Effort-reward imbalance and subjective health complaints : exploratory study among physicians in Spain.

Este estudio trasversal tuvo como objetivo explorar si el impacto del desequilibrio de esfuerzo-recompensa en las quejas de salud es moderado por la sobreimplicación. Participó una muestra de 164 médicos españoles que llenaron un cuestionario de papel y lápiz. El efecto negativo del desequilibrio de esfuerzo-recompensa percibido en las quejas de salud subjetivas fue más fuerte para los empleados con sobreimplicación alta o media, mientras que fue positivo y no significativo para aquellos con una baja implicación. El presente estudio puede contribuir a una mejor comprensión de cómo y cuándo el desequilibrio de esfuerzo-recompensa aumenta el riesgo de quejas de salud subjetivas. En consecuencia, la intervención temprana diseñada para amortiguar los efectos negativos del desequilibrio de esfuerzo-recompensa debería centrarse en aumentar el nivel individual de sobreimplicación.This cross-sectional study aimed to explore whether the impact of Effort-Reward Imbalance (ERI) on health complaints was moderated by overcommitment. A sample of 164 Spanish medical doctors that filled in a paper and pencil questionnaire. The negative effect of perceived ERI on subjective health complaints was stronger for employees with high or medium overcommitment, while it was positive and non-significant for those with low overcommitment. The present study can contribute to a better understanding of how and when ERI boosts the risk of subjective health complaints. Accordingly, early intervention designed to buffer the negative effects of ERI would focus on increasing individual level of overcommitment

Dos casos atípicos con un mismo resultado final: exéresis de trombo intracavitario

We present two atypical cases of intracavitary thrombus formation, due to their localization, clinical course and patients’ co-morbidities. In both cases cardiac magnetic resonance was the best non-invasive diagnostic tool (“single shot” technique) to establish a correct diagnosis.Se presentan dos casos de trombos intracavitarios atípicos por su localización, evolución y antecedentes de los pacientes. En ambas situaciones la resonancia magnética cardíaca fue determinante para establecer un diagnóstico adecuado

Genetic model of transformation and neoplastic progression in laryngeal epithelium

Background: To analyse genetic alterations in the transformation-progression model of larynx tumors. Methods: Copy number changes of 37 genes were analyzed by MLPA in 94 tissue samples. Results: In the smoker normal mucosa group TP53 loss was predominant, while in the precursor lesions CDKN2A loss and CDKN2D gain were most frequent. Precursor lesions with progression presented CTNNB1 loss. In the carcinoma group the most common changes were CDKN2A, MLH1, CTNNB1, CASP6 losses and RECQL4, CCND1, EMS1 gains. Positive lymph node primary tumors were related to TP53, IL1A, RB1 losses and STK11 gain. The lymph node metastases differed from their corresponding primary tumor in LMNA, RECQL4 and IGF1R losses, and N33, CDKN2D gains. Conclusions: Genetic changes and new key genes were found associated to specific steps of transformation-progression. We included new steps, not presented in the classical models: normal mucosa tobacco exposed, positive lymph node primary tumor and corresponding lymph node mestatases.projects PI02-0831 and PI07-0153 from “Fondos de Investigaciones Sanitarias” (FIS), Instituto Salud Carlos III, Spain. Project IB05-115 from Fundación de Investigación Científica y Tecnológica (FICYT), Asturias. Red Temática de Investigación Cooperativa en Cáncer (RTICC) (RD06/0020/0034) del ISCIII, Spain. IUOPA-Obra Social Caja Astur, Spain

Effort-reward imbalance and subjective health complaints: A moderated mediation model with Spanish Health professionals

Objetivos: El presente trabajo examinó el efecto del Desequilibrio Esfuerzo-Recompensa en las quejas subjetivas de salud. Se conceptualizó un modelo de mediación moderada, en el que la Identificación grupal media la relación, y la Sobreimplicación actúa como moderador. Método: La muestra estuvo compuesta por 459 profesionales de la salud españoles que cumplimentaron un cuestionario sobre Desequilibrio Esfuerzo-Recompensa, Sobreimplicación, quejas subjetivas de salud e identificación grupal. Resultados: Al contrario de lo hipotetizado, el efecto directo del desequilibrio sobre las quejas subjetivas de salud resultó significativo y negativo. El efecto indirecto, mediado por la identificación grupal, fue más intenso y estadísticamente significativo para los empleados con Sobreimplicación alta o media, mientras que fue no significativo para aquellos con una baja Sobreimplicación. Conclusiones: El presente estudio puede ayudar a comprender mejor cómo se relaciona el desequilibrio de esfuerzo-recompensa y las quejas subjetivas de salud. También contribuye a explicar el papel de la identificación con el grupo como mediador. En consecuencia, la intervención temprana debería fomentar la identificación grupal.Objectives: This paper examines the effect of the Effort-Reward Imbalance on health complaints. A moderated mediation model was conceptualized, with group identification as the mediator variable and overcommitment acting as a moderator. Method: A 459 Spanish health professionals sample completed the questionnaire: Effort-Reward Imbalance, overcommitment, subjective health complaints and group identification was measured. Results: The direct effect of the imbalance on health complaints was significant and negative. The indirect effect, mediated by group identification, was statistically significant and more intense for employees with medium or high overcommitment scores, but not for those with a low overcommitment. Conclusions: The present study can contribute to a better understanding of how Effort-Reward Imbalance and subjective health complaints are related. It also helps to explain the role of group identification as a mediator. Consequently, early interventions should encourage group identification

Direct-acting Antivirals for the Treatment of Kidney Transplant Patients With Chronic Hepatitis C Virus Infection in Spain: A Long-term Prospective Observational Study

Background: Direct-acting antivirals (DAA) allow effective and safe eradication of hepatitis C virus (HCV) in most patients. There are limited data on the long-term effects of all-oral, interferon-free DAA combination therapies in kidney transplant (KT) patients infected with HCV. Here we evaluated the long-term tolerability, efficacy, and safety of DAA combination therapies in KT patients with chronic HCV infection. Methods: Clinical data from KT patients treated with DAA were collected before, during, and after the treatment, including viral response, immunosuppression regimens, and kidney and liver function. Results: Patients (N = 226) were mostly male (65.9%) aged 56.1 +/- 10.9 years, with a median time from KT to initiation of DAA therapy of 12.7 years and HCV genotype 1b (64.6%). Most patients were treated with sofosbuvir-based therapies. Rapid virological response at 1 month was achieved by 89.4% of the patients and sustained virological response by week 12 by 98.1%. Liver function improved significantly after DAA treatment. Tacrolimus dosage increased 37% from the beginning of treatment (2.5 +/- 1.7 mg/d) to 1 year after the start of DAA treatment (3.4 +/- 1.9 mg/d, P < 0.001). Median follow-up was 37.0 months (interquartile range, 28.4-41.9) and death-censored graft survival was 91.1%. Adverse events resulting from DAA treatment, especially anemia, were reported for 31.0% of the patients. Conclusions: Chronic HCV infection can be treated efficiently and safely with DAA therapy in KT patients. Most patients retained stable kidney function and improved liver function. Tacrolimus dose had to be increased in most patients, potentially as a result of better liver function

A late iron age dump area "La Carrasca" in Los Ausines (Burgos, Spain)

[ES] Basurero de la Segunda Edad del Hierro entre los castros de Castromayor y El Castillejo en Los Ausines, ambos a corta distancia. Los restos encontrados corresponden a las épocas preceltibérica y celtibérica.[EN] Dump area from the Late Iron Age between the hill fort of Castromayor and El Castillejo in Los Ausines, both a short distance away. The remains found correspond to the pre-Celtiberian and Celtiberian times.Peer reviewe