Desarrollo de una entrevista diagnóstica para los trastornos adaptativos

Setzenes Jornades de Foment de la Investigació (Any 2011)Los Trastornos Adaptativos (TA) constituyen uno de los problemas psicológicos más frecuentes en los contextos de atención primaria y hospitalaria. Su diagnóstico cuenta con una importante popularidad entre los clínicos (Despland, Monod y Ferrero, 1995) y parece constituir un importante problema de salud pública (van der Klink et al., 2003). Sin embargo, a pesar de la gravedad que pueden presentar los síntomas y de la elevada incidencia que se le atribuye (entre un 5 y un 20%, según el DSM-IV-TR) (APA, 2000) los TA han sido muy poco estudiados. Tal vez uno de los motivos del escaso interés que la literatura científica ha mostrado históricamente por el tema, sea la ambigüedad de los criterios y especificaciones diagnósticas, que han originado diversas cuestiones polémicas que aumentan si cabe la dificultad del diagnóstico de los TA. Además la revisión de la literatura llevada a cabo pone de manifiesto que, en estos momentos, existen muy pocos instrumentos que permitan realizar una identificación y diagnóstico específico de los TA. Para facilitar la tarea del clínico en la evaluación de este tipo de trastornos nuestro grupo de investigación ha elaborado una Entrevista diagnóstica para los Trastornos Adaptativos (Andreu- Mateu et al., 2008) en la que se ha tenido en cuenta indicaciones señaladas por la SCID. El objetivo del presente trabajo es describir el proceso de elaboración de dicho instrumento cuya validación se está llevando a cabo en estos momentos. Teniendo en cuenta la ausencia de instrumentos diagnósticos validados para evaluar adecuadamente los TA, que son tan prevalentes en atención primaria y que llevan asociados importantes costes sociales, consideramos que el desarrollo y validación de esta entrevista constituye una clara aportación al campo de conocimiento debido, entre otras cosas, al riesgo que conlleva las subestimación de este trastorno y, por supuesto, un mal diagnóstico del mismo

New roles for corticosteroid binding globulin and opposite expression profiles in lung and liver

Corticosteroid-binding globulin (CBG) is the specific plasma transport glycoprotein for glucocorticoids. Circulating CBG is mainly synthesized in liver but, its synthesis has been located also in other organs as placenta, kidney and adipose tissue with unknown role. Using an experimental model of acute pancreatitis in cbg mice we investigated whether changes in CBG affect the progression of the disease as well as the metabolism of glucocorticoids in the lung. Lack of CBG does not modify the progression of inflammation associated to pancreatitis but resulted in the loss of gender differences in corticosterone serum levels. In the lung, CBG expression and protein level were detected, and it is noteworthy that these showed a sexual dimorphism opposite to the liver, i.e. with higher levels in males. Reduced expression of 11â-HSD2, the enzyme involved in the deactivation of corticosterone, was also observed. Our results indicate that, in addition to glucocorticoids transporter, CBG is involved in the gender differences observed in corticosteroids circulating levels and plays a role in the local regulation of corticosteroids availability in organs like lung.Support was provided by: Fondo Investigación Sanitaria PI09/00505 to ME MG; Fondo Investigación Sanitaria PI13/00019 to DC SG-S; Predoctoral scholarship from the University of Barcelona to JG; European and Sardinian scholarship >Master and Back> to AL; Grant from Generalitat de Catalunya (AGAUR, Grant FI DGR 2013) to LB.Peer Reviewe

Satisfação familiar em unidades de cuidados intensivos: revisão integrativa da literatura

Background: due to the difficulty of evaluating and intensive care unit (ICU) patient’s satisfaction, family satisfaction must be taken into consideration when assessing the quality of the care provided in these units. Objectives: evaluate the feasibility of the quiz 'FS-ICU-24'as an instrument to assess family satisfaction; identify satisfaction levels through a questionnaire with an emphasis on items where satisfaction levels are lower and strategies to increase it. Methodology: an integrative review that analyzes relevant articles published in EBSCO and in FSICU.org data bases between 2014 and 2019. Key words: patient satisfaction; critical care; FS-ICU-24. In order to achieve systematized information, a table with the following points was prepared: authors and publication date, country, study objectives, results and participants. Results: ‘FS-ICU-24’ is a good instrument to assess family satisfaction in the ICU. Family satisfaction levels are high (above 70%). In open-ended questions relatives refer less positive aspects such as the physical environment and communication. Some improvement suggestions are the possibility to increase privacy at waiting rooms and provide communication skills training to the staff. Conclusion: the integrative review shows that the FS-ICU-24 allows family satisfaction assessment and identification of improvements points in ICU.Marco contextual: la dificultad para evaluar la satisfacción del paciente internado en una unidad de cuidados intensivos (UCI) determina que para averiguar la calidad de los cuidados prestados en este tipo de unidades sean consideradas las necesidades y satisfacción familiar. Objetivos: comprobar la viabilidad del 'FS-ICU-24' como instrumento para evaluar la satisfacción familiar; identificando los ítems donde esta satisfacción es más baja y qué estrategias se adoptan para aumentar. Metodología: revisión integradora donde se analizaron artículos (en inglés) publicados entre el 2014 y el 2019 en la base de datos EBSCO y sitio web organizacional FSICU.org. Se utilizaron como palabras clave: satisfacción del pacient, cuidados intensivos, FS-ICU-24.Para sistematizar esta información artículos se elaboró un instrumento con informaciones talescomo, autores y año de publicación, pais, objetivo de estúdio, resultados y participantes. Resultados: el ‘FS-ICU-24’ es un bueno instrumento para averiguar la satisfacción familiar en la UCI. Los niveles de satisfacción familiar en general son altos (superiores que 70%).En la respuesta abierta del cuestionario, los familiares indican aspectos menos positivos relacionados con el ambiente físico y con la comunicación, y también son sugeridas hipótesis de mejoría cómo proporcionar más privacidad en la sala de espera y capacitar al equipo de comunicación. Conclusión: la revisión integradora muestra que la FS-ICU-24 permite medir la satisfacción familiar e identificar puntos para mejorar en la UCI.Enquadramento: a dificuldade para avaliar a satisfação do doente numa unidade de cuidados intensivos (UCI) determina que para aferir a qualidade dos cuidados nestas unidades seja considerada a satisfação familiar. Objetivos: verificar a viabilidade do questionário ‘FS-ICU-24’ enquanto instrumento para avaliar a satisfação familiar; identificar níveis de satisfação através do questionário com enfase nos itens onde os níveis são mais baixos e estratégias para aumentar a satisfação. Metodologia: revisão integrativa com análise de artigos publicados entre 2014 e 2019 na base de dados EBSCO e no FSICU.org. Descritores: Satisfação do doente; Cuidados intensivos; FS-ICU-24. Para sistematizar a informação, foi elaborada uma tabela com os pontos: autores e ano; país, objetivos do estudo; resultados e participantes. Resultados: o FS-ICU-24 é um bom instrumento para aferir a satisfação familiar na UCI. Os níveis de satisfação familiar são altos (Superiores a 70%). Nas questões de resposta aberta, familiares indicam aspetos menos positivos como o ambiente físico e a comunicação. Algumas das hipóteses de melhoria sugeridas são proporcionar privacidade na sala de espera e treino à equipa em comunicação. Conclusão: a revisão integrativa evidencia que o FS-ICU-24 permite aferir a satisfação familiar e identificar pontos a melhorar na UCI

Trazabilidad en la Cadena de Suministro Alimentaría: Revisión de la literatura desde una perspectiva tecnológica

[EN] An increasingly customer-oriented food industry needs faster response times to address dynamic and collaborative supply chains. Good traceability systems help to minimize the production and distribution of unsafe or poor quality products. Therefore, traceability is applied as a tool to help ensure the safety and quality of food, as well as to achieve consumer confidence. New technologies are being used and new proposals are being tested in this field. Industry 4.0 includes a variety of technologies that enable the development of a digital and automated manufacturing environment. These new technologies are implying a drastic change in the way companies operates. These tech-nologies are having a high impact in different areas of the company, and naturally, the traceability processes are included in this new wave of changes. The terms "tracing" and "tracking" are generally discussed in traceability. Tracing is defined as a retroactive process in which the origin is identified by the history or the records in the supply chain and tracking is the direct process in which the end users and the trading partners are identified by the location in the supply chain, both terms provide visibility in supply chains. In the present work a literature review is realized on the implementation of in-dustry 4.0 in the traceability of the food supply chain. As a result of this literature re-view have been possible to note that the interest is growing and is concentrated in the last five years. Furthermore, the temporal evolution of technologies applied in the trace-ability of food supply chain is becoming increasingly complex due to the inclusion of new proposals (RFID, QR, NFC, Barcode, ¿). Finally, an analysis of the technologies applied to different areas of the food sector is presented, thus proposals for fruit, vege-tables, meat or fish have been analyzed and the Industry 4.0 technologies have been identified for each area. This study makes it possible to reveal clearly those sectors that have not yet been approached by these new proposals, as well as technologies that are been applied in Industry 4.0 proposals but have not been used for traceability. Thus, the present work enables the identification of research gaps in this field.[ES] Una industria alimentaria, cada vez más orientada al cliente, necesita tiempos de respuesta más rápidos para conseguir cadenas de suministro dinámicas y colaborativas. Los sistemas de trazabilidad ayudan a minimizar problemas por la producción y distribución de productos inseguros o de baja calidad. Por lo tanto, la trazabilidad se presenta como una herramienta para ayudar a garantizar la seguridad y la calidad de los alimentos, así como para lograr la confianza del consumidor. En el presente trabajo se realiza una revisión bibliográfica sobre la implementación de la industria 4.0 en la tra-zabilidad de la cadena de suministro alimentariaCruz Introini, S.; Boza, A.; Alemany Díaz, MDM. (2018). Traceability in the Food Supply Chain: Review of the literature from a technological perspective. Direccion y Organizacion. 64:50-55. http://hdl.handle.net/10251/121089S50556

New roles for corticosteroid binding globulin and opposite expression profiles in lung and liver.

Corticosteroid-binding globulin (CBG) is the specific plasma transport glycoprotein for glu- cocorticoids. Circulating CBG is mainly synthesized in liver but, its synthesis has been located also in other organs as placenta, kidney and adipose tissue with unknown role. Using an experimental model of acute pancreatitis in cbg -/- mice we investigated whether changes in CBG affect the progression of the disease as well as the metabolism of gluco- corticoids in the lung. Lack of CBG does not modify the progression of inflammation associ- ated to pancreatitis but resulted in the loss of gender differences in corticosterone serum levels. In the lung, CBG expression and protein level were detected, and it is noteworthy that these showed a sexual dimorphism opposite to the liver, i.e. with higher levels in males. Reduced expression of 11 β -HSD2, the enzyme involved in the deactivation of corticoste- rone, was also observed. Our results indicate that, in addition to glucocorticoids transporter, CBG is involved in the gender differences observed in corticosteroids circulating levels and plays a role in the local regulation of corticosteroids availability in organs like lung

A Genome-Wide Association Study of Attention Function in a Population-Based Sample of Children

BACKGROUND: Attention function filters and selects behaviorally relevant information. This capacity is impaired in some psychiatric disorders and has been proposed as an endophenotype for Attention-Deficit/Hyperactivity Disorder; however, its genetic basis remains largely unknown. This study aimed to identify single nucleotide polymorphism (SNPs) associated with attention function. MATERIALS AND METHODS: The discovery sample included 1655 children (7-12 years) and the replication sample included 546 children (5-8 years). Five attention outcomes were assessed using the computerized Attentional Network Test (ANT): alerting, orienting, executive attention, Hit Reaction time (HRT) and the standard error of HRT (HRTSE). A Genome-wide Association Study was conducted for each outcome. Gene set enrichment analyses were performed to detect biological pathways associated with attention outcomes. Additional neuroimaging analyses were conducted to test neural effects of detected SNPs of interest. RESULTS: Thirteen loci showed suggestive evidence of association with attention function (P<10-5) in the discovery sample. One of them, the rs4321351 located in the PID1 gene, was nominally significant in the replication sample although it did not survive multiple testing correction. Neuroimaging analysis revealed a significant association between this SNP and brain structure and function involving the frontal-basal ganglia circuits. The mTOR signaling and Alzheimer disease-amyloid secretase pathways were significantly enriched for alerting, orienting and HRT respectively (FDR<5%). CONCLUSION: These results suggest for the first time the involvement of the PID1 gene, mTOR signaling and Alzheimer disease-amyloid secretase pathways, in attention function during childhood. These genes and pathways have been proposed to play a role in neuronal plasticity, memory and neurodegenerative disease

New flavonoid \u2013 N,N-dibenzyl(N-methyl)amine hybrids: Multi-target-directed agents for Alzheimer\ub4s disease endowed with neurogenic properties

The design of multi-target directed ligands (MTDLs) is a valid approach for obtaining effective drugs for complex pathologies. MTDLs that combine neuro-repair properties and block the first steps of neurotoxic cascades could be the so long wanted remedies to treat neurodegenerative diseases (NDs). By linking two privileged scaffolds with well-known activities in ND-targets, the flavonoid and the N,N-dibenzyl(N-methyl)amine (DBMA) fragments, new CNS-permeable flavonoid \u2013 DBMA hybrids (1\u201313) were obtained. They were subjected to biological evaluation in a battery of targets involved in Alzheimer\u2019s disease (AD) and other NDs, namely human cholinesterases (hAChE/hBuChE), \u3b2-secretase (hBACE-1), monoamine oxidases (hMAO-A/B), lipoxygenase-5 (hLOX-5) and sigma receptors (\u3c31R/\u3c32R). After a funnel-type screening, 6,7-dimethoxychromone \u2013 DBMA (6) was highlighted due to its neurogenic properties and an interesting MTD-profile in hAChE, hLOX-5, hBACE-1 and \u3c31R. Molecular dynamic simulations showed the most relevant drug-protein interactions of hybrid 6, which could synergistically contribute to neuronal regeneration and block neurodegeneration

ESPAD Report 2019: Results From European School Survey Project on Alcohol and Other Drugs

The main purpose of the European School Survey Project on Alcohol and Other Drugs (ESPAD) is to collect comparable data on substance use and other forms of risk behaviour among 15- to 16-year-old students in order to monitor trends within, as well as between, countries. Between 1995 and 2019, seven waves of data collection were conducted across 49 European countries. This report presents selected key results. The full set of data on which the current report is based, including all of the standard tables, is available online (http://www.espad.org). All tables can be downloaded in Excel format and used for further analysi

Persistence and clearance of Ebola virus RNA from seminal fluid of Ebola virus disease survivors: a longitudinal analysis and modelling study

Background By January, 2016, all known transmission chains of the Ebola virus disease (EVD) outbreak in west Africa had been stopped. However, there is concern about persistence of Ebola virus in the reproductive tract of men who have survived EVD. We aimed to use biostatistical modelling to describe the dynamics of Ebola virus RNA load in seminal fl uid, including clearance parameters. Methods In this longitudinal study, we recruited men who had been discharged from three Ebola treatment units in Guinea between January and July, 2015. Participants provided samples of seminal fl uid at follow-up every 3–6 weeks, which we tested for Ebola virus RNA using quantitative real-time RT-PCR. Representative specimens from eight participants were then inoculated into immunodefi cient mice to test for infectivity. We used a linear mixed-eff ect model to analyse the dynamics of virus persistence in seminal fl uid over time. Findings We enrolled 26 participants and tested 130 seminal fl uid specimens; median follow up was 197 days (IQR 187–209 days) after enrolment, which corresponded to 255 days (228–287) after disease onset. Ebola virus RNA was detected in 86 semen specimens from 19 (73%) participants. Median duration of Ebola virus RNA detection was 158 days after onset (73–181; maximum 407 days at end of follow-up). Mathematical modelling of the quantitative time-series data showed a mean clearance rate of Ebola virus RNA from seminal fl uid of –0·58 log units per month, although the clearance kinetic varied greatly between participants. Using our biostatistical model, we predict that 50% and 90% of male survivors clear Ebola virus RNA from seminal fl uid at 115 days (90% prediction interval 72–160) and 294 days (212–399) after disease onset, respectively. We also predicted that the number of men positive for Ebola virus RNA in aff ected countries would decrease from about 50 in January 2016, to fewer than 1 person by July, 2016. Infectious virus was detected in 15 of 26 (58%) specimens tested in mice. Interpretation Time to clearance of Ebola virus RNA from seminal fl uid varies greatly between individuals and could be more than 13 months. Our predictions will assist in decision-making about surveillance and preventive measures in EVD outbreaks

Interpreting Cancer Genomes Using Systematic Host Perturbations by Tumour Virus Proteins

Genotypic differences greatly influence susceptibility and resistance to disease. Understanding genotype-phenotype relationships requires that phenotypes be viewed as manifestations of network properties, rather than simply as the result of individual genomic variations. Genome sequencing efforts have identified numerous germline mutations associated with cancer predisposition and large numbers of somatic genomic alterations. However, it remains challenging to distinguish between background, or “passenger” and causal, or “driver” cancer mutations in these datasets. Human viruses intrinsically depend on their host cell during the course of infection and can elicit pathological phenotypes similar to those arising from mutations. To test the hypothesis that genomic variations and tumour viruses may cause cancer via related mechanisms, we systematically examined host interactome and transcriptome network perturbations caused by DNA tumour virus proteins. The resulting integrated viral perturbation data reflects rewiring of the host cell networks, and highlights pathways that go awry in cancer, such as Notch signalling and apoptosis. We show that systematic analyses of host targets of viral proteins can identify cancer genes with a success rate on par with their identification through functional genomics and large-scale cataloguing of tumour mutations. Together, these complementary approaches result in increased specificity for cancer gene identification. Combining systems-level studies of pathogen-encoded gene products with genomic approaches will facilitate prioritization of cancer-causing driver genes so as to advance understanding of the genetic basis of human cancer