Cognitive reserve mediates the severity of certain neuropsychological deficits related to cocaine use disorder

Introduction: The concept of cognitive reserve (CR) is being considered in the field of substance use disorder (SUD) by observing that there are individuals whose brain alterations are not related to the cognitive symptomatology they present. Aims: Our aims were to characterise the possible neuropsychological deficits in a sample of subjects with SUD compared to a control group and to determine whether the degree of CR is a mediator in the cognitive functioning of these patients. Methods: To perform these objectives, the study involved a sample of subjects with SUD in outpatient treatment and a control group. A CR questionnaire and a comprehensive neuropsychological assessment were administered, and we also collected data related to drug consumption and psychological well-being. Results: The SUD group showed poorer performance compared to the control group in several cognitive domains (attention, declarative memory, executive functions and emotional perception), as well as in psychological comfort. Interestingly, we observed that the deficits found in attention, declarative memory and executive functions were mediated by the CR level of the participants, an effect that we did not observe in the rest of the variables registered. Conclusion: Our results suggest that long-term drug consumption leads to cognitive deficits and affects the psychological well-being of the subjects. Moreover, the CR should be taken into account during the assessment and rehabilitation of patients with SUD due to its protective role against certain neuropsychological deficits.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Literature Review on the Harmful Effects of Occupational Exposure to Hydrocarbons on Workers in External Environments

http://gesdoc.isciii.es/gesdoccontroller?action=download&id=18/12/2018-f7f349cfd8[ES]Antecedentes: Policías de tráfico, conductores y otros profesionales, están expuestos de forma aguda y crónica a hidrocarburos ambientales del tráfico que pueden conllevar un riesgo para la salud. Dichos tóxicos, están presentes en la contaminación ambiental. En la literatura revisada no hemos encontrado protocolos ni EPIs para estas profesiones laborales, poniendo de relieve que aún queda mucho por desarrollar en este campo. En este artículo, revisamos la evidencia existente en cuanto a efectos nocivos en la salud por la exposición laboral a hidrocarburos en ambiente exterior. Objetivos: Determinar la evidencia científica existente en la literatura acerca de los efectos biológicos de la exposición crónica laboral a hidrocarburos ambientales en los trabajadores expuestos a tráfico (y/o rodeados de HAPs). Material y Métodos: Búsqueda bibliográfica en Pubmed, Toxnet, Scopus, Embase, y webs institucionales de donde recopilamos 25 artículos. Resultados: Se han evidenciado cambios y efectos biológicos nocivos por exposición a los hidrocarburos ambientales (en su mayoría debidos al tráfico), así como la presencia de metabolitos en análisis biológicos de trabajadores expuestos. Dichos efectos han afectado al sistema reproductor, al sistema cardiovascular e incluso a la reparación de DNA. Conclusiones: Parecen existir efectos nocivos para el organismo debidos a la exposición laboral ambiental. Se encontró asociación estadística significativa en la disminución de la reparación del DNA y en el aumento de metabolitos relacionados con hidrocarburos en sangre y orina. [EN] Background: Traffic officers, drivers and other professionals previously exposed to other environmental traffic hydrocarbons, are acutely and chronically exposed to multiple hazardous substances that can affect health. These toxics are present in environmental pollution. In the literature reviewed, neither protocols nor PPEs have been found for these professions, which highlight the need to be taken into consideration. In this article, the existing evidence regarding the adverse health effects due to the exposure to hydrocarbons in external working environments is reviewed. Objectives: To determine the existing scientific evidence in literature about the biological effects of the work-related chronic exposure to environmental hydrocarbons in jobs exposed to traffic (and/or surrounded by PAHs). Materials and Methods: 25 articles have been compiled from Bibliographic research in Pubmed, Toxnet, Scopus, Embase, and institutional websites. Results: Changes and harmful biological effects due to exposure to environmental hydrocarbons (most of them caused by traffic) and the presence of metabolites in the biological analyses of exposed workers have been evidenced. Such effects have affected both the reproductive and cardiovascular systems and even DNA repair.Conclusions: Adverse effects on the organism due to environmental exposure in the workplace seem to take place. Significant statistical association was found in the decrease of DNA repair and in the increase of metabolites related with hydrocarbons in blood and urine.N

Revisión de la literatura sobre efectos nocivos de la exposición laboral a hidrocarburos en trabajadores en ambiente externo

Resumen Antecedentes: Policías de tráfico, conductores y otros profesionales, están expuestos de forma aguda y crónica a hidrocarburos ambientales del tráfico que pueden conllevar un riesgo para la salud. Dichos tóxicos, están presentes en la contaminación ambiental. En la literatura revisada no hemos encontrado protocolos ni EPIs para estas profesiones laborales, poniendo de relieve que aún queda mucho por desarrollar en este campo. En este artículo, revisamos la evidencia existente en cuanto a efectos nocivos en la salud por la exposición laboral a hidrocarburos en ambiente exterior. Objetivos: Determinar la evidencia científica existente en la literatura acerca de los efectos biológicos de la exposición crónica laboral a hidrocarburos ambientales en los trabajadores expuestos a tráfico (y/o rodeados de HAPs). Material y Métodos: Búsqueda bibliográfica en Pubmed, Toxnet, Scopus, Embase, y webs institucionales de donde recopilamos 25 artículos. Resultados: Se han evidenciado cambios y efectos biológicos nocivos por exposición a los hidrocarburos ambientales (en su mayoría debidos al tráfico), así como la presencia de metabolitos en análisis biológicos de trabajadores expuestos. Dichos efectos han afectado al sistema reproductor, al sistema cardiovascular e incluso a la reparación de DNA. Conclusiones: Parecen existir efectos nocivos para el organismo debidos a la exposición laboral ambiental. Se encontró asociación estadística significativa en la disminución de la reparación del DNA y en el aumento de metabolitos relacionados con hidrocarburos en sangre y orina

Cognitive reserve mediates the severity of certain neuropsychological deficits related to cocaine use disorder

Author manuscriptThe concept of cognitive reserve (CR) is being considered in the field of substance use disorder (SUD) by observing that there are individuals whose brain alterations are not related to the cognitive symptomatology they present. Our aims were to characterise the possible neuropsychological deficits in a sample of subjects with SUD compared to healthy controls and to determine whether the degree of CR is a mediator in the cognitive functioning of these patients. To perform these objectives, the study involved a sample of subjects with SUD in outpatient treatment and a healthy control group. A CR questionnaire and a comprehensive neuropsychological assessment were administered, and we also collected data related to drug consumption and psychological well-being. The SUD group showed poorer performance compared to the control group in several cognitive domains (attention, declarative memory, executive functions and emotional perception), as well as in psychological comfort. Interestingly, we observed that the deficits found in attention and processing speed were highly mediated by the CR level of the participants, an effect that we did not observe in the rest of the variables registered. Our results suggest that long-term drug consumption leads to cognitive deficits and affects the psychological well-being of the subjects. Moreover, the CR should be taken into account during the assessment and rehabilitation of patients with SUD due to its protective role against certain neuropsychological deficits.This study was funded by grants from the Spanish Ministry of Economy and Competitiveness (MINECO, Agencia Estatal de Investigación) cofounded by the European Research Development Fund -AEI/FEDER, UE- (PSI2017-82604-R to L.J.S.), and from University of Málaga (Plan Propio 2017 – ‘Ayudas para el fomento de proyectos de investigación en Ciencias Sociales y Jurídicas, Humanidades, Arquitectura y Bellas Artes’– AYUDA_18_B.3._10 to P.S.P.). The authors P.S-P. and D.L.G-M. hold postdoctoral contracts from University of Malaga (Ayuda para la Incorporación de Doctores del Plan Propio de la Universidad de Málaga (A.4) and Contrato postdoctoral del Plan Propio de la Universidad de Málaga (A.3), respectively). The author A.P-R holds a grant from University of Malaga (Ayuda para la iniciación a la investigación del Plan Propio de la Universidad de Málaga (A.1))

IBRORS-MCL study: a Spanish retrospective and observational study of relapsed/refractory mantle-cell lymphoma treated with ibrutinib in routine clinical practice.

This retrospective study evaluated 66 patients diagnosed with relapsed and/or refractory mantle cell lymphoma (R/R MCL) treated with ibrutinib in Spain in routine clinical practice. At diagnosis, patients had a median age of 64.5 years, 63.6% presented with intermediate/high sMIPI (simplified prognostic index for advanced-stage mantle cell lymphoma), 24.5% had the blastoid variant, and 55.6% had a Ki67 > 30%. Patients had received a median of 2 prior lines of therapy (range 1-2; min-max 1-7). Overall response rate was 63.5%, with 38.1% of patients achieving complete response (CR). With a median duration of ibrutinib exposure of 10.7 months (range 5.2-19.6; min-max 0.3-36), the median progression-free survival (PFS) and overall survival (OS) were 20 months [95% confidence interval (CI) 8.8-31.1] and 32 months (95% CI 22.6-41.3), respectively, and were not reached in patients achieving CR. No grade ≥ 3 cardiovascular toxicity or bleeding was reported. This study supports that treatment with ibrutinib leads to high response rates and favorable survival outcomes in patients with R/R MCL