Cirugía, estrés y estrategias de afrontamiento: un análisis exploratorio

En este trabajo se estudia a un grupo de 34 mujeres que debían someterse a una colecistotomía, con un doble objetivo: por una parte conocer el tipo de estrategias de afrontamiento más utilizadas por estas pacientes y, por otra, analizar si las estrategias utilizadas varían a lo largo del proceso, a medida que las pacientes pueden ejercer un mayor control sobre la amenaza (i.e., el proceso quirúrgico). Si bien los resultados muestran la presencia de una cierta diversidad en relación a las estrategias utilizadas, son las de tipo evitador las más empleadas. Por otra parte, la estabilidad, en el tipo de estrategias que utilizan las pacientes, es el denominador común a lo largo del procesoThis study analizes the types of coping strategies used by a group of 34 female patients undergoing a cholecystectomy. The aim is twofold: on one hand, to analyse which coping strategies are used most and, on the other hand, to analyse whether these strategies vary during the process, in relation to thepatients'faculty of exerting control over the threat (i.e., the surgicalprocess). The results show that strategies of the avoidant type are the most used, although there is some diversity. On the other hand, stability in the type of coping strategies used by these patients is the common denominator throughout the proces

Changes in pain-related beliefs, coping, and catastrophizing predict changes in pain intensity, pain interference, and psychological functioning in individuals with myotonic muscular dystrophy and facioscapulohumeral dystrophy

The primary aim of this study was to test hypothesized associations between changes in psychological variables (i.e., pain beliefs, catastrophizing and coping strategies) and changes in pain intensity and related adjustment (i.e., pain interference and psychological functioning) in individuals with Myotonic Muscular Dystrophy (MMD) and Facioscapulohumeral Muscular Dystrophy (FSHD). Methods: A sample of 107 adults with a diagnosis of MMD or FSHD, reporting pain in the past three months, completed assessments at two time-points, separated by about 24 months. Results showed that changes in pain-related psychological variables were significantly associated with changes in psychological functioning, pain intensity and pain interference. Specifically, increases in the belief that emotion influences pain, and catastrophizing were associated with decreases in psychological functioning. Increases in the coping strategies of asking for assistance and resting, and the increases of catastrophizing were associated with increases in pain intensity. Finally, increases in pain intensity and asking for assistance were associated with increases in pain interference. Discussion: The results support the utility of the biopsychosocial model of pain for understanding pain and its impact in individuals with MMD or FSHD. These findings may inform the design and implementation of psychosocial pain treatments for people with muscular dystrophy and chronic pain

The Silhouettes Fatigue Scale: a validity study with individuals with physical disabilities and chronic pain.

Purpose: Fatigue is known to interfere with function in individuals with physical disabilities. In order to monitor changes in fatigue over time and evaluate the efficacy of treatments, psychometrically sound measures of fatigue are needed. The aim of this work was to evaluate the validity of the Silhouettes Fatigue Scale with English instructions (SFS-EN) in a sample of adults with physical disabilities living in the USA. Methods: Individuals with medical conditions associated with physical disabilities responded to an online survey that included the SFS-EN as well as another validated measure of fatigue (PROMIS short form-4a Fatigue Scale), and measures of pain intensity and pain catastrophizing. Results: 523 individuals participated (mean age ¼ 59.1 years; SD¼11.4). Most participants were Caucasian (89%), women (59%) and unemployed (71%). Results showed strong positive correlations between both measures of fatigue, supporting the convergent validity of the SFS-EN. In addition, the magnitude of this association was significantly greater than the association between the scores of the SFS-EN and the measures of pain intensity and pain catastrophizing, supporting the former’s discriminant validity. Conclusions: The findings extend previous results supporting the SFS as a brief, easy to administer and understand, and valid measure of fatigue

Melatonin receptors MT1 and MT2 are expressed in spermatozoa from several seasonal and nonseasonal breeder species

P. 1958-1968Melatonin is a ubiquitous and multipurpose molecule, and one of its roles is to regulate reproduction in some seasonal mammals. Our group has previously reported the variation in the melatonin levels in ram seminal plasma along the year and identified MT1 and MT2 receptors in ram spermatozoa. The objective of this study was to elucidate whether the presence of melatonin receptors (MT1 and MT2) in the sperm plasma membrane, and melatonin in the seminal plasma is related to seasonal breeding. For this purpose, the presence of melatonin receptors and the levels of melatonin in seminal plasma have been examined in several species: donkey and stallion as long-day breeders; red deer as a wild, short-day, highly seasonal breeder (epididymal spermatozoa); bull as a conventional nonseasonal breeder; boar as a seasonal breeder under management techniques; and dog as possible a seasonal breeder not regulated by melatonin. We have detected measurable levels of melatonin in the seminal plasma of all ejaculated semen samples (from donkey, stallion, boar, bull, and dog). Also, and for the first time, we have demonstrated the presence of MT1 and MT2 melatonin receptors in the spermatozoa of all these species, regardless their type of reproduction or sperm source (ejaculated or epididymal), using indirect immunofluorescence techniques and Western blotting. Our findings suggest that melatonin and melatonin receptors may be universally distributed in the reproductive system of mammals and that the sperm melatonin receptors cells may not be necessarily related with seasonal reproduction. Furthermore, the presence of MT1 at the cytoplasmic droplet in immature ejaculated stallion spermatozoa found in one sample and epididymal red deer spermatozoa suggests that melatonin may be involved in specific functions during spermatogenesis and sperm maturation, like protecting spermatozoa from oxidative damage, this activity being mediated through these receptors.S

Effect of Maraviroc intensification on HIV-1-specific T cell immunity in recently HIV-1-infected individuals

BACKGROUND: The effect of maraviroc on the maintenance and the function of HIV-1-specific T cell responses remains unknown. METHODS: Subjects recently infected with HIV-1 were randomized to receive anti-retroviral treatment with or without maraviroc intensification for 48 weeks, and were monitored up to week 60. PBMC and in vitro-expanded T cells were tested for responses to the entire HIV proteome by ELISpot analyses. Intracellular cytokine staining assays were conducted to monitor the (poly)-functionality of HIV-1-specific T cells. Analyses were performed at baseline and week 24 after treatment start, and at week 60 (3 months after maraviroc discontinuation). RESULTS: Maraviroc intensification was associated with a slower decay of virus-specific T cell responses over time compared to the non-intensified regimen in both direct ex-vivo as well as in in-vitro expanded cells. The effector function profiles of virus-specific CD8⁺ T cells were indistinguishable between the two arms and did not change over time between the groups. CONCLUSIONS: Maraviroc did not negatively impact any of the measured parameters, but was rather associated with a prolonged maintenance of HIV-1-specific T cell responses. Maraviroc, in addition to its original effect as viral entry inhibitor, may provide an additional benefit on the maintenance of virus-specific T cells which may be especially important for future viral eradication strategies

Uso de recursos materiales y actividades de experimentación para la enseñanza de matemáticas en bachillerato

El uso de recursos materiales y actividades de experimentación en clase de matemáticas se está normalizando en educación primaria y, quizás en menor medida, en educación secundaria obligatoria. Así podemos encontrar muchos ejemplos de uso de materiales manipulativos y TAC, en las aportaciones que se han ido presentando en diferentes ediciones de las JAEM. En cambio, para la etapa de Bachillerato este tipo de recursos didácticos no parece que sean tan populares. Parece que en Bachillerato el formalismo toma un protagonismo que deja de lado otras opciones. Llevar al aula buenos recursos materiales inmersos en actividades adecuadas puede ser el método de transporte más eficaz para llegar a las ideas de fondo que subyacen en los contenidos propios de bachillerato. Las actividades de experimentación con recursos materiales nos permiten poner en juego el ciclo: experimentación, descubrimiento, conceptuación y formalización de una forma natural. Durante su desarrollo mostraremos y discutiremos con los asistentes la diferente utilización de éstos y cómo pueden gestionarse para que este tipo de actividades puedan ser aportaciones relevantes en los niveles más avanzados de la educación secundaria y que son un buen camino para llegar a comprender y a formalizar ideas abstractas

Role-plays en clase de matemáticas

El uso de recursos didácticos en clase de matemáticas es una manera magnífica de ayudar a los alumnos a entender los conceptos y procedimientos del currículum matemático. Hay diferentes tipos de recursos, dos de los más extendidos son los manipulativos y los TAC. Nosotros proponemos también el uso de unos materiales muy especiales como son los propios alumnos y profesores, que se convierten en recursos adoptando el papel de entes matemáticos y comportándose con coherencia en este rol. Se trata así de realizar simulaciones de hechos que pasan en el mundo de las matemáticas de manera que “seres matemáticos” como números, puntos, funciones... son representados por los propios alumnos. Los role-plays son unas de las actividades docentes en que, de una forma más clara, se pone de manifiesto la construcción colectiva de un nuevo conocimiento, armonizando acciones individuales en una representación conjunta de la cual emergerán ideas relevantes desde el punto de vista didáctico. En el taller os animaremos a participar en role-plays adecuados para diferentes niveles y que plantean diferentes dinámicas. Se trata de visitar un territorio muy poco explorado desde el punto de vista de la educación matemática, y a la vez lleno de bonitas posibilidades

Reappraisal of [18F]FDG-PET/CT for diagnosis and management of cardiac implantable electronic device infections

Introduction and objectives: The role of [18F]FDG-PET/CT in cardiac implantable electronic device (CIED) infections requires better evaluation, especially in the diagnosis of systemic infections. We aimed to determine the following: a) the diagnostic accuracy of [18F]FDG-PET/CT in each CIED topographical region, b) the added value of [18F]FDG-PET/CT over transesophageal echocardiography (TEE) in diagnosing systemic infections, c) spleen and bone marrow uptake in differentiating isolated local infections from systemic infections, and d) the potential application of [18F]FDG-PET/CT in follow-up. Methods: Retrospective single-center study including 54 cases and 54 controls from 2014 to 2021. The Primary endpoint was the diagnostic yield of [18F]FDG-PET/CT in each topographical CIED region. Secondary analyses described the performance of [18F]FDG-PET/CT compared with that of TEE in systemic infections, bone marrow and spleen uptake in systemic and isolated local infections, and the potential application of [18F]FDG-PET/CT in guiding cessation of chronic antibiotic suppression when completed device removal is not performed. Results: We analyzed 13 (24%) isolated local infections and 41 (76%) systemic infections. Overall, the specificity of [18F]FDG-PET/CT was 100% and sensitivity 85% (79% pocket, 57% subcutaneous lead, 22% endovascular lead, 10% intracardiac lead). When combined with TEE, [18F]FDG-PET/CT increased definite diagnosis o fsystemic infections from 34% to 56% (P=.04). Systemic infections with bacteremia showed higher spleen (P=.05) and bone marrow metabolism (P=.04) than local infections. Thirteen patients without complete device removal underwent a follow-up [18F]FDG-PET/CT, with no relapses after discontinuation of chronic antibiotic suppression in 6 cases with negative follow-up [18F]FDG-PET/CT. Conclusions: The sensitivity of [18F]FDG-PET/CT for evaluating CIED infections was high in local infections but much lower in systemic infections. However, accuracy increased when [18F]FDG-PET/CT was combined with TEE in endovascular lead bacteremic infection. Spleen and bone marrow hypermetabolism could differentiate bacteremic systemic infection from local infection. Although further prospective studies are needed, follow-up [18F]FDG-PET/CT could play a potential role in the management of chronic antibiotic suppression therapy when complete device removal is unachievable

The surface-boundary layer connection across spatial scales of irrigation-driven thermal heterogeneity: An integrated data and modeling study of the LIAISE field campaign

Irrigation in semi-arid regions induces thermal heterogeneity across a range of spatial scales that impacts the partitioning of energy at the surface, the development of the atmospheric boundary layer, and the bidirectional interactions between the atmosphere and the surface. In this analysis, we use data from the Land Surface Interactions with the Atmosphere in the Iberian Semi-Arid Environment (LIAISE) experiment combined with a coupled land–atmosphere model to understand the role of the scales of irrigation-induced, thermal heterogeneity on the surface fluxes and consequently, the development of the diurnal convective boundary layer. The surface heterogeneity is characterized by Bowen ratios that range from ∼0.01 in the irrigated areas to ∼30 in the non-irrigated areas; however, the observed boundary-layers dynamics in both locations are similar. In this analysis, we address the questions of how the surface fluxes impact the development of the boundary-layer dynamics and how the boundary layer influences the diurnal cycle of surface fluxes. To interpret the observations, we introduce a heterogeneity scaling scheme where length scales range from local scale (∼100 m) to regional scale (∼10 km) to investigate the role of scale on surface representation in numerical models and to address the discrepancy between surface observations and their representation in weather and climate models. We find that at the surface, both the available energy and its partitioning depend on spatial scale. The observed boundary-layer properties can be explained through the composite of surface fluxes at the regional scale. Surface fluxes at the local scales are unable to replicate the observed boundary layer — even when including large-scale contributions. We find that non-local boundary layer processes like advection are important for partitioning energy at the local scale. We explore the connection between surface fluxes and the development of the boundary layer and the potential non-local effects on boundary-layer development

Clinical Presentation and Outcome of COVID-19 in a Latin American Versus Spanish Population: Matched Case-Control Study

Introduction: Increased mortality has been reported in the Latin American population. The objective is to compare the clinical characteristics and outcome of Latin American and Spanish populations in a cohort of patients hospitalized with COVID-19 during the first year of the pandemic. Methods: We retrospectively analysed all the Latin American patients (born in South or Central America) hospitalized in our centre from February 2020 to February 2021 and compared them with an age- and gender-matched group of Spanish subjects. Variables included were demographics, co-morbidities, clinical and analytical parameters at admission and treatment received. The primary outcomes were ICU admission and mortality at 60 days. A conditional regression analysis was performed to evaluate the independent baseline predictors of both outcomes. Results: From the 3216 patients in the whole cohort, 216 pairs of case-controls (Latin American and Spanish patients, respectively) with same age and gender were analysed. COPD was more frequent in the Spanish group, while HIV was more prevalent in the Latin American group. Other co-morbidities showed no significant difference. Both groups presented with similar numbers of days from symptom onset, but the Latin American population had a higher respiratory rate (21 vs. 20 bpm, P = 0.041), CRP (9.13 vs. 6.22 mg/dl, P = 0.001), ferritin (571 vs. 383 ng/ml, P = 0.012) and procalcitonin (0.10 vs. 0.07 ng/ml, P = 0.020) at admission and lower cycle threshold of PCR (27 vs. 28.8, P = 0.045). While ICU admission and IVM were higher in the Latin American group (17.1% vs. 13% and 9.7% vs. 5.1%, respectively), this was not statistically significant. Latin American patients received remdesivir and anti-inflammatory therapies more often, and no difference in the 60-day mortality rate was found (3.2% for both groups). Conclusion: Latin American patients with COVID-19 have more severe disease than Spanish patients, requiring ICU admission, antiviral and anti-inflammatory therapies more frequently. However, the mortality rate was similar in both groups