Quemaduras neonatales que ameritaron hospitalización en la Unidad Pediátrica de Quemados del estado de Puebla del 1 de enero de 2014 al 1 de enero de 2016. Maltrato infantil o accidente

“Se considera que las quemaduras son una de las causas más frecuentes de atención médica en las salas de urgencias. Los niños y los adultos mayores son los grupos más vulnerables de la población. Los pacientes pediátricos de 0 a 4 años son los más afectados, presentándose más de la mitad de todas las lesiones ocasionadas por quemaduras. Objetivo: Determinar si las quemaduras neonatales son ocasionadas por maltrato infantil o accidente. Se incluyeron 5 pacientes de entre 5 y 25 días de vida, 3 (60%) del sexo masculino y 2 (40%) del sexo femenino. Con respecto a la región anatómica más afectada: dorso de mano en 2/5 (40%), el resto en cara, tórax y muslo con un paciente respectivamente. El reactivo que ocasionó la quemadura fue: 3/5 (60%) escaldadura, 1/5 (20%) fuego directo y 1/5 (20%) por un producto químico. El grado de las quemaduras fue: 4/5 (80%) de tercer grado, 1/5 (20%) de segundo grado profundo. El mecanismo que seestableció como causal en 3/5 de los pacientes, fue iatrogenia y en 2 accidental.

Rheumatoid Arthritis Disease Activity Is Determinant for ABCB1 and ABCG2 Drug-Efflux Transporters Function.

To compare drug efflux function of ABCB1 and ABCG2 transporters in rheumatoid arthritis (RA) patients with active disease and in remission.Twenty two active RA patients (DAS28 ≥3.2) and 22 patients in remission (DAS28<2.6) were selected from an early RA clinic. All patients were evaluated at study inclusion and six months later. ABCB1 and ABCG2 functional activity was measured in peripheral lymphocytes by flow cytometry. The percentage of cells able to extrude substrates for ABCB1 and ABCG2 was recorded.Active patients had higher ABCB1 and ABCG2 activity compared with patients in remission (median [interquartile range]): 3.9% (1.4-22.2) vs (1.3% (0.6-3.2), p = 0.003 and 3.9% (1.1-13.3) vs 0.9% (0.5-1.9) p = 0.006 respectively. Both transporters correlated with disease activity assessed by DAS28, rho = 0.45, p = 0.002 and rho = 0.47, p = 0.001 respectively. Correlation was observed between the time from the beginning of treatment and transporter activity: rho = 0.34, p = 0.025 for ABCB1 and rho = 0.35, p = 0.018 for ABCG2. The linear regression model showed that DAS28 and the time from the onset of treatment are predictors of ABCB1 and ABCG2 functional activity, even after adjustment for treatment. After six months we calculated the correlation between change in DAS28 and change in the functional activity in both transporters and found a moderate and significant correlation for ABCG2 (rho = 0.28, p = 0.04) and a non-significant correlation for ABCB1 (rho = 0.22, p = 0.11).Patients with active RA have an increased function of ABCB1 and ABCG2, and disease activity is the main determinant of this phenomena

Estimating Neonatal Necrotizing Enterocolitis Based on Feeding Practices

(1) Background: The relationship between enteral nutrition and neonatal necrotizing enterocolitis (NEC) among premature neonates is still unclear. The present work was designed to assess the relationship between NEC and feeding strategies compared to control infants. (2) Methods: A retrospective case-control study of premature infants (&lt;35 weeks’ gestation) with or without NEC that examined feeding practices and clinical characteristics at birth and 3, 7, and 14-day hospitalization, with a longitudinal and cross-sectional analysis. (3) Results: A total of 100 newborns with NEC diagnosis and 92 neonates without the disease with similar demographic and clinical characteristics were included. The median day of NEC diagnosis was 15 days (Interquartile Range (IQR) 5–25 days). A significantly higher number of neonates that were fasting on days 7 and 14 developed NEC (p &lt; 0.05). In the longitudinal analysis, generalized linear and mixed models were fit to evaluate NEC association with feeding strategies and showed that exclusive mother’s own milk (MM) and fortified human milk (FHM) across time were significantly less likely associated with NEC (p &lt; 0.001) and that enteral fasting was positively related with NEC. In the cross-sectional analysis, a binary logistic regression model was fit and predicted 80.7% of NEC cases. MM was also found to correlate with a reduced risk for NEC (OR 0.148, 95% CI 0.044–0.05, p = 0.02), and in particular, on day 14, several factors were related to a decreased odd for NEC, including birth weight, antenatal steroids, and the use of FHM (p &lt; 0.001). (4) Conclusions: MM and FHM were associated with less NEC compared to fasting on days 7 and 14. Feeding practices in Neonatal Intensive Care Units (NICUs) should promote exclusive MM across the two-week critical period as a potential guideline to improve NEC outcome

Representative flow cytometric analyses of daunorubicin and mitoxantrone extruding lymphocytes.

<p>Panel A. Representative flow cytometric analyses of DNR extruding lymphocytes. The figure displays representative cytograms and their corresponding histograms obtained by cells incubated at 4°C (a) (negative control), 37°C (b) and 37°C (c) in the presence of verapamil. The non DNR-effluxing (fluorescent cluster at the right) and the DNR-effluxing (fluorescent cluster at the left) lymphocytes are clearly evident in either cytograms or histograms. (b): active RA patient with 46.5% lymphocytes able to extrude DNR; (c) Inhibitory effect of verapamil with only 22% of effluxing cells. Panel B. Representative flow cytometric analyses of mitoxantrone-extruding lymphocytes. The figure displays representative cytograms and their corresponding histograms obtained by cells incubated at 4°C (a) (negative control), 37°C (b) and 37°C (c) in the presence of KO143. The non-mitoxantrone effluxing-(fluorescence cluster at the right) and the mitoxantrone-effluxing (fluorescence cluster at the left) lymphocytes are clearly evident in either cytograms or histograms. b): active RA patient with 33.3% lymphocytes able to extrude mitoxantrone; (c) Inhibitory effect of KO143 with only 21.5% effluxing lymphocytes.</p

ABCB1 and ABCG2 transporters activity in active RA patients, in remission, and in those with recent diagnosis.

<p>Shown are the percent effluxing lymphocytes from all patients studied in each group.</p

Clinical and Demographic Characteristics.

<p>Clinical and Demographic Characteristics.</p

Association between type 2 diabetes and depressive symptoms after a 1-year follow-up in an older adult Mediterranean population

Altres ajuts: Recercaixa (number 2013ACUP00194); grants from the Consejería de Salud de la Junta de Andalucía (PI0458/2013, PS0358/2016, PI0137/2018); the PROMETEO/2017/017 grant from the Generalitat Valenciana; University of Rovira i Virgili (2020PMF-PIPF-37); Juan de la Cierva-Incorporación research grant (IJC2019-042420-I).To examine the cross-sectional association between baseline depressive symptoms and the presence of type 2 diabetes (T2D), and its association with glycated hemoglobin (HbA1c) and other metabolic variables, and the prospective association of depressive symptoms and HbA1c after 1 year of follow-up. n = 6224 Mediterranean older adults with overweight/obesity and metabolic syndrome (48% females, mean age 64.9 ± 4.9 years) were evaluated in the framework of the PREDIMED-Plus study cohort. Depressive symptoms were assessed using the Beck Depression Inventory-II and HbA1c was used to measure metabolic control. The presence of T2D increased the likelihood of higher levels of depressive symptoms (χ 2 = 15.84, p = 0.001). Polynomial contrast revealed a positive linear relationship (χ 2 = 13.49, p = 0.001), the higher the depressive symptoms levels, the higher the prevalence of T2D. Longitudinal analyses showed that the higher baseline depressive symptoms levels, the higher the likelihood of being within the HbA1c ≥ 7% at 1-year level (Wald-χ 2 = 24.06, df = 3, p < .001, for the full adjusted model). Additionally, depressive levels at baseline and duration of T2D predicted higher HbA1c and body mass index, and lower physical activity and adherence to Mediterranean Diet at 1 year of follow-up. This study supports an association between T2D and the severity of depressive symptoms, suggesting a worse metabolic control from mild severity levels in the short-medium term, influenced by lifestyle habits related to diabetes care. Screening for depressive symptoms and a multidisciplinary integrative therapeutic approach should be ensured in patients with T2D

Tratamientos Psicológicos Empíricamente Apoyados Para la Infancia y Adolescencia: : Estado de la Cuestión

Background: The empirical evidence accumulated on the effi cacy, effectiveness, and effi ciency of psychotherapeutic treatments in children and adolescents calls for an update. The main goal of this paper objective was to carry out a selective review of empirically supported psychological treatments for a variety of common psychological disorders and problems in childhood and adolescence. Method: A review was carried out of the psychological treatments for different psychological disorders and problems in socialemotional or behavioral adjustment in the child-adolescent population according to the Spanish National Health System (Clinical Practice Guidelines) levels of evidence and degrees of recommendation. Results: The fi ndings suggest that psychological treatments have empirical support for addressing a wide range of psychological problems in these developmental stages. The degree of empirical support ranges from low to high depending on the phenomenon analyzed. The review suggests unequal progress in the different fi elds of intervention. Conclusions: From this update, psychologists will be able to make informed decisions when implementing those empirically supported treatments to address the problems that occur in childhood and adolescence.Antecedentes: la evidencia empírica acumulada en los últimos años sobre la efi cacia, efectividad y efi ciencia de los tratamientos psicológicos en la infancia y adolescencia reclama una actualización. El principal objetivo de este artículo es el de llevar a cabo una revisión de los tratamientos psicológicos empíricamente apoyados para una diversidad de problemas psicológicos habituales en la infancia y la adolescencia. Método: se revisan los tratamientos psicológicos para diferentes trastornos psicológicos y problemas en el ajuste socioemocional o conductual en población infanto-juvenil en función de los niveles de evidencia y grados de recomendación del Sistema Nacional de Salud de España (Guías de Práctica Clínica). Resultados: los hallazgos sugieren que los tratamientos psicológicos específi camente dirigidos a niños, niñas y adolescentes disponen de apoyo empírico para el abordaje de un amplio elenco de problemas psicológicos. Este grado de apoyo empírico oscila de bajo a alto en función del problema analizado. La revisión muestra un avance desigual en los diferentes campos de intervención. Conclusiones: a partir de esta actualización, los profesionales de la psicología podrán tomar decisiones informadas a la hora de implementar aquellas intervenciones psicológicas con apoyo empírico para el abordaje de los problemas en la infancia y la adolescenci