Los sistemas observantes: conceptos, estrategias y entrenamiento en terapia familiar sistémica.

Este artículo ofrece un resumen de un programa de formación en terapia familiar sistémica. Está dividido en cuatro secciones. La sección primera está dedicada a las bases de la teoría de los sistemas observantes. La sección segunda describe la estrategia de la terapia sistémica. La sección tercera describe las técnicas de terapia sistémica. Finalmente, la sección cuarta describe los métodos de entrenamiento utilizados en la enseñanza de todo lo anterio

Los sistemas observantes: conceptos, estrategias y entrenamiento en terapia familiar sistémica.

Este artículo ofrece un resumen de un programa de formación en terapia familiar sistémica. Está dividido en cuatro secciones. La sección primera está dedicada a las bases de la teoría de los sistemas observantes. La sección segunda describe la estrategia de la terapia sistémica. La sección tercera describe las técnicas de terapia sistémica. Finalmente, la sección cuarta describe los métodos de entrenamiento utilizados en la enseñanza de todo lo anterio

Student perceptions of the CEFR levels and the impact of guided practice on Aptis Oral Test performance

Este documento se considera que es un informe en lugar de libroThis study compares students' scores on an Aptis Speaking Test to their results during an informal oral interview and a mock speaking test. First, it examines differences in the testing of oral skills between in-person paired interviews and a computer-delivered test, both following the British Council Aptis test, the former rated by university professors and the later rated by Aptis. Second, it analyses whether there are significant differences in performance due to repetition of the test and guided practice. In addition, it looks at the participants? different skill scores from the test to determine whether there are any consistent variations within the group. Finally, the study examines the students' impressions of their level on the CEFR. A total of 86 students took part in this exploratory study that has a quasi-experimental design. The data for the study include initial speaking interviews conducted by the research team, Aptis Test scores, and qualitative along with quantitative questionnaires. The study found that guided practice and repetition of the test lead to slightly higher scores, and that there were mixed results compared to the two measures

Quorum Sensing as a Target for Controlling Surface Associated Motility and Biofilm Formation in Acinetobacter Baumannii ATCC® 17978TM

[Abstract] The important nosocomial pathogen Acinetobacter baumannii presents a quorum sensing (QS) system (abaI/abaR) mediated by acyl-homoserine-lactones (AHLs) and several quorum quenching (QQ) enzymes. However, the roles of this complex network in the control of the expression of important virulence-related phenotypes such as surface-associated motility and biofilm formation is not clear. Therefore, the effect of the mutation of the AHL synthase AbaI, and the exogenous addition of the QQ enzyme Aii20J on surface-associated motility and biofilm formation by A. baumannii ATCC® 17978TM was studied in detail. The effect of the enzyme on biofilm formation by several multidrug-resistant A. baumannii clinical isolates differing in their motility pattern was also tested. We provide evidence that a functional QS system is required for surface-associated motility and robust biofilm formation in A. baumannii ATCC® 17978TM. Important differences were found with the well-studied strain A. nosocomialis M2 regarding the relevance of the QS system depending on environmental conditions The in vitro biofilm-formation capacity of A. baumannii clinical strains was highly variable and was not related to the antibiotic resistance or surface-associated motility profiles. A high variability was also found in the sensitivity of the clinical strains to the action of the QQ enzyme, revealing important differences in virulence regulation between A. baumannii isolates and confirming that studies restricted to a single strain are not representative for the development of novel antimicrobial strategies. Extracellular DNA emerges as a key component of the extracellular matrix in A. baumannii biofilms since the combined action of the QQ enzyme Aii20J and DNase reduced biofilm formation in all tested strains. Results demonstrate that QQ strategies in combination with other enzymatic treatments such as DNase could represent an alternative approach for the prevention of A. baumannii colonization and survival on surfaces and the prevention and treatment of infections caused by this pathogen.Xunta de Galicia; ED481A-2015/311Xunta de Galicia; IN606B-2019/010Biotechnology and Biological Sciences Research Council (United Kingdom); BB/R012415/1Xunta de Galicia; ED481A-2019/19

Fiebre y lesiones dérmicas: ¿tiene que ver con el corazón?

We present the clinical case of a 73-year-old patient who performs cardiac catheterization begins with erythematous maculopapular skin lesions associated with high fever. The key to the final diagnosis, like most cases involving several possible differential diagnoses, lies in a complete history and careful physical examination.Se expone el caso clínico de una paciente de 73 años que tras realización de cateterismo cardíaco comenzó con lesiones cutáneas maculopapulosas eritematosas asociadas a fiebre alta. La clave para el diagnóstico final, como en la mayoría de los casos que entrañan varios diagnósticos diferenciales posibles, reside en una anamnesis completa y en una cuidadosa exploración física. We present the clinical case of a 73-year-old patient who performs cardiac catheterization begins with erythematous maculopapular skin lesions associated with high fever. The key to the final diagnosis, like most cases involving several possible differential diagnoses, lies in a complete history and careful physical examination

Microbiological and Molecular Characterization of Staphylococcus hominis Isolates from Blood

Background: Among Coagulase-Negative Staphylococci (CoNS), Staphylococcus hominis represents the third most common organism recoverable from the blood of immunocompromised patients. The aim of this study was to characterize biofilm formation, antibiotic resistance, define the SCCmec (Staphylococcal Chromosomal Cassette mec) type, and genetic relatedness of clinical S. hominis isolates. Methodology: S. hominis blood isolates (n = 21) were screened for biofilm formation using crystal violet staining. Methicillin resistance was evaluated using the cefoxitin disk test and the mecA gene was detected by PCR. Antibiotic resistance was determined by the broth microdilution method. Genetic relatedness was determined by pulsed-field gel electrophoresis (PFGE) and SCCmec typed by multiplex PCR using two different methodologies described for Staphylococcus aureus. Results: Of the S. hominis isolates screened, 47.6% (10/21) were categorized as strong biofilm producers and 23.8% (5/21) as weak producers. Furthermore, 81% (17/21) of the isolates were methicillin resistant and mecA gene carriers. Resistance to ampicillin, erythromycin, and trimethoprim was observed in .70% of isolates screened. Each isolate showed a different PFGE macrorestriction pattern with similarity ranging between 0–95%. Among mecA-positive isolates, 14 (82%) harbored a non-typeable SCCmec type: eight isolates were not positive for any ccr complex; four contained the mec complex A ccrAB1 and ccrC, one isolate contained mec complex A, ccrAB4 and ccrC, and one isolate contained the mec complex A, ccrAB1, ccrAB4, and ccrC. Two isolates harbored the association: mec complex A and ccrAB1. Only one strain was typeable as SCCmec III. Conclusions: The S. hominis isolates analyzed were variable biofilm producers had a high prevalence of methicillin resistance and resistance to other antibiotics, and high genetic diversity. The results of this study strongly suggested that S. hominis isolates harbor new SCCmec structural elements and might be reservoirs of ccrC1 in addition to ccrAB1 and mec complex A

The complex association between the antioxidant defense system and clinical status in early psychosis

Oxidative stress is a pathophysiological mechanism potentially involved in psychiatric disorders. The objective of this study was to assess the relationship between total antioxidant status (TAS) and the functional status of patients with a first episode of psychosis at the onset of the disease. For this purpose, a sample of 70 patients aged between 9 and 17 years with a first episode of psychosis were followed up for a period of two years. Blood samples were drawn to measure TAS levels at three time points: at baseline, at one year, and at two years. Clinical symptoms and functioning were also assessed at the same time points using various scales. Linear regression analysis was performed to investigate the relationship between TAS and clinical status at each assessment, adjusting for potential confounding factors. The distribution of clinical variables was grouped in different percentiles to assess the dose-response in the relation between clinical variables and TAS. At baseline, patient's score on Children's Global Assessment Scale (CGAS) was directly and significantly associated with TAS with a monotonic increase in percentiles, and surprising this association was reversed after one and two years of follow-up with a monotonic decrease. In summary at the onset of the illness, TAS is positively related to clinical status, whereas as the illness progresses this correlation is reversed and becomes negative. This may be the result of an adaptive response.This study has been funded by Instituto de Salud Carlos III through the projects PI14/01900, PI16/01164 (Co-funded by European Regional Development Fund/European Social Fund, "Investing in your future"); the Basque Foundation for Health Innovation and Research (BIOEF); Networking Center for Biomedical Research in Mental Health (CIBERSAM) and the University of the Basque Country (GIC12/84). The psychiatric research department in University Hospital Araba is supported by the Stanley Research Foundation (03-RC-003). Sainza Garcia has a PhD fellowship from the University of the Basque Country. The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication

Antibiotic Susceptibility of Biofilm Cells and Molecular Characterisation of Staphylococcus hominis Isolates from Blood

Objectives We aimed to characterise the staphylococcal cassette chromosome mec (SCCmec) type, genetic relatedness, biofilm formation and composition, icaADBC genes detection, icaD expression, and antibiotic susceptibility of planktonic and biofilm cells of Staphylococcus hominis isolates from blood. Methods The study included 67 S. hominis blood isolates. Methicillin resistance was evaluated with the cefoxitin disk test. mecA gene and SCCmec were detected by multiplex PCR. Genetic relatedness was determined by pulsed-field gel electrophoresis. Biofilm formation and composition were evaluated by staining with crystal violet and by detachment assay, respectively; and the biofilm index (BI) was determined. Detection and expression of icaADB Cgenes were performed by multiplex PCR and real-time PCR, respectively. Antibiotic susceptibilities of planktonic cells (minimum inhibitory concentration, MIC) and biofilm cells (minimum biofilm eradication concentration, MBEC) were determined by the broth dilution method. Results Eighty-five percent (57/67) of isolates were methicillin resistant and mecA positive. Of the mecA-positive isolates, 66.7% (38/57) carried a new putative SCCmec type. Four clones were detected, with two to five isolates each. Among all isolates, 91% (61/67) were categorised as strong biofilm producers. Biofilm biomass composition was heterogeneous (polysaccharides, proteins and DNA). All isolates presented the icaD gene, and 6.66% (1/15) isolates expressed icaD. This isolate presented the five genes of ica operon. Higher BI and MBEC values than the MIC values were observed for amikacin, vancomycin, linezolid, oxacillin, ciprofloxacin, and chloramphenicol. Conclusions S. hominis isolates were highly resistant to methicillin and other antimicrobials. Most of the detected SCCmec types were different than those described for S. aureus. Isolates indicated low clonality. The results indicate that S. hominis is a strong biofilm producer with an extracellular matrix with similar composition of proteins, DNA and N-acetylglucosamine; and presents high frequency and low expression of icaD gene. Biofilm production is associated with increased antibiotic resistance

The complex association between the antioxidant defense system and clinical status in early psychosis

Oxidative stress is a pathophysiological mechanism potentially involved in psychiatric disorders. The objective of this study was to assess the relationship between total antioxidant status (TAS) and the functional status of patients with a first episode of psychosis at the onset of the disease. For this purpose, a sample of 70 patients aged between 9 and 17 years with a first episode of psychosis were followed up for a period of two years. Blood samples were drawn to measure TAS levels at three time points: at baseline, at one year, and at two years. Clinical symptoms and functioning were also assessed at the same time points using various scales. Linear regression analysis was performed to investigate the relationship between TAS and clinical status at each assessment, adjusting for potential confounding factors. The distribution of clinical variables was grouped in different percentiles to assess the dose-response in the relation between clinical variables and TAS. At baseline, patient's score on Children's Global Assessment Scale (CGAS) was directly and significantly associated with TAS with a monotonic increase in percentiles, and surprising this association was reversed after one and two years of follow-up with a monotonic decrease. In summary at the onset of the illness, TAS is positively related to clinical status, whereas as the illness progresses this correlation is reversed and becomes negative. This may be the result of an adaptive response