Un caso de revisión diagnóstica de una depresión previamente diagnosticada de trastorno bipolar

A combined therapeutic intervention -pharmacological and psychological- is described for the treatment of a patient previously diagnosed of Bipolar Disorder. The cooperation of psychiatrists and psychologists helped to set an alternative diagnosis (depression) and the subsequent treatment. The therapeutic outcome obtained shows the need to assume, under certain circumstances, several simultaneous and competitive diagnoses, especially when the overall pattern of the gathered data cannot be unequivocally translated into symptoms according to current diagnostic criteria.ResumenSe persenta la intervención terapéutica combinada con farmacología y psicoterapia en un caso diagnosticado previamente de trastorno bipolar. El trabajo conjunto de psiquiatra y psicólogos permitió plantear una alternativa diagnóstica y una intervención conjunta de acuerdo a la misma. El caso, dados los resultados obtenidos, muestra la necesidad, en muchas ocasiones, de plantear más de una hipótesis diagnóstica, especialmente cuando los datos conseguidos no se pueden interpretar de forma unívoca con respecto a los crieterios diagnósticos al uso.AbstractA combined therapeutic intervention -pharmacological and psychological- is described for the treatment of a patient previously diagnosed of Bipolar Disorder. The cooperation of psychiatrists and psychologists helped to set an alternative diagnosis (depression) and the subsequent treatment. The therapeutic outcome obtained shows the need to assume, under certain circumstances, several simultaneous and competitive diagnoses, especially when the overall pattern of the gathered data cannot be unequivocally translated into symptoms according to current diagnostic criteria

Modelado con elementos finitos y actualización con ensayos modales experimentales de un cantón de catenaria rígida

La catenaria rígida, comúnmente instalada en metropolitanos subterráneos, presenta ciertas ventajas respecto a otros sistemas convencionales de alimentación eléctrica en el transporte ferroviario, como es la catenaria flexible. La catenaria rígida aún se encuentra en fases de desarrollo y mejora de su comportamiento. Con el fin de potenciar sus ventajas y mejorar su funcionamiento, los autores de este trabajo presentan el modelado con elementos finitos de un cantón de catenaria rígida instalado en la red de cercanías de Málaga y su actualización mediante ensayos modales experimentales. La actualización del semi-cantón de entrada en el modelo de elementos finitos presenta un error medio en frecuencia de 1.39 % y una similitud del 91% en las deformadas modales del modelo de elementos finitos respecto a los ensayos. Estos resultados muestran la validez del modelo.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. ADIF con Proyecto CARIMA (Nº Contrato: 3.15/49570.003

Elaboración y propuesta de un instrumento para la detección de malestar emocional en enfermos al final de la vida

Establecer la sistemática de trabajo de un grupo multidisciplinar cuyo objetivo es elaborar un instrumento para detectar el malestar emocional en enfermos al fi nal de la vida. Material y métodos: Se describe la formación y composición del equipo investigador así como su dinámica de trabajo a lo largo de 2007 y 2008 en múltiples reuniones presenciales y on-line así como la bibliografía, el modelo y criterios que sirvieron de base para el debate que condujo a la elaboración del instrumento. Se presenta el cuestionario DME, que consta de dos partes: 1) cuatro preguntas dirigidas al enfermo, y 2) observación, por parte del sanitario, de signos que muestren la presencia de malestar emocional. Actualmente se encuentra en proceso de validación.To establish the methodology of work for a multidisciplinary group whose objective is to generate a tool to detect the emotional distress in patients at the end of their lives. Material and method: It describes the confi guration and composition of the researching team as well as its method of work throughout 2007 and 2008. The combination of multiple face to face meetings, online conferences and the review of related bibliography formed the model and the criteria used as the basis for the debate that lead to the elaboration of the instrument. Results: The questionnaire DME is presented, and consists 1) four questions addressed to the patient, and 2) observation by the health staff of signs that show the presence of emotional distress. At the moment, the instrument is under validation

Soporte de catenaria rígida del túnel Sol-Nuevos Ministerios: modelado con elementos finitos y actualización con ensayos modales experimentales

La catenaria rígida presenta ciertas ventajas respecto a otros sistemas más convencionales de alimentación eléctrica en el transporte ferroviario. La tendencia a incrementar las velocidades de funcionamiento, crean la necesidad de optimizar el sistema. En este trabajo, los autores presentan el modelado con elementos finitos del soporte de catenaria rígida instalado en el tramo Sol-Nuevos Ministerios y la actualización mediante ensayos modales experimentales. Este modelo permitirá obtener la rigidez que aporta el soporte al sistema de catenaria rígida. Tras la actualización, el modelo de elementos finitos presenta un error medio de 1.26 % en los modos de mayor influencia en la respuesta dinámica bajo las condiciones de trabajo del soporte. Además, las deformadas modales del modelo de elementos finitos actualizado presentan una similitud media del 91.3 % respecto a ensayos. Los resultados indican la validez del modelo.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Perceived Motivational Climate Determines Self-Confidence and Precompetitive Anxiety in Young Soccer Players: Analysis by Gender

The main objective of this study was to analyze whether the perception of the motivational climate in young soccer players determines the level of competitive anxiety and self-confidence. In addition, the results were explored according to gender, in order to observe if there were differences between the female and male categories. A total of 113 cadet and youth soccer players from six soccer teams in the provinces of Malaga and Granada, aged between 14 and 19 years, who competed in regional leagues, participated in the study. Of these, 50 were female and 63 were male. The Competitive Sport Anxiety (CSAI-2), Perceived Motivational Climate in Sport Questionnaire-2 (PMCSQ-2), and Self-Confidence in Sport Competition Questionnaire (CACD) were used to collect the information. Correlation, linear regression and cluster analyses were performed. The data analyses carried out affirmed the relationship between the study variables, observing that the perception of ego climate was positively related to cognitive anxiety (p < 0.05) and insecurity (p < 0.01), and inversely to self-confidence (p < 0.05). By gender, boys showed a higher perception of an ego-oriented (p < 0.001) and lower perception of a task-oriented climate (p < 0.05) than girls. However, girls showed a greater intensity in the relationships related to ego climate and lower scores in self-confidence (p < 0.01), as well as higher scores in insecurity (p < 0.001). The results have shown positive relationships between self-confidence and a task-oriented climate, as well as negative ones with an ego-oriented climate. It is also observed that ego orientation generates more insecurity and anxiety, which is more evident in girls.Partial funding for open access charge: Universidad de Mála

Elaboración y propuesta de un instrumento para la detección de malestar emocional en enfermos al final de la vida

Establecer la sistemática de trabajo de un grupo multidisciplinar cuyo objetivo es elaborar un instrumento para detectar el malestar emocional en enfermos al fi nal de la vida. Material y métodos: Se describe la formación y composición del equipo investigador así como su dinámica de trabajo a lo largo de 2007 y 2008 en múltiples reuniones presenciales y on-line así como la bibliografía, el modelo y criterios que sirvieron de base para el debate que condujo a la elaboración del instrumento. Se presenta el cuestionario DME, que consta de dos partes: 1) cuatro preguntas dirigidas al enfermo, y 2) observación, por parte del sanitario, de signos que muestren la presencia de malestar emocional. Actualmente se encuentra en proceso de validación

Steppes, savannahs, forests and phytodiversity reservoirs during the Pleistocene in the Iberian Peninsula

A palaeobotanical analysis of the Pleistocene floras and vegetation in the Iberian Peninsula shows the existence of patched landscapes with Pinus woodlands, deciduous and mixed forests, parklands (savannah-like), shrublands, steppes and grasslands. Extinctions of Arctotertiary woody taxa are recorded during the Early and Middle Pleistocene, but glacial refugia facilitated the survival of a number of temperate, Mediterranean and Ibero-North African woody angiosperms. The responses of Iberian vegetation to climatic changes during the Pleistocene have been spatially and temporarily complex, including rapid changes of vegetation in parallel to orbital and suborbital variability, and situations of multi-centennial resilience or accommodation to climatic changes. Regional characteristics emerged as soon as for the Middle Pleistocene, if not earlier: Ericaceae in the Atlantic coast indicating wetter climate, thermo-mediterranean elements in the south as currently, and broad-leaf trees in the northeastern. Overall, steppe landscapes and open Pinus woodlands prevailed over many continental regions during the cold spells of the Late Pleistocene. The maintenance of a high phytodiversity during the glacials was linked to several refuge zones in the coastal shelves of the Mediterranean and intramountainous valleys. Northern Iberia, especially on coastal areas, was also patched with populations of tree species, and this is not only documented by palaeobotanical data (pollen, charcoal) but also postulated by phylogeographical models

Effectiveness of a clinical practice guideline implementation strategy for patients with anxiety disorders in primary care: cluster randomized trial

<p>Abstract</p> <p>Background</p> <p>Anxiety is a common mental health problem seen in primary care. However, its management in clinical practice varies greatly. Clinical practice guidelines (CPGs) have the potential to reduce variations and improve the care received by patients by promoting interventions of proven benefit. However, uptake and adherence to their recommendations can be low.</p> <p>Method/design</p> <p>This study involves a community based on cluster randomized trial in primary healthcare centres in the Madrid Region (Spain). The project aims to determine whether the use of implementation strategy (including training session, information, opinion leader, reminders, audit, and feed-back) of CPG for patients with anxiety disorders in primary care is more effective than usual diffusion.</p> <p>The number of patients required is 296 (148 in each arm), all older than 18 years and diagnosed with generalized anxiety disorder, panic disorder, and panic attacks by the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). They are chosen by consecutive sampling.</p> <p>The main outcome variable is the change in two or more points into Goldberg anxiety scale at six and twelve months. Secondary outcome variables include quality of life (EuroQol 5D), and degree of compliance with the CPG recommendations on treatment, information, and referrals to mental health services. Main effectiveness will be analyzed by comparing the patients percentage improvement on the Goldberg scale between the intervention group and the control group. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors or factors that might alter the effect recorded will be taken into account in this analysis.</p> <p>Discussion</p> <p>There is a need to identify effective implementation strategies for CPG for the management of anxiety disorders present in primary care. Ensuring the appropriate uptake of guideline recommendations can reduce clinical variation and improve the care patients receive.</p> <p>Trial registration</p> <p>ISRCTN: <a href="http://www.controlled-trials.com/ISRCTN83365316">ISRCTN83365316</a></p

Remediation of bentazone contaminated water by Trametes versicolor: characterization, identification of transformation products, and implementation in a trickle-bed reactor under non-sterile conditions

It is possible to consult this version in open access at the following web address: arXiv:2011.11738Bentazone, an herbicide widely applied in rice and cereal crops, is widespread in the aquatic environment. This study evaluated the capacity of Trametes versicolor to remove bentazone from water. The fungus was able to completely remove bentazone after three days at Erlenmeyer-scale incubation. Both laccase and cytochrome P450 enzymatic systems were involved in bentazone degradation. A total of 19 transformation products (TPs) were identified to be formed during the process. The reactions involved in their formation included hydroxylations, oxidations, methylations, N-nitrosation, and dimerization. A laccase mediated radical mechanism was proposed for TP formation. In light of the results obtained at the Erlenmeyer scale, a trickle-bed reactor with T. versicolor immobilized on pine wood chips was set up to evaluate its stability during bentazone removal under non-sterile conditions. After 30 days of sequencing batch operation, an average bentazone removal of 48% was obtained, with a considerable contribution of adsorption onto the lignocellulosic support material. Bacterial contamination, which is the bottleneck in the implementation of fungal bioreactors, was successfully addressed by this particular system according to its maintained performance. This research is a pioneering step forward to the implementation of fungal bioremediation on a real scale.This work has been supported by the Spanish Ministry of Economy and Competitiveness State Research Agency (CTM2016-75587-C2-1-R and CTM2016-75587-C2-2-R) and co-financed by the European Union through the European Regional Development Fund (ERDF) and the Horizon 2020 research and innovation WATERPROTECT project (727450). This work was partly supported by the Generalitat de Catalunya (Consolidate Research Group 2017-SGR-01404) and the Ministry of Science and Innovation (Project CEX2018-000794-S). The Department of Chemical, Biological and Environmental Engineering of the Universitat Autònoma de Barcelona is a member of the Xarxa de Referència en Biotecnologia de la Generalitat de Catalunya. K. Hu acknowledges the financial support from the Chinese Scholarship Council.Peer reviewe

Fungal degradation of selected medium to highly polar pesticides by Trametes versicolor: kinetics, biodegradation pathways, and ecotoxicity of treated waters

The massive use of pesticides represents one of the main causes of environmental deterioration, as they have adverse effects on non-target organisms. Thus, the development of technologies capable of reducing their release into the environment is urgently needed. This study reports for the first time the white-rot fungus Trametes versicolor as an alternative towards the degradation of medium to highly polar pesticides such as the organophosphate malathion, and the neonicotinoids acetamiprid and imidacloprid. Specifically, T. versicolor could completely remove 1 mg/L of malathion in an Erlenmeyer flask within 48 h, while experiments of acetamiprid and imidacloprid (4 mg/L), conducted in air-pulse fluidized bioreactors, resulted in degradation percentages of 20% and 64.7%, respectively, after 7 days of operation. Enzymatic exploration studies revealed that the cytochrome P450 system, instead of the extracellular enzyme laccase, is involved in the degradation of acetamiprid and imidacloprid. The degradation pathways were proposed based on the main transformation products (TPs) formed in the solutions: seven in the case of malathion, and two and one in the case of imidacloprid and acetamiprid, respectively. Although the TPs identified were predicted to be less toxic than the investigated pesticides, the toxicity of the individual solutions slightly increased throughout the degradation process, according to the Microtox assay. However, the solution toxicity was always below the threshold established in the local regulation. Although additional research is needed to implement this treatment at a pilot plant scale, this work highlights the potential of T. versicolor to bio-remediate pesticide-contaminated waters.This work has been supported by the Spanish Ministry of Economy and Competitiveness State Research Agency (CTM2016-75587-C2-1-R and CTM2016-75587-C2-2-R) and co-financed by the European Union through the European Regional Development Fund (ERDF) and the Horizon 2020 research and innovation WATERPROTECT project (727450). This work was partly supported by the Generalitat de Catalunya (Consolidate Research Group 2017-SGR-01404) and the Ministry of Science and Innovation (Project CEX2018-000794-S). The Department of Chemical, Biological, and Environmental Engineering of the Universitat Autònoma de Barcelona is a member of the Xarxa de Referència en Biotecnologia de la Generalitat de Catalunya. K. Hu acknowledges the financial support from the Chinese Scholarship Council.Peer reviewe