CTX deterioration and reduced cardiomyocyte damage in histologic analyses. However, echocardiographic measurements did not indicate a functional benefit. These results provide new insights into the underlying mechanisms of AMI-induced endothelial dysfunction and perspectives for future studies on the benefit of rSyn-1 in post-AMI treatment

Initiation of reflective frames in counseling for Huntingtons Disease predictive testing.

Genetic professionals and clients are likely to assign different meanings to the extended format of the counseling protocols for predictive testing. In order to facilitate informed, client-centered decisions about the possibility of predictive testing, counselors routinely use the question format to initiate what we call "reflective frames" that invite clients to discuss their feelings and encourage them to adopt introspective and self-reflective stances toward their own experience--spanning the past, the present, and the hypothetical future. We suggest that such initiations of reflective frames constitute a key element of counselors' nondirective stance, although the exact nature of their formulations can be complex and varied. Examining 24 Huntington's Disease (HD) clinic sessions involving 12 families in South Wales with the tools of discourse analysis, our focus in this paper is twofold: (i) to propose a classification of six types of reflective questions (e.g. nonspecific invites, awareness and anxiety, decision about testing, impact of result, dissemination, and other) and to examine their distribution across the various clinic appointments, and (ii) to investigate the scope of these questions in terms of temporal and social axes. We link our analysis to the current debate within the genetic counseling profession about the merits of reflection- versus information-focused counseling styles and the need to abide by professionally warranted and institutionally embedded counseling protocols