Guía de atención psicológica a pacientes y familiares en el proceso de donación y trasplante de órganos

Los trasplantes de órganos son expresión del desarrollo científico y tecnológico alcanzado por las ciencias hasta la actualidad, y en especial en el campo de las ciencias médicas. Para que se produzca un trasplante debe haber una donación (donante) y una recepción (receptor) y en el acto de la donación se refleja toda la subjetividad de los seres humanos, marcada por la cultura, el entorno, la educación, las creencias, los dilemas éticos y las actitudes éticas. Esto explica por qué el psicólogo es un integrante imprescindible dentro del equipo multidisciplinario. En esta guía se definen los pasos, técnicas psicológicas para el diagnóstico y la intervención psicológica, aspectos éticos y otros elementos de interés para garantizar la calidad de la asistencia psicológica, en el contexto de la donación y trasplante de órganos. Para ello, se consultó la literatura científica existente sobre el tema, incluyendo directrices de la Organización Mundial de la Salud, y se conformó el documento a partir de las mejores referencias que resultaron de la revisión. La guía constituye una herramienta para orientar el trabajo de los psicólogos que forman parte de los equipos multidisciplinarios de trasplante y rescate de órganos, ajustada a pautas de la Organización Mundial de la Salud y experiencias de Cuba y otros países

Significados y prácticas de ser hombre y mujer en un grupo de jóvenes de la periferia de Bogotá

La presente investigación aborda los significados y prácticas alrededor del ser mujer y ser hombre en un grupo de jóvenes estudiantes de bachillerato de un colegio oficial, en el sur de la ciudad de Bogotá. Cuyo objetivo se orienta a favorecer la comprensión de los procesos sociales que atraviesan la constitución de la identidad desde una perspectiva de género con el enfoque de la interseccionalidad. Es un estudio cualitativo que recurre al método interpretativo de textos, a partir de la revisión bibliográfica que da cuenta de la teoría y del análisis textual de los registros de entrevistas semiestructuradas y grupos focales. Entre los resultados más destacados se encuentra que el estereotipo machista y hetero-patriarcal se sigue reproduciendo en los hogares, pero ambigüedades como; princesas y guerreras, marcan las resistencias que caracterizan el ser mujer, estas quiebran los modos tradicionales de sometimiento y exclusión, a partir de la producción de nuevas gramáticas que van desde el uso de cuerpo como transgresión, hasta la incursión en ámbitos laborales y educativos. Por su parte, el ser hombre se configura a partir del patriarcalismo jerárquico en el que predomina la violencia simbólica hacia la mujer, pero también por la irrupción de conductas que desarticulan la verticalidad de la jerarquía y se desplazan hacia la afirmación de masculinidades mucho más sensibles y conscientes de la necesidad de transformar esta realidad

Can Oncologists Prompt Patient Prognostic Awareness to Enhance Decision-Making? Data From the NEOetic Study

Introduction: Anti-neoplastic therapy improves the prognosis for advanced cancer, albeit it is not curative. An ethical dilemma that often arises during patients’ first appointment with the oncologist is to give them only the prognostic information they can tolerate, even at the cost of compromising preference-based decision-making, versus giving them full information to force prompt prognostic awareness, at the risk of causing psychological harm. Methods: We recruited 550 participants with advanced cancer. After the appointment, patients and clinicians completed several questionnaires about preferences, expectations, prognostic awareness, hope, psychological symptoms, and other treatment-related aspects. The aim was to characterize the prevalence, explanatory factors, and consequences of inaccurate prognostic awareness and interest in therapy. Results: Inaccurate prognostic awareness affected 74%, conditioned by the administration of vague information without alluding to death (odds ratio [OR] 2.54; 95% CI, 1.47-4.37, adjusted P = .006). A full 68% agreed to low-efficacy therapies. Ethical and psychological factors oriented firstline decision-making, in a trade-off in which some lose quality of life and mood, for others to gain autonomy. Imprecise prognostic awareness was associated with greater interest in low-efficacy treatments (OR 2.27; 95% CI, 1.31-3.84; adjusted P = .017), whereas realistic understanding increased anxiety (OR 1.63; 95% CI, 1.01-2.65; adjusted P = 0.038), depression (OR 1.96; 95% CI, 1.23-3.11; adjusted P = .020), and diminished quality of life (OR 0.47; 95% CI, 0.29-0.75; adjusted P = .011). Conclusion: In the age of immunotherapy and targeted therapies, many appear not to understand that antineoplastic therapy is not curative. Within the mix of inputs that comprise inaccurate prognostic awareness, many psychosocial factors are as relevant as the physicians’ disclosure of information. Thus, the desire for better decision-making can actually harm the patient

Respuesta humoral a dos inmunógenos contra la Peste Porcina Clásica en condiciones de campo

La Peste Porcina Clásica (PPC) es una enfermedad altamente contagiosa, presente en Cuba de forma endémica, por lo que está sujeta a un programa de control que incluye la vacunación con la vacuna viva atenuada de la cepa China lapinizada (LABIOFAM, S.A.), de probada seguridad y efectividad. Por las bondades que brinda el uso de una vacuna marcadora en fases avanzadas del control, fue aplicado en condiciones de campo un candidato vacunal de subunidad, basado en la glicoproteína E2 (CVE2) del virus de la peste porcina clásica. Se comparó la respuesta serológica inducida por el nuevo candidato vacunal con la inducida por la vacuna cepa China (VCC) en un mismo escenario epidemiológico, una granja porcina con antecedentes de manifestación clínica de la enfermedad y sujeta a vacunación sistemática con la VCC. Se evaluó la respuesta inmune humoral de animales vacunados con ambos productos mediante el ensayo de neutralización ligado a la peroxidasa (NPLA). Para ello se investigaron muestras de sangre obtenidas en diferentes fases del ciclo tecnológico. Se encontró en los sueros evaluados de animales vacunados con el CVE2 que estos mantuvieron altos títulos (³ 1:100) hasta el final de la ceba, a diferencia de los vacunados con la VCC. También se comprobó que animales vacunados con la VCC tuvieron un riesgo relativo 12,2 veces mayor de tener títulos de anticuerpos <1:50 que los vacunados con el CVE2

Thio- and selenosemicarbazones as antiprotozoal agents against Trypanosoma cruzi and Trichomonas vaginalis

Herein, we report the preparation of a panel of Schiff bases analogues as antiprotozoal agents by modification of the stereoelectronic effects of the substituents on N-1 and N-4 and the nature of the chalcogen atom (S, Se). These compounds were evaluated towards Trypanosoma cruzi and Trichomonas vaginalis. Thiosemicarbazide 31 showed the best trypanocidal profile (epimastigotes), similar to benznidazole (BZ): IC50 (31)=28.72 μM (CL-B5 strain) and 33.65 μM (Y strain), IC50 (BZ)=25.31 μM (CL-B5) and 22.73 μM (Y); it lacked toxicity over mammalian cells (CC50 > 256 µM). Thiosemicarbazones 49, 51 and 63 showed remarkable trichomonacidal effects (IC50 =16.39, 14.84 and 14.89 µM) and no unspecific cytotoxicity towards Vero cells (CC50 ≥ 275 µM). Selenoisosters 74 and 75 presented a slightly enhanced activity (IC50=11.10 and 11.02 µM, respectively). Hydrogenosome membrane potential and structural changes were analysed to get more insight into the trichomonacidal mechanism.Junta de Andalucía Grant PID2020- 116460RB-I00, funded by MCIN/AEI/10.13039/50110001103

Gender differences in addiction severity

Gender has been associated with substance use disorders (SUD). However, there are few studies that have evaluated gender differences in a global and a standardized way, and with a large sample of patients with SUD. Our goal is to analyze the role of gender in addiction severity throughout multiple life domains, using the Addiction Severity Index-6 (ASI-6). A naturalistic, multicenter and prospective study was conducted. A total of 221 patients with SUD (80.1% men) were interviewed with the ASI-6. Our results indicate that the Recent Summary Scores (RSSs) of men and women are similar, with the exception of Psychiatric and Partner- Problems, where women showed higher severity (p = .017 and p = .013, respectively). Statistically significant gender differences were found in certain aspects of the ASI-6 domains: men have more problems of physical health, legal issues, and alcohol and other substance use; and woman score higher in problems of mental health, social network, subjective evaluations of SUD consequences, and treatment needs. These results should be taken into account to improve the identification, prevention, and treatment of SUD.Se ha descrito que el género es un factor que condiciona los trastornos por uso de sustancias (TUS). Sin embargo, hay pocos estudios que hayan evaluado esas diferencias de género de manera global, estandarizada y en una muestra amplia de pacientes con TUS. Nuestro objetivo es analizar el rol del género en la gravedad de la adicción a través de los diversos dominios de vida mediante el Addiction Severity Index-6 (ASI-6). Se llevó a cabo un estudio naturalístico, multicéntrico y prospectivo con una muestra compuesta por 221 pacientes con TUS (80,1% hombres). Los participantes fueron entrevistados con el ASI-6. Los resultados han mostrado que las Puntuaciones Sumarias Recientes (PSRs) son similares entre hombres y mujeres a excepción de las correspondientes a Salud mental y Pareja- Problemas, donde las mujeres presentan mayor gravedad (p = 0,017 y p = 0,013, respectivamente). Por otra parte, se han encontrado diferencias estadísticamente significativas e diversos aspectos concretos de las áreas contempladas por el ASI-6, que indican que los hombres presentan más problemas en cuanto a salud física, cuestiones legales y uso de alcohol y drogas, y la mujeres en salud mental, red social y la valoración subjetiva sobre las consecuencias del TUS y la necesidad de tratamiento. Estos resultados deben tenerse en cuenta a la hora de implementar una mejora en la identificación, prevención y tratamiento de los TUS

IgG4-related disease: results from a multicenter Spanish registry

IgG4-related disease (IgG4-RD) is a rare entity consisting of inflammation and fibrosis that has been described in multiple organs. Concrete diagnostic criteria have been established recently and there is a lack of large series of patients.To describe the clinical presentation, histopathological characteristics, treatment and evolution of a series of IgG4-RD Spanish patients.A retrospective multicenter study was performed. Twelve hospitals across Spain included patients meeting the current 2012 consensus criteria on IgG4-RD diagnosis.Fifty-five patients were included in the study, 38 of whom (69.1%) were male. Median age at diagnosis was 53 years. Thirty (54.5%) patients were included in the Histologically Highly Suggestive IgG4-RD group and 25 (45.5%) in the probable IgG4-RD group. Twenty-six (47.3%) patients had more than 1 organ affected at presentation. The most frequently affected organs were: retroperitoneum, orbital pseudotumor, pancreas, salivary and lachrymal glands, and maxillary sinuses.Corticosteroids were the mainstay of treatment (46 patients, 83.6%). Eighteen patients (32.7%) required additional immunosuppressive agents. Twenty-four (43.6%) patients achieved a complete response and 26 (43.7%) presented a partial response (<50% of regression) after 22 months of follow-up. No deaths were attributed directly to IgG4-RD and malignancy was infrequent.This is the largest IgG4-RD series reported in Europe. Patients were middle-aged males, with histologically probable IgG4-RD. The systemic form of the disease was frequent, involving mainly sites of the head and abdomen. Corticosteroids were an effective first line treatment, sometimes combined with immunosuppressive agents. Neither fatalities nor malignancies were attributed to IgG4-RD

Resilient Response to Combined Heat and Drought Stress Conditions of a Tomato Germplasm Collection, Including Natural and Ethyl Methanesulfonate-Induced Variants

Agricultural systems are currently facing significant issues, primarily due to population growth rates in the context of global climate change. Rising temperatures cause plant heat stress and impact crop yield, which in turn compromises global food production and safety. Climate change is also having a significant impact on water availability around the world, and droughts are becoming more frequent and severe in many regions. The combined effect of both heat and drought stresses increases plant damage, resulting in reduced plant development and productivity loss. Therefore, developing heat&ndash;drought-tolerant crop varieties is crucial for enhancing yield under these challenging conditions. Tomato (Solanum lycopersicum L.), a major vegetable crop highly appreciated for its nutritional qualities, is particularly sensitive to extreme temperatures, which have a significant negative impact on tomato fruit setting and cause male gametophyte abortion. In this work, a classical genetic approach was employed to identify tomato genotypes showing a resilient response to combined heat and drought stress conditions. A phenotype screening of a natural germplasm collection and an ethyl methanesulfonate (EMS) mutagenized population resulted in the identification of a significant number of tomato lines tolerant to combined heat and drought conditions, specifically 161 EMS lines and 24 natural accessions as tolerant. In addition, TILLING and Eco-TILLING analyses were used as proof-of-concept to isolate new genetic variants of genes previously reported as key regulators of abiotic stress responses in different species. The identification of these variants holds the potential to provide suitable plant material for breeding programs focused on enhancing tomato resilience to adverse climate conditions

A genome-wide association study follow-up suggests a possible role for PPARG in systemic sclerosis susceptibility

Introduction: A recent genome-wide association study (GWAS) comprising a French cohort of systemic sclerosis (SSc) reported several non-HLA single-nucleotide polymorphisms (SNPs) showing a nominal association in the discovery phase. We aimed to identify previously overlooked susceptibility variants by using a follow-up strategy.&lt;p&gt;&lt;/p&gt; Methods: Sixty-six non-HLA SNPs showing a P value &#60;10-4 in the discovery phase of the French SSc GWAS were analyzed in the first step of this study, performing a meta-analysis that combined data from the two published SSc GWASs. A total of 2,921 SSc patients and 6,963 healthy controls were included in this first phase. Two SNPs, PPARG rs310746 and CHRNA9 rs6832151, were selected for genotyping in the replication cohort (1,068 SSc patients and 6,762 healthy controls) based on the results of the first step. Genotyping was performed by using TaqMan SNP genotyping assays. Results: We observed nominal associations for both PPARG rs310746 (PMH = 1.90 × 10-6, OR, 1.28) and CHRNA9 rs6832151 (PMH = 4.30 × 10-6, OR, 1.17) genetic variants with SSc in the first step of our study. In the replication phase, we observed a trend of association for PPARG rs310746 (P value = 0.066; OR, 1.17). The combined overall Mantel-Haenszel meta-analysis of all the cohorts included in the present study revealed that PPARG rs310746 remained associated with SSc with a nominal non-genome-wide significant P value (PMH = 5.00 × 10-7; OR, 1.25). No evidence of association was observed for CHRNA9 rs6832151 either in the replication phase or in the overall pooled analysis.&lt;p&gt;&lt;/p&gt; Conclusion: Our results suggest a role of PPARG gene in the development of SSc

The systemic lupus erythematosus IRF5 risk haplotype is associated with systemic sclerosis

Systemic sclerosis (SSc) is a fibrotic autoimmune disease in which the genetic component plays an important role. One of the strongest SSc association signals outside the human leukocyte antigen (HLA) region corresponds to interferon (IFN) regulatory factor 5 (IRF5), a major regulator of the type I IFN pathway. In this study we aimed to evaluate whether three different haplotypic blocks within this locus, which have been shown to alter the protein function influencing systemic lupus erythematosus (SLE) susceptibility, are involved in SSc susceptibility and clinical phenotypes. For that purpose, we genotyped one representative single-nucleotide polymorphism (SNP) of each block (rs10488631, rs2004640, and rs4728142) in a total of 3,361 SSc patients and 4,012 unaffected controls of Caucasian origin from Spain, Germany, The Netherlands, Italy and United Kingdom. A meta-analysis of the allele frequencies was performed to analyse the overall effect of these IRF5 genetic variants on SSc. Allelic combination and dependency tests were also carried out. The three SNPs showed strong associations with the global disease (rs4728142: P = 1.34×10&lt;sup&gt;−8&lt;/sup&gt;, OR = 1.22, CI 95% = 1.14–1.30; rs2004640: P = 4.60×10&lt;sup&gt;−7&lt;/sup&gt;, OR = 0.84, CI 95% = 0.78–0.90; rs10488631: P = 7.53×10&lt;sup&gt;−20&lt;/sup&gt;, OR = 1.63, CI 95% = 1.47–1.81). However, the association of rs2004640 with SSc was not independent of rs4728142 (conditioned P = 0.598). The haplotype containing the risk alleles (rs4728142*A-rs2004640*T-rs10488631*C: P = 9.04×10&lt;sup&gt;−22&lt;/sup&gt;, OR = 1.75, CI 95% = 1.56–1.97) better explained the observed association (likelihood P-value = 1.48×10&lt;sup&gt;−4&lt;/sup&gt;), suggesting an additive effect of the three haplotypic blocks. No statistical significance was observed in the comparisons amongst SSc patients with and without the main clinical characteristics. Our data clearly indicate that the SLE risk haplotype also influences SSc predisposition, and that this association is not sub-phenotype-specific