L'ecografia pulmonar guanya protagonisme a les unitats neonatals

Immediatesa en l'exploració, precisió en el diagnòstic, encert en la predicció i innocuïtat per als nadons. Són els sòlids arguments, després de fer un estudi amb cent nounats, amb què els autors d'aquest article, doctors i investigadors dels hospitals Parc Taulí (UAB) i Sant Joan de Déu (UB), defensen la necessitat de fer servir l'ecografia pulmonar com una eina bàsica per a la cura i el tractament dels bebés que ingressen a l'hospital en les primeres hores de vida amb dificultat respiratòria.Inmediatez en la exploración, precisión en el diagnóstico, acierto en la predicción e inocuidad para los bebés. Son los sólidos argumentos, después de hacer un estudio con cien neonatos, con los que los autores de este artículo, doctores e investigadores de los hospitales Parc Taulí (UAB) y Sant Joan de Déu (UB), defienden la necesidad de usar la ecografía pulmonar como una herramienta básica para la cura y el tratamiento de los bebés que en las primeras horas de vida ingresan en el hospital con dificultad respiratoria.Quick exploration, accuracy in diagnosis, correct prediction and no harm to newborns. After conducting a research with one hundred babies, these are the strong arguments given by doctors and researchers from the hospitals Parc Taulí (UAB) and Sant Joan de Déu (UB) on the need to use lung ultrasounds as a basic tool for the care and treatment of newborns being admitted with respiratory distress to hospital in their first hours of life

Maneig de l'hemorràgia digestiva alta no varicosa

En els últims anys s'han produït avenços en el maneig de l'hemorràgia digestiva alta no varicosa, originada en estómac i duodè i no provocada per varius esofàgiques. Aquests avenços, recollits en noves guies de pràctica clínica, fan èmfasi en la prevenció de les complicacions cardiovasculars durant l'hemorràgia, l'ús d'adequats medicaments per reduir la secreció d'àcid gàstric, antiinflamatoris menys lesius i protectors gàstrics, l'ús de tractaments menys invasius que la cirurgia i la curació d'infeccions.En los últimos años se han producido avances en el manejo de la hemorragia digestiva alta no varicosa, originada en estómago y duodeno y no provocada por varices esofágicas. Estos avances, recogidos en nuevas guías de práctica clínica, hacen énfasis en la prevención de las complicaciones cardiovasculares durante la hemorragia, el uso de adecuados medicamentos para reducir la secreción de ácido gástrico, antiinflamatorios menos lesivos y protectores gástricos, el uso de tratamientos menos invasivos que la cirugía y la curación de infecciones

All-cause mortality in the cohorts of the Spanish AIDS Research Network (RIS) compared with the general population: 1997Ł2010

Abstract Background: Combination antiretroviral therapy (cART) has produced significant changes in mortality of HIVinfected persons. Our objective was to estimate mortality rates, standardized mortality ratios and excess mortality rates of cohorts of the AIDS Research Network (RIS) (CoRIS-MD and CoRIS) compared to the general population. Methods: We analysed data of CoRIS-MD and CoRIS cohorts from 1997 to 2010. We calculated: (i) all-cause mortality rates, (ii) standardized mortality ratio (SMR) and (iii) excess mortality rates for both cohort for 100 personyears (py) of follow-up, comparing all-cause mortality with that of the general population of similar age and gender. Results: Between 1997 and 2010, 8,214 HIV positive subjects were included, 2,453 (29.9%) in CoRIS-MD and 5,761 (70.1%) in CoRIS and 294 deaths were registered. All-cause mortality rate was 1.02 (95% CI 0.91-1.15) per 100 py, SMR was 6.8 (95% CI 5.9-7.9) and excess mortality rate was 0.8 (95% CI 0.7-0.9) per 100 py. Mortality was higher in patients with AIDS, hepatitis C virus (HCV) co-infection, and those from CoRIS-MD cohort (1997. Conclusion: Mortality among HIV-positive persons remains higher than that of the general population of similar age and sex, with significant differences depending on the history of AIDS or HCV coinfection

Maneig de l'hemorràgia digestiva alta no varicosa

En els últims anys s'han produït avenços en el maneig de l'hemorràgia digestiva alta no varicosa, originada en estómac i duodè i no provocada per varius esofàgiques. Aquests avenços, recollits en noves guies de pràctica clínica, fan èmfasi en la prevenció de les complicacions cardiovasculars durant l'hemorràgia, l'ús d'adequats medicaments per reduir la secreció d'àcid gàstric, antiinflamatoris menys lesius i protectors gàstrics, l'ús de tractaments menys invasius que la cirurgia i la curació d'infeccions.En los últimos años se han producido avances en el manejo de la hemorragia digestiva alta no varicosa, originada en estómago y duodeno y no provocada por varices esofágicas. Estos avances, recogidos en nuevas guías de práctica clínica, hacen énfasis en la prevención de las complicaciones cardiovasculares durante la hemorragia, el uso de adecuados medicamentos para reducir la secreción de ácido gástrico, antiinflamatorios menos lesivos y protectores gástricos, el uso de tratamientos menos invasivos que la cirugía y la curación de infecciones

Free Thyroxine Concentrations Moderate the Response to a Cognitive Remediation Therapy in People With Early Psychosis : A Pilot Randomized Clinical Trial

Cognitive deficits are a cause of functional disability in psychotic disorders. Cognitive remediation therapy (CRT) might be applied to improve these deficits. We conducted a pilot study to explore whether thyroid hormones might predict the response to CRT in patients with recent-onset psychosis (ROP). Twenty-eight stable ROP outpatients (9 women) were randomized to receive computerized CRT (N=14) or treatment as usual (TAU) (N=14), over three months. Both cognitive and thyroid functions were assessed at the baseline and after those three months to all patients. A full cognitive battery (CANTAB) was administered before and after the treatment. Serum levels of thyroid-stimulating hormone (TSH) and free thyroxine (FT4) were measured. FT4 concentrations were recoded into a dichotomic variable (FT4 group) based on the median of the sample (1.2 ng/dL). Data were analyzed on an intention-to-treat basis with linear mixed models. Afterwards, we offered CRT to all participants from the TAU group and seven enrolled CRT, reassessing them when finished. Secondary analyses were repeated in a sample of 14 participants who completed the CRT (either from the beginning or after the TAU period) and attended at least one third of the sessions. The linear mixed models showed a significant time x CRT x FT4 group effect in two cognitive tasks dealing with executive functions and sustained attention (participants with higher FT4 concentrations worsened executive functions but improved sustained attention after CRT). In the secondary analysis including all patients assigned to CRT, higher FT4 concentrations were associated with a poorer response in verbal memory but a better response in spatial working memory. Free thyroxine concentrations moderate the response to a CRT in patients with early psychosi

The Role of Sleep Quality, Trait Anxiety and Hypothalamic-Pituitary-Adrenal Axis Measures in Cognitive Abilities of Healthy Individuals

Altres ajuts: This study was supported in part by grants from the European Regional Development Fund (ERDF) "A way to build Europe", the Fundació La Marató de TV3 (092230/092231), CIBERSAM. Samples from patients included in this study were processed and preserved by the Biobank IISPV and the Biobank HUB-ICO-IDIBELL, integrated in the Spanish National Biobanks Network (PT17/0015/0024) and Xarxa Banc de Tumors. The funders had no role in the study design,data collection and analysis, decision to publish, or preparation of the manuscript.Sleep plays a crucial role in cognitive processes. Sleep and wake memory consolidation seem to be regulated by glucocorticoids, pointing out the potential role of the hypothalamic-pituitary-adrenal (HPA) axis in the relationship between sleep quality and cognitive abilities. Trait anxiety is another factor that is likely to moderate the relationship between sleep and cognition, because poorer sleep quality and subtle HPA axis abnormalities have been reported in people with high trait anxiety. The current study aimed to explore whether HPA axis activity or trait anxiety moderate the relationship between sleep quality and cognitive abilities in healthy individuals. We studied 203 healthy individuals. We measured verbal and visual memory, working memory, processing speed, attention and executive function. Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Trait anxiety was assessed with the State-Trait Anxiety Inventory. HPA axis measures included the cortisol awakening response (CAR), diurnal cortisol slope and cortisol levels during the day. Multiple linear regression analyses explored the relationship between sleep quality and cognition and tested potential moderating effects by HPA axis measures and trait anxiety. Poor sleep quality was associated with poorer performance in memory, processing speed and executive function tasks. In people with poorer sleep quality, a blunted CAR was associated with poorer verbal and visualmemory and executive functions, and higher cortisol levels during the day were associated with poorer processing speed. Trait anxiety was a moderator of visual memory and executive functioning. These results suggest that subtle abnormalities in the HPA axis and higher trait anxiety contribute to the relationship between lower sleep quality and poorer cognitive functioning in healthy individuals