Efectividad de la estimulación multisensorial (EMS) en sala Snoezelen desde Terapia Ocupacional (TO) en enfermedad de Alzheimer (EA): Estudio de un caso clínico.

Introducción: La demencia tipo enfermedad de Alzheimer (EA) es considerada uno de los principales problemas socio – sanitarios y de salud pública del siglo XXI, abarcando cerca de 30 millones de casos en la actualidad. Objetivo: Explorar la efectividad del tratamiento de Terapia Ocupacional (TO) basado en la estimulación multisensorial (EMS) en ambiente Snoezelen en demencia tipo EA en fase leve. Métodos: Se plantea un diseño de caso único a través de una intervención de 14 sesiones desde TO basada en EMS en ambiente Snoezelen. Para la evaluación de la paciente se han utilizado diferentes test estandarizados: Inventario neuropsiquiátrico (NPI-Q), evaluación de la discapacidad en demencia (DAD-e), mini-examen cognoscitivo (MEC), batería neuropsicológica de evaluación de funciones frontales (FAB-e), escala de Hamilton (HDRS) y el cuestionario volicional (VQ). Resultados: Tras la intervención se realiza una reevaluación que reporta resultados positivos a nivel de síntomas psicológicos y conductuales de la demencia (SPCD), capacidad funcional, depresión y volición; respecto a los resultados obtenidos en la evaluación basal. Conclusión: Los resultados obtenidos apoyan el uso de la técnica de EMS en ambiente Snoezelen en demencia tipo EA en fase leve. Los resultados no pueden generalizarse, pero ofrecen una primera aproximación exploratoria para el planteamiento de nuevas hipótesis de futuros estudios epidemiológicos que aporten una evidencia científica de rigor al tema

La implantación del Aprendizaje Basado en Proyectos Artísticos en un Centro de Acción Educativa Singular. Didáctica de las artes plásticas

Treball Final de Grau en Mestre o Mestra d'Educació Primària. Codi: MP1040. Curs acadèmic: 2019/202

Perfil neuropsicológico de paciente con trastorno por uso de sustancias.

Aunque los Trastornos por Uso de Sustancias (TUS) no se han considerado un componente esencial en la etiología de la demencia durante mucho tiempo, el DSM-5 ha introducido recientemente el trastorno neurocognitivo leve y mayor inducido por sustancias, y la OMS ha incluido la demencia alcohólica como una de las consecuencias del consumo problemático de alcohol. Sin embargo, este conocimiento no ha tenido impacto en la práctica clínica y la neuropsicología aún no forma parte del tratamiento de las adicciones. Por lo tanto, la detección y el seguimiento del deterioro cognitivo en pacientes con TUS sigue siendo un gran desafío clínico, sobre todo cuando se requiere un diagnóstico precoz. El objetivo del presente estudio fue estudiar el efecto del consumo crónico de sustancias sobre el rendimiento cognitivo y su correlación con variables relacionadas con el consumo de sustancias (inicio del consumo, desarrollo de la dependencia, abstinencia, años del trastorno, número de recaídas). Participaron 61 pacientes con TUS reclutados de Proyecto Hombre-Málaga en tratamiento y se compararon con 38 controles sanos. Los participantes fueron evaluados mediante la entrevista PRISM, MoCA, D2-R, TESEN, TAVEC, ROCF, Dígitos, anillas, Stroop y M-WCST. Los resultados se analizaron mediante los programas estadísticos SPSS versión 25.0 y GraphPad Prism 8. Un valor p<0.05 fue considerado como estadísticamente significativo. Cuando fueron comparados con los sujetos controles, los pacientes TUS mostraron amplias alteraciones cognitivas en dominios como la atención, la memoria y el aprendizaje y las funciones ejecutivas. Además, estas disfunciones cognitivas se correlacionaron con variables relacionadas con el consumo de sustancias. La detección temprana del deterioro cognitivo en los dispositivos de tratamiento de adicciones es fundamental ya que el grado de disfunción cognitiva se ha considerado como un predictor fiable de una menor adherencia al tratamiento y un mayor riesgo de recaída.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Antipsychotic Medication Influences the Discriminative Value of Acylethanolamides as Biomarkers of Substance Use Disorder.

Plasma acylethanolamides (NAEs), including the endocannabinoid anandamide (AEA), have been proposed as circulating biomarkers of substance use disorders. However, the concentration of these lipid transmitters might be influenced by the use of drugs prescribed for either the treatment of addiction or the associated psychiatric co-morbidities such as psychosis. As an example, neuroleptics, used for attenuation of psychotic symptoms and sedation, might theoretically interfere with the monoamine-mediated production of NAEs, obstructing the interpretation of plasma NAEs as clinical biomarkers. To solve the lack of information on the impact of neuroleptics on the concentration of NAEs, we evaluated the concentrations of NAEs in a control group and compared them to those present in (a) substance use disorders (SUD) patients that are not prescribed with neuroleptics, and (b) SUD patients (both alcohol use disorder and cocaine use disorder patients) using neuroleptics. The results demonstrate that SUD patients exhibited greater concentrations of NAEs than the control population, affecting all species with the exception of stearoylethanolamide (SEA) and palmitoleoylethanolamide (POEA). Neuroleptic treatment enhanced the concentrations of NAEs, especially those of AEA, linoleoylethanolamide (LEA), and oleoylethanolamide (OEA). This effect of neuroleptic treatment was observed independently of the drug addiction that motivated the demand for treatment (either alcohol or cocaine). This study remarks the need to control the current use of psychotropic medication as a potential confounding variable when considering the use of NAEs as biomarkers in SUDPartial funding for open access charge: Universidad de Málag

Plasma Concentrations of Neurofilament Light Chain Protein and Brain-Derived Neurotrophic Factor as Consistent Biomarkers of Cognitive Impairment in Alcohol Use Disorder

For a long time, Substance Use Disorders (SUDs) were not considered a component in the etiology of dementia. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders introduced substance-induced neurocognitive disorders, incorporating this notion to clinical practice. However, detection and monitoring of neurodegenerative processes in SUD patients remain a major clinical challenge, especially when early diagnosis is required. In the present study, we aimed to investigate new potential biomarkers of neurodegeneration that could predict cognitive impairment in SUD patients: the circulating concentrations of Neurofilament Light chain protein (NfL) and Brain-Derived Neurotrophic Factor (BDNF). Sixty SUD patients were compared with twenty-seven dementia patients and forty healthy controls. SUD patients were recruited and assessed using the Psychiatric Research Interview for Substance and Mental (PRISM) and a battery of neuropsychological tests, including the Montreal Cognitive Assessment test for evaluation of cognitive impairment. When compared to healthy control subjects, SUD patients showed increases in plasma NfL concentrations and NfL/BDNF ratio, as well as reduced plasma BDNF levels. These changes were remarkable in SUD patients with moderate–severe cognitive impairment, being comparable to those observed in dementia patients. NfL concentrations correlated with executive function and memory cognition in SUD patients. The parameters “age”, “NfL/BDNF ratio”, “first time alcohol use”, “age of onset of alcohol use disorder”, and “length of alcohol use disorder diagnosis” were able to stratify our SUD sample into patients with cognitive impairment from those without cognitive dysfunction with great specificity and sensibility. In conclusion, we propose the combined use of NfL and BDNF (NfL/BDNF ratio) to monitor substance-induced neurocognitive disorder.Instituto de Salud Carlos III (ISCIII], Ministerio de Ciencia e Innovación and European Regional Development Funds-European Union (ERDF-EU] grants “Proyectos de Investigación en Salud” PI19/01577, PI19/00886, PI20/01399 and PI22/00427; Grants Programa RICORS RIAPAD (Red de Investigación en Atención Primaria en Adicciones), Programa RETICS Red de Trastornos Adictivos, (RD16/0017/000); Ministerio de Sanidad, Delegación de Gobierno para el Plan Nacional sobre Drogas (PND 2022I020, PND2020/048, PND 2019/040]; Consejería de Salud y Familia, Junta de Andalucía (Neuro-RECA, RIC-0111-2019]. FJP (CPII19/00022] and AS (CPII19/00031] hold “Miguel Servet II” research contracts from the National System of Health, ISCIII, ERDF-EU. FJP also holds a “Nicolas Monardes” contract from Servicio Andaluz de Salud, Consejería de Salud y Familia, Junta de Andalucía (C1-0049-2019]. PA has a research contract (UMA-FEDERJA-076) funded by the Ministry of Economy and Knowledge—Regional Government of Andalucía and ERDF-EU. The funding sources had no further role in the study design; in the collection, analysis, and interpretation of data; in writing of the report; or in the decision to submit the paper for publication

High adherence to the Western, Prudent, and Mediterranean dietary patterns and risk of gastric adenocarcinoma: MCC-Spain study

BACKGROUND: The influence of dietary habits on the development of gastric adenocarcinoma is not clear. The objective of the present study was to explore the association of three previously identified dietary patterns with gastric adenocarcinoma by sex, age, cancer site, and morphology. METHODS: MCC-Spain is a multicase-control study that included 295 incident cases of gastric adenocarcinoma and 3040 controls. The association of the Western, Prudent, and Mediterranean dietary patterns-derived in another Spanish case-control study-with gastric adenocarcinoma was assessed using multivariable logistic regression models with random province-specific intercepts and considering a possible interaction with sex and age. Risk according to tumor site (cardia, non-cardia) and morphology (intestinal/diffuse) was evaluated using multinomial regression models. RESULTS: A high adherence to the Western pattern increased gastric adenocarcinoma risk [odds ratiofourth_vs._first_quartile (95% confidence interval), 2.09 (1.31; 3.33)] even at low levels [odds ratiosecond_vs._first_quartile (95% confidence interval), 1.63 (1.05; 2.52)]. High adherence to the Mediterranean dietary pattern could prevent gastric adenocarcinoma [odds ratiofourth_vs._first_quartile (95% confidence interval), 0.53 (0.34; 0.82)]. Although no significant heterogeneity of effects was observed, the harmful effect of the Western pattern was stronger among older participants and for non-cardia adenocarcinomas, whereas the protective effect of the Mediterranean pattern was only observed among younger participants and for non-cardia tumors. CONCLUSION: Decreasing the consumption of fatty and sugary products and of red and processed meat in favor of an increase in the intake of fruits, vegetables, legumes, olive oil, nuts, and fish might prevent gastric adenocarcinoma.The study was supported by the “Acción Transversal del Cáncer,” approved by the Spanish Ministry Council on 11 October 2007, by the Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), by the Instituto de Salud Carlos III grants, co-funded by FEDER funds: a way to build Europe-PI08/1770 (to M. Kogevinas), PI09/0773 (to J. Llorca), PI09/1286 (to V. Martín), PI09/1903 (to R. Peiró), PI09/2078 (to F.J. Caballero), PI09/1662 (to J.J. Jiménez-Moleón), PI11/01403 (to N. Aragonés), and PI12/00150 (to B. Pérez-Gómez), by the Fundación Marqués de Valdecilla grant API 10/09 (to J. Llorca), by Catalan Government DURSI grant 2014SGR647 (to V. Moreno) and 2014SGR756 (to S. de Sanjose), by the Junta de Castilla y León Grant LE22A10-2 (to V. Martín), by the Consejería de Salud of the Junta de Andalucía Grant 2009-S0143 (to J. Alguacil), by the Conselleria de Sanitat of the Generalitat Valenciana grant AP061/10 (to R. Peiró), by the Regional Government of the Basque Country, by the Consejería de Sanidad de la Región de Murcia, by the Fundación Caja de Ahorros de Asturias, by the University of Oviedo, by the Spanish Association Against Cancer (AECC) Scientific Foundation, and by the Spanish Ministry of Economy and Competitiveness Juan de la Cierva de Incorporación Grant IJCI-2014-20900 (to A. Castelló). None of the sponsors intervened in any stage of the research.S

Prostate cancer genetic propensity risk score may modify the association between this tumour and type 2 diabetes mellitus (MCC-Spain study)

Background: Some studies have reported an inverse association between type 2 diabetes mellitus (T2DM) and prostate cancer (PCa), but results on this issue are still inconsistent. In this study, we evaluate whether this heterogeneity might be related to differences in this relationship by tumour or by individual genetic susceptibility to PCa. Methods: We studied 1047 incident PCa cases and 1379 randomly selected controls, recruited in 7 Spanish provinces for the population-based MCC-Spain case-control. Tumour were classified by aggressiveness according to the International Society of Urological Pathology (ISUP), and we constructed a PCa polygenic risk score (PRS) as proxy for genetic susceptibility. The epidemiological questionnaire collected detailed self-reported data on T2DM diagnosis and treatment. The association between T2DM status and PCa was studied by fitting mixed logistic regression models, and, for its association by aggressiveness of PCa, with multinomial logistic regression models. To evaluate the possible modulator role of PRS in this relationship, we included the corresponding interaction term in the model, and repeated the analysis stratified by PRS tertiles. Results: Globally, our results showed an inverse association between T2DM and overall PCa limited to grade 1 tumours (ORISUP = 1: 0.72; 95% CI: 0.53-0.98), which could be compatible with a detection bias. However, PCa risk also varied with duration of diabetes treatment -inversely to metformin and positively with insulin-, without differences by aggressiveness. When we considered genetic susceptibility, T2DM was more strongly associated with lower PCa risk in those with lower PRS (ORtertile 1: 0.31; 95% CI: 0.11-0.87), independently of ISUP grade. Conclusions: Our findings reinforce the need to include aggressiveness and susceptibility of PCa, and T2DM treatments in the study of the relationship between both diseases

Meat Intake, Cooking Methods, Doneness Preferences and Risk of Gastric Adenocarcinoma in the MCC-Spain Study

Background: The association of meat intake with gastric adenocarcinoma is controversial. We examined the relation between white, red, and processed meat intake and gastric adenocarcinoma, considering doneness preference and cooking methods, by histological subtype and anatomical subsite. Methods: MCC-Spain is a multicase-control study that included 286 incident gastric adenocarcinoma cases and 2993 controls who answered a food-frequency questionnaire. The association of gastric adenocarcinoma with meat intake, doneness preference and cooking methods was assessed using binary multivariate logistic regression mixed models and a possible interaction with sex was considered. Multinomial logistic regression models were used to estimate risk by tumor subsite (cardia vs. non-cardia) and subtype (intestinal vs. diffuse). Sensitivity analyses were conducted comparing models with and without data on Helicobacter pylori infection. Results: The intake of red and processed meat increased gastric adenocarcinoma risk (OR for one serving/week increase (95% CI) = 1.11 (1.02;1.20) and 1.04 (1.00;1.08), respectively), specifically among men and for non-cardia and intestinal gastric adenocarcinoma. Those who consume well done white or red meat showed higher risk of non-cardia (white: RRR = 1.57 (1.14;2.16); red: RRR = 1.42 (1.00;2.02)) and intestinal tumors (white: RRR = 1.69 (1.10;2.59); red: RRR = 1.61 (1.02;2.53)) than those with a preference for rare/medium doneness. Stewing and griddling/barbequing red and white meat, and oven baking white meat, seemed to be the cooking methods with the greatest effect over gastric adenocarcinoma. The reported associations remained similar after considering Helicobacter pylori seropositivity. Conclusions: Reducing red and processed meat intake could decrease gastric adenocarcinoma risk, especially for intestinal and non-cardia tumors. Meat cooking practices could modify the risk of some gastric cancer subtypes

Experiencia de uso de un cómic (“Arrugas”) como material didáctico en el aula universitaria.

En la actualidad, existen pocas experiencias docentes que incorporen el cómic al entorno universitario. En este trabajo hemos explorado la utilidad de un cómic (“Arrugas”, de Paco Roca) para mejorar el proceso de enseñanza-aprendizaje de contenidos relacionados con la vejez y la demencia, en una asignatura del Grado en Psicología.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech

Consumption of aspartame and other artificial sweeteners and risk of cancer in the Spanish multicase‐control study (MCC‐Spain)

[EN] Use of artificial sweeteners (AS) such as aspartame, cyclamate, saccharin and sucralose is widespread. We evaluated the association of use of aspartame and other AS with cancer. In total 1881 colorectal, 1510 breast, 972 prostate and 351 stomach cancer and 109 chronic lymphocytic leukaemia (CLL) cases and 3629 population controls from the Spanish Multicase-Control (MCC-Spain) study were recruited (2008-2013). The consumption of AS, from table-top sweeteners and artificially sweetened beverages, was assessed through a self-administered and validated food frequency questionnaire (FFQ). Sex-specific quartiles among controls were determined to compare moderate consumers (<third quartile) and high consumers (≥ third quartile) vs non consumers (reference category), distinguishing aspartame-containing products and other AS. Unconditional logistic regression models were used to estimate adjusted OR and 95%CI, and results were stratified by diabetes status. Overall, we found no associations between the consumption of aspartame or other AS and cancer. Among participants with diabetes, high consumption of other AS was associated with colorectal cancer (OR = 1.58, 95% CI 1.05-2.41, P trend = .03) and stomach cancer (OR = 2.27 [0.99-5.44], P trend = .06). High consumption of aspartame, was associated with stomach cancer (OR = 2.04 [0.7-5.4], P trend = .05), while a lower risk was observed for breast cancer (OR = 0.28 [0.08-0.83], P trend = .03). In some cancers, the number of cases in participants with diabetes were small and results should be interpreted cautiously. We did not find associations between use of AS and cancer, but found associations between high consumption of aspartame and other AS and different cancer types among participants with diabetes.SIAGAURConsejería de Salud of the Junta de AndalucíaConsejería de Sanidad de la Región de MurciaConselleria de Sanitat of the Generalitat ValencianaFundaci on Caja de Ahorros de AsturiasFundación Marqués de ValdecillaGeneralitat de CatalunyaICGC International Cancer Genome Consortium CLLJunta de Castilla y Leó