Discursos científicos sobre el dolor cronificado sin-causa-orgánica Incorporando una mirada de género para resignificar-repolitizar el dolor

Chronic pain, without any organic or physical cause (DC), which in psycho-medical terminology is known as fi bromyalgia, (FM), is diagnosed each year to a considerable number of women in capitalistic societies. Our main interest in the following paper is to go in depth in the elaboration of this symptom, its treatment and the psychosocial effects, both in the social order as well as in the lives of the people who suffer from it. Our main goal in the following paper is to look deeper in the elaboration (conceptualization) of this symptom, its treatment and psychological affects, both in the social order as well as in the lives of the people who suffer from it, we are using linked speeches in Spanish magazines publications. The result has been the emergence of three hegemonic discourse positions: One position “scientist”, one “therapeutic of the conformity” position and one “economic and legalistic” position. Each of these has a specifi c feature, but on the whole, is enhanced, producing effects such as the absence of social context to explain the disease; disregard of gender differences in the management and treatment; the instrumentalization of pain to legitimize their practices and the subjection of women to the “psycho-biomedical” paradigm. In that way, a new signifi cance and politicization of the concept of pain is proposed.El dolor cronifi cado sin-causa-orgánica (DC) conocido en terminología psicomédica como fibromialgia (FM) afecta cada vez más a una proporción considerable de mujeres diagnosticadas en sociedades capitalistas. El interés del siguiente artículo es profundizar en la construcción de este síntoma, su tratamiento y los efectos psicosociales tanto en el orden social, como en la vida de las personas que lo padecen utilizando los discursos que se vehiculizan en publicaciones de revistas españolas. El resultado ha sido la emergencia de tres posiciones discursivas hegemónicas: la posición “cientifi sta”, la posición “terapéutica de la conformidad” y la posición “económico-legalista”. Cada una de ellas tiene una especifi cidad característica, pero en su conjunto se potencian produciendo efectos como la ausencia de contexto social para explicar la enfermedad, la desconsideración de diferencias de género en el abordaje y tratamiento, la instrumentalización del dolor para legitimar sus prácticas y la sujección de las mujeres al paradigma psicobiomédico. Se propone una resignifi cación-repolitización del concepto de dolor

Sarcoma de estroma endometrial. Estudio clinicopatológico e inmunofenotípico de 5 casos

Introducción: El sarcoma de estroma endometrial uterino es un tumor muy poco frecuente con una incidencia de 0,4 -3,4 por 100.000 mujeres, comprende menos del 1% de tumores malignos ginecológicos y el 2-5% de tumores malignos uterinos, siendo el tercer sarcoma en frecuencia después del carcinosarcoma y el leiomiosarcoma. Material y métodos: Presentamos cinco casos de sarcoma de estroma endometrial diagnosticados en un periodo de siete años con la evolución clínica de las pacientes. Resultados: Immunohistoquímicamente, estos tumores expresaban vimentina, receptores hormonales, CD10 y p53 (sarcomas de alto grado), siendo los marcadores musculares, la CK, el c-kit y ALK negativos. De estos cinco sarcomas dos de ellos eran de alto grado y tres de bajo grado (uno con diferenciación miogénica y otro combinado con áreas tipo «cordones sexuales», áreas miogénicas y áreas estromales puras). Discusión: Asimismo se plantean una serie de diagnósticos diferenciales con metodología práctica para poder caracterizar estos tumores.Introduction: Endometrial stromal sarcoma (ESS) is an infrequent neoplasm with an incidence of 0,4-3,4 cases/100.000 woman. This tumor represents less than 1% of the gynecologic malignancies as well as the 2,5% of the uterine malignant tumors being the third malignancy after carcinosarcoma and leiomyosarcoma. Patients and methods: We present five cases of endometrial sarcoma, diagnosed in a period of seven years. This study includes a complete immunohistochemical analysis as well as the follow-up of the patients. Results: Immunohistochemically, these tumors expressed vimentin, hormone receptors, CD10 and p53 (high grade sarcomas), whereas muscle markers, CK, c-Kit and ALK resulted negative. Two of the ESS were high grade tumors whereas the other three were considered low grade tumors (one with myogenic differentiation and the other combining sex cord areas, myogenic foci and pure stromal areas). Discussion: We discuss their differential diagnosis with other uterine malignant tumors.Martinez Rodriguez, Miguel, [email protected] ; Llombart Bosch, Antonio, [email protected] ; Navarro Fos, Samuel, [email protected]

Los contextos de vulnerabilidad de género del dolor cronificado

In this paper we analyze the contexts of vulnerability involved in the formation of the phenomenon of chronic pain without organic cause, or fibromyalgia (DC / FM). A key factor that articulates the contexts of vulnerability and subjectivities that they produce are gender relations, we characterize two (traditional and transitional) models. The research from which we derive the data is qualitative by semi-structured interviews, in the context of metropolitan Barcelona (Spain). From the analysis we have made a close relationship between the development of the DC / FM and social models of gender, both in the context of constitution of subjectivity of the interviewees, child life, and in the context of occurrence follows and development of the DC / FM in adulthood.En este artículo analizamos los contextos de vulnerabilidad que intervienen en la constitución del fenómeno del dolor crónico sin causa orgánica, o fibromialgia (DC/FM). Es uno de los pocos estudios que abordan el DC/FM desde la perspectiva biopsicosocial. Centramos nuestro interés en las relaciones de género que articulan los contextos de vulnerabilidad con las subjetividades que en ellos se producen. Caracterizamos dos modelos de género: el tradicional y el transicional. La investigación de la que obtenemos los datos es cualitativa. Empleamos entrevistas semiestructuradas en el contexto del área metropolitana de Barcelona (España). Del análisis identificamos una estrecha relación entre el desarrollo de la DC/FM y los modelos sociales de género, tanto en el contexto de constitución de la subjetividad de las personas entrevistadas, en la vida infantil, como en el contexto de aparición y desarrollo de la DC/FM en la vida adulta

El semestre europeo 2018 y las recomendaciones específicas para España

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Posicionamientos críticos y tensiones profesionales en un servicio de atención psicosocial a la violencia de género

En el presente artículo nos proponemos comprender las tensiones que se producen en la intervención psicosocial hacia la violencia de género, identificando los posicionamientos que adoptan profesionales de un servicio de atención en Catalunya. Los conceptos de gubernamentalidad y dispositivo nos permiten analizar críticamente el funcionamiento de la intervención psicosocial. En términos metodológicos, es una aproximación cualitativa mediante un estudio de caso, en la que realizamos seis entrevistas en profundidad y un grupo de discusión con profesionales de un servicio de atención a la violencia de género. El análisis temático revela tres tensiones principales hacia la práctica profesional: el aparataje institucional, la especialización de la intervención en violencia de género, y la relación interventora-intervenida. Concluimos que, ante las tensiones referidas, las profesionales generan resistencias como el posicionamiento de flexibilidad, el cual posibilita desarticular la homogenización, el disciplinamiento y la estandarización del dispositivo de atención a la violencia de género

Discursos científicos sobre el dolor cronificado sin-causa-orgánica : incorporando una mirada de género para resignificar-repolitizar el dolor

El dolor cronificado sin-causa-orgánica (DC) conocido en terminología psicomédica como fibromialgia (FM) afecta cada vez más a una proporción considerable de mujeres diagnosticadas en sociedades capitalistas. El interés del siguiente artículo es profundizar en la construcción de este síntoma, su tratamiento y los efectos psicosociales tanto en el orden social, como en la vida de las personas que lo padecen utilizando los discursos que se vehiculizan en publicaciones de revistas españolas. El resultado ha sido la emergencia de tres posiciones discursivas hegemónicas: la posición "cientifista", la posición "terapéutica de la conformidad" y la posición "económico-legalista". Cada una de ellas tiene una especificidad característica, pero en su conjunto se potencian produciendo efectos como la ausencia de contexto social para explicar la enfermedad, la desconsideración de diferencias de género en el abordaje y tratamiento, la instrumentalización del dolor para legitimar sus prácticas y la sujección de las mujeres al paradigma psicobiomédico. Se propone una resignificación-repolitización del concepto de dolor.Chronic pain, without any organic or physical cause (DC), which in psycho-medical terminology is known as fibromyalgia, (FM), is diagnosed each year to a considerable number of women in capitalistic societies. Our main interest in the following paper is to go in depth in the elaboration of this symptom, its treatment and the psychosocial effects, both in the social order as well as in the lives of the people who suffer from it. Our main goal in the following paper is to look deeper in the elaboration (conceptualization) of this symptom, its treatment and psychological affects, both in the social order as well as in the lives of the people who suffer from it, we are using linked speeches in Spanish magazines publications. The result has been the emergence of three hegemonic discourse positions: One position "scientist", one "therapeutic of the conformity" position and one "economic and legalistic" position. Each of these has a specific feature, but on the whole, is enhanced, producing effects such as the absence of social context to explain the disease; disregard of gender differences in the management and treatment; the instrumentalization of pain to legitimize their practices and the subjection of women to the "psycho-biomedical" paradigm. In that way, a new significance and soliticization of the concept of pain is proposed

Terapia Cognitiva Basada en Mindfullness en Pacientes Oncológicos Españoles: el Protocolo Bartley

Objectives: The aim of this study is to analyse whether MBCT will reduce the general level of psychopathology, increase the quality of life, and increase meta-knowledge about their emotional state in Spanish participants with cancer. Method: The sample consisted of n = 88 Spanish oncology patients. This was a non-randomized, two-group (experimental vs waiting list) trial conducted in a naturalistic setting. We evaluated psychological distress (BSI-18), quality of life (FACT-G), and meta-knowledge of emotions (TMMS-24). Results: The participants who received the MBCT treatment improved more than the control group in distress (F= 6.79; p = .01, BSI-18), depression (F= 8.38; p = .005 ), quality of life -physical health (F = 5.56; p = .02), emotional state (F = 7.06; p= .01), and functional capacity (F = 7.98; p = .006), as well as meta-knowledge about their emotional state (F = 35.4; p = .01), and its subscales of perception, (F = 8.95; p = .004), comprehension, (F= 16.06; p = .01), and repair (F = 15.67; p = .01). Conclusions: The Bartley MBCT program was feasible and showed promise in improving general psychopathology (depression), improving patients’ quality of life, and increasing meta-knowledge about their emotional state.Objetivos: el objetivo de este estudio es analizar el papel de la MBCT en la reducción de la psicopatología, la mejora de la calidad de vida y del metaconocimiento del estado emocional en participantes españoles oncológicos. Método: la muestra consta de n = 88 pacientes oncológicos españoles. Este es un ensayo no aleatorio de dos grupos (experimental versus lista de espera) realizado en un entorno hospitalario. Se evaluaron distrés psicológico (BSI-18), calidad de vida (FACTG) y metaconocimiento de las emociones (TMMS). Resultados: los participantes con tratamiento MBCT mejoraron más que el grupo control en distrés (F= 6.79; p = .01), depresión (F= 8.38; p = .005), en la calidad de vida asociada a salud física (F = 5.56; p = .02), al estado emocional (F = 7.06; p= .01) y a la capacidad funcional personal (F = 7.98; p = .006), y en metaconocimiento de las emociones (F = 35.4; p = .01), y sus subescalas percepción (F = 8.95; p = .004), comprensión, (F= 16.06; p = .01) y reparación (F = 15.67; p = .01). Conclusiones: la MBCT mostró resultados prometedores para mejorar la psicopatología general, la calidad de vida y el metaconocimiento sobre el estado emocional.Psicologí

A de novo complete BRCA1 gene deletion identified in a Spanish woman with early bilateral breast cancer

<p>Abstract</p> <p>Background</p> <p>Germline mutations in either of the two tumor-suppressor genes, <it>BRCA1 </it>and <it>BRCA2</it>, account for a significant proportion of hereditary breast and ovarian cancer cases. Most of these mutations consist of deletions, insertions, nonsense mutations, and splice variants, however an increasing number of large genomic rearrangements have been identified in these genes.</p> <p>Methods</p> <p>We analysed <it>BRCA1 </it>and <it>BRCA2 </it>genes by direct sequencing and MLPA. We confirmed the results by an alternative MLPA kit and characterized the <it>BRCA1 </it>deletion by Array CGH.</p> <p>Results</p> <p>We describe the first case of a patient with no strong family history of the disease who developed early-onset bilateral breast cancer with a <it>de novo </it>complete <it>BRCA1 </it>gene deletion in the germinal line. The detected deletion started from the region surrounding the <it>VAT1 </it><it>locus </it>to the beginning of <it>NBR1 </it>gene, including the <it>RND2</it>, Ψ<it>BRCA1</it>, <it>BRCA1 </it>and <it>NBR2 </it>complete genes.</p> <p>Conclusion</p> <p>This finding supports the large genomic rearrangement screening of <it>BRCA </it>genes in young breast cancer patients without family history, as well as in hereditary breast and ovarian cancer families previously tested negative for other variations.</p

Spanish adaptation of meaning-centered psychotherapy for participants with cancer: Study protocol of a randomized control Trial

Background: Meaning-Centered Psychotherapy (MCP) is effective in improving meaning in life, hope, optimism, self-efficacy, well-being, and quality of life, and in reducing stress in people with cancer. However, all the studies on the application of MCP in cancer patients have been carried out in Anglo-Saxon samples. Therefore, it is necessary to adapt and verify the efficacy of MCP in populations that speak languages other than English, such as Spanish. Moreover, to expand the data supporting the efficacy of MCP for cancer patients, it would be necessary to compare MCP to other active therapies such as Cognitive Behavioral Therapy (CBT). Methods: The aims of the proposed study are: the first objective is to verify the efficacy of the MCP intervention for Spanish participants with cancer in a randomized control trial (RCT) comparing it to CBT. The second objective is to analyze the feasibility and acceptance of MCP in Spanish participants with cancer. The third objective is to analyze whether the changes produced in the meaning in life dimensions (presence, search, comprehension, purpose, and mattering) will predict changes in anxiety, depression, quality of life, etc. Our research team adapted MCP for Spanish participants with cancer. This paper presents the study protocol. The study design consists of a two-arm RCT with two conditions: MCP and CBT, where participants will be randomized to one of the two groups. Eligible participants will be adults with stage I, II, and III cancer who were treated with curative intent and had completed their main medical treatment (surgery, radiotherapy, or chemotherapy). Participants will be assessed at pretreatment, post-treatment, and 6-month follow-up. The intention-to-treat principle will be used when analyzing data, using mixed-effects models with full information and maximum likelihood estimation. Discussion: This study will provide results that confirm the efficacy of the MCP in Spanish participants with cancer. Trial Registration: ClinicalTrials.gov; https://register.clinicaltrials.gov/prs/app/template/Home.vm?uid=U0005WS9&ts=4&sid=S000BOTT&cx=bvr2ue, identifier NCT0519734

Gene variation at immunomodulatory and cell adhesion molecules Loci impacts primary Sjögren's Syndrome

Primary Sjögren's syndrome (pSS) is an autoimmune disease triggered by a combination of environmental and host genetic factors, which results in the focal lymphocytic infiltration of exocrine glands causing eye and mouth dryness. Glandular infiltrates include T and B cell subsets positive for CD5 and/or CD6, two surface scavenger receptors involved in the fine-tuning of intracellular signals mediated by the antigen-specific receptor complex of T (TCR) and B (BCR) cells. Moreover, the epithelial cells of inflamed glands overexpress CD166/ALCAM, a CD6 ligand involved in homo and heterotypic cell adhesion interactions. All this, together with the reported association of functionally relevant single nucleotide polymorphisms (SNPs) of CD5, CD6, and CD166/ALCAM with the risk or prognosis of some immune-mediated inflammatory disorders, led us to investigate similar associations in a local cohort of patients with pSS. The logistic regression analyses of individual SNPs showed the association of CD5 rs2241002T with anti-Ro/La positivity, CD6 rs17824933C with neutropenia, and CD6 rs11230563T with increased leukopenia and neutropenia but decreased peripheral nervous system EULAR Sjögren's syndrome disease activity index (ESSDAI). Further analyses showed the association of haplotypes from CD5 (rs2241002T-rs2229177C) with anemia and thrombocytopenia, CD6 (rs17824933G-rs11230563C-rs12360861G) with cutaneous ESSDAI, and CD166/ALCAM (rs6437585C-rs579565A-rs1044243C and rs6437585C-rs579565G-rs1044243T) with disease susceptibility and several analytical parameters (anti-nuclear antibodies, neurological ESSDAI, and hematologic cytopenias). These results support the relevance of gene variation at loci coding for cell surface receptors involved in the modulation of T and B lymphocyte activation (CD5, CD6) and epithelial-immune cell adhesion (CD166/ALCAM) in modulating the clinical and analytical outcomes in patients with pSS.Peer ReviewedPostprint (published version