Tratamiento psicosocial Matrix para la adicción a cocaína: componentes de un tratamiento efectivo

España, uno de los países europeos con mayor prevalencia de consumo de cocaína entre población joven, tiene una necesidad de transferencia de modelos empíricos de tratamiento llegados de otros países. El instituto Norteamericano NIDA recomienda Matrix como un modelo efectivo de tratamiento en adicciones a estimulantes. Los objetivos de este estudio teórico-descriptivo del modelo son describir con detalle: 1) el desarrollo histórico y repercusión del modelo, 2) la fi losofía y base teórica, 3) los constructos centrales; 4) la estructura y organización, y 5) los recursos materiales, humanos e infraestructura necesarios para implementarlo. La metodología incluye una revisión bibliográfi ca exhaustiva, la formación y experiencia clínica directa con el modelo. Los resultados muestran que Matrix está basado en teorías psicológicas consideradas efi caces para el tratamiento de las adicciones y comunes a las utilizadas por los psicólogos a nivel internacional (cognitivo-conductuales, psico-educativas, motivacionales, manejo de contingencias, monitorización del consumo, apoyo social). Consiste en una intervención intensiva inicial de 62 sesiones mínimas repartidas en 4 meses, seguida de un tratamiento de continuación indefi nido. Conclusiones: el modelo en su conjunto cumple los principios de buenas prácticas de NIDA. Su estandarización y materiales lo hacen fácil de implementar a nivel internacional.Evidence-Based Models for the psychosocial treatment drug addiction are in need in Spain, currently one of the European countries with highest prevalence on cocaine use among youth. This article describes in detail the Matrix model, one of the EBM recommended by NIDA as effective treatments for stimulant drugs. The goals are to describe: 1) the history and impact of this model, 2) philosophy and basic psychosocial theories, 3) core constructs, 4) structure of the model and 5) infrastructure and needed resources. Methods include a comprehensive literature review of the model descriptive publications, collaboration with the model authors, on-site training and direct experience utilizing the model sessions. Results showed that Matrix is based on psychological theories known and used by Spanish psychologists (cognitive-behavioral therapy, motivational strategies, relapse prevention, contingency management, monitoring drug-use, social support). It consists on 62 multivariate sessions along 4 months of intensive treatment followed by continuous support group sessions. The model follows the NIDA principles of Drugaddiction Treatment. Its standardization, structure and writing materials make possible to easily transfer this model to multiple communities and countries

CIBERER : Spanish national network for research on rare diseases: A highly productive collaborative initiative

Altres ajuts: Instituto de Salud Carlos III (ISCIII); Ministerio de Ciencia e Innovación.CIBER (Center for Biomedical Network Research; Centro de Investigación Biomédica En Red) is a public national consortium created in 2006 under the umbrella of the Spanish National Institute of Health Carlos III (ISCIII). This innovative research structure comprises 11 different specific areas dedicated to the main public health priorities in the National Health System. CIBERER, the thematic area of CIBER focused on rare diseases (RDs) currently consists of 75 research groups belonging to universities, research centers, and hospitals of the entire country. CIBERER's mission is to be a center prioritizing and favoring collaboration and cooperation between biomedical and clinical research groups, with special emphasis on the aspects of genetic, molecular, biochemical, and cellular research of RDs. This research is the basis for providing new tools for the diagnosis and therapy of low-prevalence diseases, in line with the International Rare Diseases Research Consortium (IRDiRC) objectives, thus favoring translational research between the scientific environment of the laboratory and the clinical setting of health centers. In this article, we intend to review CIBERER's 15-year journey and summarize the main results obtained in terms of internationalization, scientific production, contributions toward the discovery of new therapies and novel genes associated to diseases, cooperation with patients' associations and many other topics related to RD research

Spatiotemporal Characteristics of the Largest HIV-1 CRF02_AG Outbreak in Spain: Evidence for Onward Transmissions

Background and Aim: The circulating recombinant form 02_AG (CRF02_AG) is the predominant clade among the human immunodeficiency virus type-1 (HIV-1) non-Bs with a prevalence of 5.97% (95% Confidence Interval-CI: 5.41–6.57%) across Spain. Our aim was to estimate the levels of regional clustering for CRF02_AG and the spatiotemporal characteristics of the largest CRF02_AG subepidemic in Spain.Methods: We studied 396 CRF02_AG sequences obtained from HIV-1 diagnosed patients during 2000–2014 from 10 autonomous communities of Spain. Phylogenetic analysis was performed on the 391 CRF02_AG sequences along with all globally sampled CRF02_AG sequences (N = 3,302) as references. Phylodynamic and phylogeographic analysis was performed to the largest CRF02_AG monophyletic cluster by a Bayesian method in BEAST v1.8.0 and by reconstructing ancestral states using the criterion of parsimony in Mesquite v3.4, respectively.Results: The HIV-1 CRF02_AG prevalence differed across Spanish autonomous communities we sampled from (p < 0.001). Phylogenetic analysis revealed that 52.7% of the CRF02_AG sequences formed 56 monophyletic clusters, with a range of 2–79 sequences. The CRF02_AG regional dispersal differed across Spain (p = 0.003), as suggested by monophyletic clustering. For the largest monophyletic cluster (subepidemic) (N = 79), 49.4% of the clustered sequences originated from Madrid, while most sequences (51.9%) had been obtained from men having sex with men (MSM). Molecular clock analysis suggested that the origin (tMRCA) of the CRF02_AG subepidemic was in 2002 (median estimate; 95% Highest Posterior Density-HPD interval: 1999–2004). Additionally, we found significant clustering within the CRF02_AG subepidemic according to the ethnic origin.Conclusion: CRF02_AG has been introduced as a result of multiple introductions in Spain, following regional dispersal in several cases. We showed that CRF02_AG transmissions were mostly due to regional dispersal in Spain. The hot-spot for the largest CRF02_AG regional subepidemic in Spain was in Madrid associated with MSM transmission risk group. The existence of subepidemics suggest that several spillovers occurred from Madrid to other areas. CRF02_AG sequences from Hispanics were clustered in a separate subclade suggesting no linkage between the local and Hispanic subepidemics

VARIABLES PSICOLÓGICAS Y ADICTIVAS EN UNA MUESTRA DE JUGADORES PATOLÓGICOS

Objectives: The aim of the present work is to study the following variable factors: severity of pathological gambling, stage of change, anxiety and depression, and drug use, abuse or dependency. This work is also intended to study the existing relation among the variables stage of change, age and sex, and the remaining ones. Material and Methods: Data has been obtained from a clinical interview, SOGS, BDI, STAI, and CBA. The sample consists of 158 subjets (140 males and 18 females) all being addicted to gambling. Results: Results shows high severity on pathological gambling, high levels of both trait anxiety and state anxiety, as well as dysphoric mood. ½ of the sample subjects are in a contemplative state. Almost ½ of them show signs of gambling associated alcohol consumption. Conclusions: In our opinion, subjects with alcohol consumption associated problems require a specific kind of therapy. Subjects in a pre-contemplative stage have lower depression levels due to lack of concern and negation of the problem. Although subjects under treatment also show lower depression levels, in their case it is due to perceived self-efficiency following therapy instructions.Objetivos: estudiar la severidad de la adicción al juego, el estadio de cambio, la presencia de sintomatología ansiosa y depresiva, y por último el consumo, abuso o dependencia de sustancias adictivas. Analizar la relación entre las variables estadio de cambio, edad y sexo con el resto de las variables. Material y método: se recoge información a través de la entrevista clínica, SOGS, BDI, STAI y CBA. La muestra está compuesta por 158 sujetos (140 varones y 18 mujeres) adictos al juego. Resultados: se ha obtenido una severidad de la adicción al juego elevada, altos niveles de ansiedad rasgo y estado y un estado emocional disfórico. La mitad de la muestra se ubica en el estadio de contemplación. Casi la mitad de la muestra presenta consumo de alcohol asociado a la conducta de juego. Conclusiones: Consideramos que aquellos sujetos que presentan consumo problemático de alcohol requieren una intervención especifica. Tanto los precontempladores como los sujetos en actuación presentan un menor grado de depresión, consideramos que debido a falta de concienciación y/o negación del problema en el caso de los primeros y a la autoeficacia percibida derivada del éxito conseguido en los segundos

Motivación al cambio y perfil psicosocial del jugador patológico que demanda tratamiento: estudio multicéntrico

Este artículo analiza el perfil psicosocial del jugador patológico que demanda tratamiento en la Comunidad Valenciana, así como su motivación al cambio, destacando la creación de las Unidades de Conductas Adictivas en la sanidad pública como un recurso adecuado para la prestación de atención psicológica que requiere este tipo de adicciones

Variables psicológicas y adictivas en una muestra de jugadores patológicos

Objetivos: estudiar la severidad de la adicción al juego, el estadio de cambio, la presencia de sintomatología ansiosa y depresiva, y por último el consumo, abuso o dependencia de sustancias adictivas. Analizar la relación entre las variables estadio de cambio, edad y sexo con el resto de las variables. Material y método: se recoge información a través de la entrevista clínica, SOGS, BDI, STAI y CBA. La muestra está compuesta por 158 sujetos (140 varones y 18 mujeres) adictos al juego. Resultados: se ha obtenido una severidad de la adicción al juego elevada, altos niveles de ansiedad rasgo y estado y un estado emocional disfórico. La mitad de la muestra se ubica en el estadio de contemplación. Casi la mitad de la muestra presenta consumo de alcohol asociado a la conducta de juego. Conclusiones: Consideramos que aquellos sujetos que presentan consumo problemático de alcohol requieren una intervención especifica. Tanto los precontempladores como los sujetos en actuación presentan un menor grado de depresión, consideramos que debido a falta de concienciación y/o negación del problema en el caso de los primeros y a la autoeficacia percibida derivada del éxito conseguido en los segundos

Effects of a single dose of beetroot juice on cycling time trial performance at ventilatory thresholds intensity in male triathletes

Abstract Background Beetroot juice (BJ) is classified as a high-level supplement for improving sports performance. There is some controversy over the benefits of BJ supplementation for endurance exercise performance, especially when referring to well-trained athletes. This study examines the effects of acute BJ supplementation on cardioventilatory responses, exercise economy/efficiency, slow component of oxygen uptake, time trial performance, blood lactate, energy consumption, and carbohydrate and fat oxidation. Methods Twelve well-trained, male triathletes (aged 21–47 yr) were assigned in a randomized, double-blind, crossover design to receive 70 ml of BJ (6.5 mmol NO3 −) or placebo (PL). Three hours after taking the supplement, participants completed an endurance test on a cycle ergometer at a constant work rate (W) corresponding to first ventilatory threshold (VT1) (30 min) and second ventilatory threshold (VT2) time trial (~ 15 min). Results Maximal oxygen uptake was 54.78 ± 3.13 mL·min− 1·kg− 1, and gross efficiency was > 22% at each load intensity and experimental condition. No significant interaction effect (supplement*intensity) was observed on any of the cardioventilatory variables, efficiency/economy, VT2 time trial, energy expenditure, carbohydrate oxidation and fat oxidation (p > 0.05). Conclusion Our findings do not support an improvement in the variables examined in response to acute BJ supplementation. Probably, higher doses are needed for improving time trial performance in male triathletes during a cycle ergometer test conducted at a load intensity equivalent to the first and second ventilatory threshold

Complex Care Needs in Multiple Chronic Conditions: Population Prevalence and Characterization in Primary Care. A Study Protocol

Background: Chronicity, and particularly complex care needs for people with chronic diseases is one of the main challenges of health systems. Objective: To determine the population prevalence of people with chronic diseases and complex care needs and to characterize these needs considering features of health and social complexity in Primary Care. Design: Cross-sectional population-based study. Scope: Patients who have one or more chronic health conditions from three Primary Care urban centres of a reference population of 43.647 inhabitants older than 14 years old. Methodology: Data will be obtained from the review of electronical medical records. Complexity will be defined by: 1) the independent clinical judgment of primary care physicians and nurses and 2) the aid of three complexity domains (clinical and social). Patients with advanced chronic disease and limited life prognosis will be also described. Conclusions: This research protocol intends to describe and analyse complex care needs from a primary care professional perspective in order to improve knowledge of complexity beyond multimorbidity and previous consumption of health resources. Knowing about health and social complexity with a more robust empirical basis could help for a better integration of social and health policies and a more proactive and differentiated care approach in this most vulnerable population

Postranscriptional modification of the tubulin cytoskeleton in primary sensory and motor neuron cultures.

<p><b>(A)</b> DRG sensory neurons and <b>(B)</b> embryonic MNs were double-stained for acetylated α-tubulin (acetylated α-tub, green) and β-III tubulin (β-III tub, red). As indicated by respective histograms there is a significant reduction of acetylated α-tubulin in both MN and sensory neurites in <i>Gdap1</i>^<i>-/-</i> mice. Graph represents means and S.E.M of 3 independent culture preparation per genotype. Student’s <i>t</i> test ***p<0.001.</p

Behavioural testing and electrophysiological measurements on <i>Gdap1</i>^<i>-/-</i> mice.

<p><b>(A)</b> Upper panel shows photographs of 3 months-old mice suspended by its tail. WT mice show a characteristic response trying to escape by splaying its hind limbs away from the trunk of its body. In contrast, hind limbs of <i>Gdap1</i>^-/- mice are held tonically against its trunk in an abnormal dystonic posture. Lower panels display a low body position and a dragging tail present in <i>Gdap1</i>^<i>-/-</i> mice as compared to age-matched WT mice. <b>(B)</b> Motor coordination was assessed by rotarod test, (n = 10 for each genotype and at each age group). <b>(C)</b> Representative hind limb walking patterns of 5 months-old WT and <i>Gdap1</i>^-/- mice where the stride length (SL) and stride angle (SA) have been depicted. Footprints revealed that <i>Gdap1</i>^<i>-/-</i> mice walk with an abnormal gait. The scheme of a hindpaw footprint indicating measured parameters (PL: plantar length; TS: toe spreading) has been included. <b>(D)</b> Quantification of various parameters obtained from the gait analysis of WT (black columns) and <i>Gdap1</i>^<i>-/-</i> (grey columns) animals at 5 and 12 months of age. Upper graphs show stride length (left) and stride angle (right). Lower graphs show the quantitative analysis of the hindpaw footprint parameters toe spreading (left) and plantar length (right). Analysis was conducted on 10 clearly visible footprints at 5 animals per genotype. Determination of sciatic nerve compound muscle action potential (CMAP) amplitudes at both distal and proximal <b>(E)</b> as well as motor nerve conduction velocities (MNCV) <b>(F)</b> measured in WT and <i>Gdap1</i>^-/- mice at 2 and 5 months of age (n = 4). Error bars indicate standard error of the mean (S.E.M.). <i>p</i> values were calculated using Student's <i>t</i> test,*p<0.05, **p<0.001, ***p<0.0001.</p