Gender Differences in Patients Candidates for Bariatric Surgery: Anxiety, Depression and Causal Attributions

Objetivo. Analizar la relación entre las variables psicológicas tipo de atribución, sintomatología ansiosa y sintomatología depresiva en función del género en una muestra de pacientes con obesidad mórbida candidatos a cirugía bariátrica. Material y Métodos. Estudio observacional, transversal y unicéntrico. Se seleccionaron 259 pacientes candidatos a cirugía bariátrica del Hospital Universitario Virgen del Rocío, Sevilla. Se utilizaron plantillas para la recogida de datos sociodemográficos y clínicos, así como el instrumento validado Escala de Ansiedad y Depresión Hospitalaria. Resultados. En su mayoría, los pacientes realizaron atribuciones controlables, aunque las mujeres presentaron una mayor proporción de atribuciones incontrolables. En lo que respecta a la sintomatología ansiosa y depresiva, se encontró que los pacientes no aptos para la cirugía bariátrica presentaron mayores niveles de sintomatología ansiosa y depresiva. Además, apareció una tendencia a que mayores niveles de sintomatología ansiosa y depresiva estuvieran asociados a atribuciones de tipo controlable, lo que resulta controvertido atendiendo a la literatura disponible. Conclusiones. Este estudio muestra la importancia de continuar investigando acerca de distintas variables psicológicas para ajustar los tratamientos preoperatorios a las características de los pacientes, así como de realizar investigaciones que tengan en cuenta también medidas postoperatorias que permitan encontrar variables predictoras del éxito de las intervenciones.Objective. To analyze the relationship between the psychological variables type of attribution, anxiety and depressive symptoms according to gender in a sample of patients with morbid obesity who are candidates for bariatric surgery. Material and methods. Observational, cross-sectional and single-center study. 259 patients who were candidates for bariatric surgery were selected from the Virgen del Rocío University Hospital, Seville. Templates were used to collect sociodemographic and clinical data, as well as the validated Hospital Anxiety and Depression Scale instrument. Results. Most of the patients had controllable attributions, although women had a higher proportion of uncontrollable attributions. Regarding anxiety and depressive symptoms, it was found that patients ineligible for bariatric surgery presented higher levels of anxiety and depression. In addition, there was a tendency for higher levels of anxiety and depressive symptoms to be associated with controllable attributions, which is controversial based on the available literature

Air-sea CO2 fluxes in the Atlantic as measured during the FICARAM cruises

A total of fourteen hydrographic cruises spanning from 2000 to 2008 were conducted during the spring and autumn seasons between Spain and the Southern Ocean, under the framework of the Spanish research project FICARAM. The performed underway measurements are processed and analysed to describe the meridional air-sea CO2 fluxes (F CO2) along the Atlantic Ocean. The data was organised into different biogeochemical oceanographic provinces, according mainly to the thermohaline characteristics. The obtained spatial and temporal distributions of F CO2 follow the generally expected patterns and annual trends. The Subtropical regions in both hemispheres alternated the CO2 source and sink nature from autumn to spring, respectively. On the other hand, Tropical waters and the Patagonian Sea clearly behaved as sinks of atmospheric CO2 like the waters of the Drake Passage during autumn. The obtained results during the cruises also revealed significant long-term trends, such as the warming of equatorial waters (0.11±0.03 Cyr−1) and the decrease of surface salinity (−0.16±0.01 yr−1) in tropical waters caused by the influence of the Amazon River plume. This reduction in surface salinity appears to have a direct influence over the CO2 storage rates, fostering the uptake capacity of atmospheric CO2 (−0.09±0.03 molm−2 yr−1). An analysis of the biogeochemical forcing on the CO2 fugacity (fCO2) variability performed from an empirical algorithm highlighted the major role of the Amazon River input in the tropical North Atlantic fluxes. In addition, it has provided a quantitative measure of the importance of the thermodynamic control of F CO2 at temperate latitudes

Effect of Immunosuppressive Treatments on Kidney Outcomes After Gross Hematuria-Related Acute Kidney Injury in Older Patients With IgA Nephropathy

Macroscopic hematuria (MH) bouts, frequently accompanied by acute kidney injury (AKI-MH) are one of the most common presentations of IgA nephropathy (IgAN) in the elderly. Immunosuppressive therapies are used in clinical practice; however, no studies have analyzed their efficacy on kidney outcomes. This is a retrospective, multicenter study of a cohort of patients aged ≥50 years with biopsy-proven IgAN presenting with AKI-MH. Outcomes were complete, partial, or no recovery of kidney function at 1 year after AKI-MH, and kidney survival at 1, 2, and 5 years. Propensity score matching (PSM) analysis was applied to balance baseline differences between patients treated with immunosuppression and those not treated with immunosuppression. The study group consisted of 91 patients with a mean age of 65 ± 15 years, with a mean follow-up of 59 ± 36 months. Intratubular red blood cell (RBC) casts and acute tubular necrosis were found in all kidney biopsies. The frequency of endocapillary hypercellularity and crescents were low. Immunosuppressive therapies (corticosteroids alone or combined with mycophenolate mofetil or cyclophosphamide) were prescribed in 52 (57%) patients, whereas 39 (43%) received conservative treatment. There were no significant differences in the proportion of patients with complete, partial, or no recovery of kidney function at 1 year between patients treated with immunosuppression and those not treated with immunosuppression (29% vs. 36%, 30.8% vs. 20.5% and 40.4 % vs. 43.6%, respectively). Kidney survival at 1, 3, and 5 years was similar among treated and untreated patients (85% vs. 81%, 77% vs. 76% and 72% vs. 66%, respectively). Despite the PSM analysis, no significant differences were observed in kidney survival between the two groups. Fourteen patients (27%) treated with immunosuppression had serious adverse events. Conclusions: Immunosuppressive treatments do not modify the unfavorable prognosis of patients with IgAN who are aged ≥50 years presenting with AKI-MH, and are frequently associated with severe complications

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

La hepatopatía crónica en el trasplantado renal: influencia sobre la evolución clínica y estudio de la histología hepática

Tesis doctoral inédita. Universidad Autónoma de Madrid, Facultad de Medicina,Departamento de Medicina. Fecha de lectura: 17 de Diciembre de 199

Physical oceanography, CFC-12, SF6, pH, and alkalinity measured on water bottle samples during cruise SUBPOLAR08 with RV Thalassa

Temperature, salinity, oxygen data, anthropogenic tracers, pH and alkalinity measured on the RV Thalassa Cruise SUBPOLAR08 St. John's - Brest 08/25 - 09/15/2008 Chief Scientist: Dagmar Kieke Region: Subpolar North Atlanti

Dyslipemia in Our Society: Is There Anything Beyond Lipid Profile?

Original[ES] Dos aspectos relevantes de la medicina laboral son estudiar la salud del individuo en su ámbito de trabajo y promover entornos laborales saludables. Actualmente, los factores de riesgo cardiovascular siguen liderando la morbi-mortalidad en nuestra sociedad. El entorno laboral es la oportunidad de conocer la situación real e iniciar estrategias de prevención precoz. Uno de los factores más prevalentes son las alteraciones de los lípidos, siendo el colesterol LDL el que define el riesgo del paciente, pero sabemos que no identifica a todos los pacientes en riesgo de padecer un evento, persistiendo un riesgo residual. Determinar el número y tamaño de partículas de lipoproteínas mediante resonancia magnética nuclear, aporta valor añadido en la identificación de pacientes con riesgo lipídico. Esta revisión presenta una actualización de la situación del riesgo lipídico y muestra las características de un nuevo método para la caracterización de las lipoproteínas basada en espectroscopia de RMN de difusión 2D. [EN] Two relevant aspects of occupational medicine are studying the health of the individual in their occupational environment and promoting healthy occupational environments. Currently, cardiovascular risk factors continue to lead morbidity and mortality in our society. The occupational environment is the opportunity to know the real situation and initiate early prevention strategies. One of the most prevalent factors are the alterations of the lipids, being the LDL cholesterol (low-density lipoprotein) the one that defines the risk of the patient, but we know that it does not identify all patients at risk of suffering an event, persisting a residual risk. Determining the number and size of lipoprotein particles by nuclear magnetic resonance provides added value in the identification of patients with lipid risk. This review presents an update of the status of lipid risk and shows the characteristics of a new method for the characterization of lipoproteins based on 2D diffusion NMR spectroscopy.N

La dislipemia en nuestra sociedad: ¿hay algo más allá del perfil lipídico?

Resumen Dos aspectos relevantes de la medicina laboral son estudiar la salud del individuo en su ámbito de trabajo y promover entornos laborales saludables. Actualmente, los factores de riesgo cardiovascular siguen liderando la morbi-mortalidad en nuestra sociedad. El entorno laboral es la oportunidad de conocer la situación real e iniciar estrategias de prevención precoz. Uno de los factores más prevalentes son las alteraciones de los lípidos, siendo el colesterol LDL el que define el riesgo del paciente, pero sabemos que no identifica a todos los pacientes en riesgo de padecer un evento, persistiendo un riesgo residual. Determinar el número y tamaño de partículas de lipoproteínas mediante resonancia magnética nuclear, aporta valor añadido en la identificación de pacientes con riesgo lipídico. Esta revisión presenta una actualización de la situación del riesgo lipídico y muestra las características de un nuevo método para la caracterización de las lipoproteínas basada en espectroscopia de RMN de difusión 2D

La cultura oral en Acebo y sierra de Gata

En el documento no aparece la fecha de publicaciónTras hacer un análisis de las geografía, la historia y otros aspectos culturales de Acebo (Cáceres) y de la zona de la sierra de Gata (Cáceres) se presentan una serie de tradiciones de la zona (juegos populares, refranes, poesías, canciones, etc.) que se han trasmitido de generación en generación y que pretenden ser un material que permita a los alumnos describir, conocer y valorar su propia cultura y tradiciones.ExtremaduraCPR de Navalmoral de la Mata (Cáceres); Avda. San Isidro, 10; Apdo. 221; 10300 Navalmoral de la Mata (Cáceres); +34927016720; +34927016721; [email protected]