Estrés vital: variables psicológicas y sociodemográficas predictoras del malestar emocional

Introduction: Personality and coping used to man­age stress play an important role in the development of mental health problems. The aim of this study was to analyse whether these variables, together with per­ceived stress and some relevant socio-demographic characteristics, could predict the level of anxiety and depressive symptoms presented in people diagnosed with Adjustment Disorder (AD). As well as analys­ing if the significant predictor variables were the same in the control group. Method: Perceived stress, personality, positivity, coping and symptoms were assessed in a group of patients with Adjustment Dis­order who went to a Mental Health Unit (N = 80) and a control group (N = 80). Regression analyses were carried out to predict symptomatology. Results: Psy­chological and some socio-demographic variables predicted symptomatology, however, the results were different depending on the group and type of symp­tom considered. In the control group, higher neuroti­cism and perceived stress, lower positivity, and un­employment status predicted more depressive symp­toms; whereas higher neuroticism, being a female, and unemployment predicted higher anxiety (coping was not relevant in any case). In the clinical group, the predictive capacity of variables was lower, espe­cially in the case of anxiety. Lower positivity, greater use of disengagement or avoidant coping, being a male and unemployment predicted higher depressive symptomatology, whereas only neuroticism predicted symptoms of anxiety. Conclusions: Personality, coping, perceived stress and socio-demographic characteristics could be factors of vulnerability that should be considered in the development of assess­ment, prevention and treatment strategies with people exposed to life stress. However, the characteristics of the group considered are a key factor in the selection of the most relevant strategyResumenIntroducción: La personalidad y las estrategias de afrontamiento utilizadas ante el estrés juegan un papel importante en el desarrollo de problemas de salud mental. El objetivo de este estudio fue comprobar si estas variables, junto con el estrés percibido y algunas variables sociodemográficas significativas, permitían predecir el nivel de sintomatología ansiosa y depresiva presentada en una muestra de personas con Trastorno Adaptativo (TA), y si las variables predictoras eran las mismas en una muestra control. Método: Se aplicó un protocolo compuesto por cuestionarios de estrés percibido, personalidad, positividad, afrontamiento y síntomas a un grupo de pacientes que acudieron a una Unidad de Salud Mental, diagnosticados de Trastorno Adaptativo (N = 80), y a un grupo control (N = 80). Se realizaron análisis de regresión sobre la sintomatología. Resultados: En general, las variables psicológicas y sociodemográficas consideradas contribuyeron en la predicción de la sintomatología, aunque los resultados variaron dependiendo del grupo considerado y del tipo de síntoma. En el grupo control, un mayor neuroticismo, menor positividad, mayor estrés percibido y estar en paro predijeron mayores puntuaciones en depresión, y mayor neuroticismo, estar en paro y ser mujer predijeron mayor ansiedad (no siendo relevante el afrontamiento en ningún caso). En el grupo clínico, la capacidad predictiva de las variables fue menor, especialmente en el caso de la ansiedad. Las variables que predijeron mayor sintomatología depresiva fueron ser menos positivo, un mayor uso del afrontamiento de falta de compromiso o evitativo, ser hombre y estar en paro, mientras que en la predicción de la sintomatología ansiosa sólo resultó significativo el neuroticismo. Conclusiones: Las características de personalidad y afrontamiento, el estrés percibido y las características sociodemográficas podrían ser factores de vulnerabilidad a considerar en el desarrollo de estrategias de evaluación, preventivas y de intervención en personas sometidas a estrés vital, aunque probablemente es importante considerar el tipo de muestra en la selección de las estrategias más relevantes. AbstractIntroduction: Personality and coping used to man­age stress play an important role in the development of mental health problems. The aim of this study was to analyse whether these variables, together with per­ceived stress and some relevant socio-demographic characteristics, could predict the level of anxiety and depressive symptoms presented in people diagnosed with Adjustment Disorder (AD). As well as analys­ing if the significant predictor variables were the same in the control group. Method: Perceived stress, personality, positivity, coping and symptoms were assessed in a group of patients with Adjustment Dis­order who went to a Mental Health Unit (N = 80) and a control group (N = 80). Regression analyses were carried out to predict symptomatology. Results: Psy­chological and some socio-demographic variables predicted symptomatology, however, the results were different depending on the group and type of symp­tom considered. In the control group, higher neuroti­cism and perceived stress, lower positivity, and un­employment status predicted more depressive symp­toms; whereas higher neuroticism, being a female, and unemployment predicted higher anxiety (coping was not relevant in any case). In the clinical group, the predictive capacity of variables was lower, espe­cially in the case of anxiety. Lower positivity, greater use of disengagement or avoidant coping, being a male and unemployment predicted higher depressive symptomatology, whereas only neuroticism predicted symptoms of anxiety. Conclusions: Personality, coping, perceived stress and socio-demographic characteristics could be factors of vulnerability that should be considered in the development of assess­ment, prevention and treatment strategies with people exposed to life stress. However, the characteristics of the group considered are a key factor in the selection of the most relevant strategy

Contribución del Neuroticismo, Rasgos Patológicos de Personalidad y Afrontamiento en la Predicción de la Evolución Clínica: Estudio de Seguimiento a los 5 Años de una Muestra de Pacientes con Trastorno Adaptativo

Numerosos estudios han demostrado que tanto la personalidad como las estrategias de afrontamiento utilizadas para manejar el estrés tienen un papel importante en el desarrollo de problemas de salud mental, entre los que se encuentra el trastorno adaptativo (TA). El objetivo de este estudio fue, en primer lugar, analizar las diferencias entre neuroticismo, comorbilidad y afrontamiento en un grupo de pacientes diagnosticados de TA con evolución clínica favorable (n = 58) y otro grupo con evolución desfavorable (n = 20); en segundo lugar, se comprobó si estas variables permitían predecir la evolución clínica a los 5 años. El grupo con evolución clínica desfavorable presentó un mayor neuroticismo, más presencia de rasgos comórbidos de personalidad patológica y un afrontamiento más desadaptativo. Además, los principales factores del riesgo de pertenecer al grupo con peor evolución fueron mayor neuroticismo, presencia de comorbilidad y uso del afrontamiento de negación, mientras que las estrategias de planificación y de apoyo instrumental redujeron dicho riesgo

Plasma rich in growth factors (PRGF)

In most of the cases the objective of the medical research it is not centered solely in prolonging the time of life of the patient, but in improving the quality of he himself. Rich Plasma in Growth Factors is a novel and relatively recent technique applicable to the tissue repair. It consists of a simple system for the platelets proteins obtaining from a blood sample of the patient. In the scope of the podiatry, the application of PRGF allows to improve the evolution of patients with titular regenerative necessities in the foot and lower limb such as: to accelerate the osseous consolidation in the postoperative period, to shorten the time of resolution in diabetic ulcers or to improve the healing among other many. Diverse studies on the application of Factors of Growth have demonstrated excellent results in different medical specialties between which is the podiatry, therefore considers a technique of high effectiveness and clinical interest for their contribution to the scientific community.In most of the cases the objective of the medical research it is not centered solely in prolonging the time of life of the patient, but in improving the quality of he himself. Rich Plasma in Growth Factors is a novel and relatively recent technique applicable to the tissue repair. It consists of a simple system for the platelets proteins obtaining from a blood sample of the patient. In the scope of the podiatry, the application of PRGF allows to improve the evolution of patients with titular regenerative necessities in the foot and lower limb such as: to accelerate the osseous consolidation in the postoperative period, to shorten the time of resolution in diabetic ulcers or to improve the healing among other many. Diverse studies on the application of Factors of Growth have demonstrated excellent results in different medical specialties between which is the podiatry, therefore considers a technique of high effectiveness and clinical interest for their contribution to the scientific community

Análisis del programa educativo “Cubilete” para la prevención de adicciones a TIC en adolescentes. Caso específico de juegos de azar y apuestas online

RESUMENEl objetivo de este estudio fue analizar la efectividad del programa educativo “Cubilete” para la prevención de adicciones a Internet, móvil, juegos y apuestas online en estudiantes de Educación Secundaria y Bachillerato, diseñado por la Asociación Alujer. La muestra estuvo compuesta por un total de 637 alumnos de diferentes centros de la ciudad de Jaén (España). El instrumento para medir la eficacia del programa en una medida pre y postest fue el Cuestionario escolar de creencias, actitudes y usos de tecnologías, juegos virtuales y apuestas online (CCAU), construido ad hoc. La intervención tuvo una duración de 4 semanas y fue llevada a cabo durante las horas de tutoría. Los resultados muestran una reducción significativa en cuanto al uso de Tecnologías de la Información y la Comunicación (TIC), así como en la frecuencia en las que se utilizan las mismas. También se observó un aumento en el reconocimiento de adicción a las TIC una vez llevada a cabo la intervención, además de un mayor conocimiento de los padres del uso que hacen sus hijos de las mismas. Así mismo, la participación a juegos de azar y apuestas online se ve reducida considerablemente. Por último, hay un esclarecimiento en lo referido al significado del concepto adicción, aunque no significativamente del concepto juego patológico. Como conclusión se destaca el papel revelador que tiene este tipo de intervenciones sobre la población joven en lo referido al uso de las TIC y las adicciones a juegos de azar, virtuales y apuestas.ABSTRACTThe objective of this study was to analyze the effectiveness of the educational program "Cubilete" for the prevention of addictions to Internet, mobile, games and online bets in students of Secondary Education and Baccalaureate, designed by the Alujer Association. The sample consisted of a total of 637 students from different centers in the city of Jaén (Spain). The instrument to measure the effectiveness of the program in a pre- and post-test measure was the school Cuestionario escolar de creencias, actitudes y usos de tecnologías, juegos virtuales y apuestas online (CCAU), made ad hoc. The intervention lasted 4 weeks and was carried out during the tutorial hours. The results show a significant reduction in the use of Information and Communication Technologies (ICT), as well as in the frequency in which they are used. There was also an increase in the recognition of addiction to ICT once the intervention was carried out, as well as a greater knowledge of the parents of the use made by their children. Likewise, participation in online gambling and betting is considerably reduced. Finally, there is clarification regarding the meaning of the concept of addiction, although not significantly of the concept of pathological gambling. In conclusion, the revealing role of this type of interventions on the young population in the use of ICT and addictions to gambling, virtual and betting is highlighted

Percutaneous tracheostomy in COVID patients. Experience in our hospital center after one year of pandemic and review of the literature

The pandemic caused by SARS-COV-2 has caused an increase in the need of tracheostomies in patients affected with respiratory distress syndrome. In this article we report our experience during a year of pandemic, we develop our surgical technique to perform percutaneous tracheostomy with the patient in apnea and we compare our results with those of other centers through a bibliographic review. A one-year retrospective clinical study was carried out on tracheotomies performed on patients admitted to the intensive care unit with severe SARS-CoV-2, with difficulty for ventilation or weaning. The technique performed was percutaneous, with fibroscopic control through the endotracheal tube, keeping the patient under apnea during the opening of the airway, reducing by this method the risk of exposure to the virus. From 35 percutaneous tracheotomies performed, 31% of the patients died from respiratory complications due to SARS-COV-2, but none due to the surgical procedure. The most frequent complication (8.5% of patients) was bleeding around the tracheostoma, resolved with local measures. No healthcare provider involved in the performance of the technique had symptoms or was diagnosed with COVID-19. Our technique of performing percutaneous tracheostomy maintaining apnea during the procedure, under fibroscopic control, has proven to be safe for all those involved in the procedure, and for the patient

Efectos de la actividad física y condición física sobre funciones ejecutivas y rendimiento académico en niños de EducaciónPrimaria. Una revisión sistemática

This systematic review sought to investigate the influence of physical activity and physical fitness on cognitive functions and academic performance. Studies were identified in four databases from January 2010 through January 2021. A total of 26 studies were selected after meeting the established criteria. Nine studies showed an association between physical activity and physical fitness variables and academic performance. Cardiorespiratory fitness, speed-agility, motor coordination, and perceptual-motor skill had the strongest association with executive function, including attention, memory, inhibition and shifting in 17 studies. High levels of physical activity and physical fitness are associated with higher academic performance and executive function. More hours of Physical Education are needed to more effectively develop the cognitive aspects and physical fitness of children in elementary school.Esta revisión sistemática buscó investigar la influencia de la actividad física y la aptitud física en las funciones cognitivas y el rendimiento académico. Los estudios se identificaron en cuatro bases de datos desde enero de 2010 hasta enero de 2021. Se seleccionaron un total de 26 estudios después de cumplir con los criterios establecidos. Nueve estudios mostraron una asociación entre la actividad física y las variables de aptitud física y el rendimiento académico. La aptitud cardiorrespiratoria, la velocidad-agilidad, la coordinación motora y la habilidad perceptivo-motora tuvieron la asociación más fuerte con la función ejecutiva, incluida la atención, la memoria, la inhibición y el cambio en 17 estudios. Los altos niveles de actividad física y aptitud física están asociados con un mayor rendimiento académico y función ejecutiva. Se necesitan más horas de Educación Física para desarrollar de manera más efectiva los aspectos cognitivos y la aptitud física de los niños en la escuela primaria.Actividad Física y Deport

Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers Withdrawal Is Associated with Higher Mortality in Hospitalized Patients with COVID-19

Our main aim was to describe the effect on the severity of ACEI (angiotensin-converting enzyme inhibitor) and ARB (angiotensin II receptor blocker) during COVID-19 hospitalization. A retrospective, observational, multicenter study evaluating hospitalized patients with COVID-19 treated with ACEI/ARB. The primary endpoint was the incidence of the composite outcome of prognosis (IMV (invasive mechanical ventilation), NIMV (non-invasive mechanical ventilation), ICU admission (intensive care unit), and/or all-cause mortality). We evaluated both outcomes in patients whose treatment with ACEI/ARB was continued or withdrawn. Between February and June 2020, 11,205 patients were included, mean age 67 years (SD = 16.3) and 43.1% female; 2162 patients received ACEI/ARB treatment. ACEI/ARB treatment showed lower all-cause mortality (p < 0.0001). Hypertensive patients in the ACEI/ARB group had better results in IMV, ICU admission, and the composite outcome of prognosis (p < 0.0001 for all). No differences were found in the incidence of major adverse cardiovascular events. Patients previously treated with ACEI/ARB continuing treatment during hospitalization had a lower incidence of the composite outcome of prognosis than those whose treatment was withdrawn (RR 0.67, 95%CI 0.63-0.76). ARB was associated with better survival than ACEI (HR 0.77, 95%CI 0.62-0.96). ACEI/ARB treatment during COVID-19 hospitalization was associated with protection on mortality. The benefits were greater in hypertensive, those who continue

The Genotype of the Donor for the (GT)n Polymorphism in the Promoter/Enhancer of FOXP3 Is Associated with the Development of Severe Acute GVHD but Does Not Affect the GVL Effect after Myeloablative HLA-Identical Allogeneic Stem Cell Transplantation

The FOXP3 gene encodes for a protein (Foxp3) involved in the development and functional activity of regulatory T cells (CD4+/CD25+/Foxp3+), which exert regulatory and suppressive roles over the immune system. After allogeneic stem cell transplantation, regulatory T cells are known to mitigate graft versus host disease while probably maintaining a graft versus leukemia effect. Short alleles (≤(GT)15) for the (GT)n polymorphism in the promoter/enhancer of FOXP3 are associated with a higher expression of FOXP3, and hypothetically with an increase of regulatory T cell activity. This polymorphism has been related to the development of auto- or alloimmune conditions including type 1 diabetes or graft rejection in renal transplant recipients. However, its impact in the allo-transplant setting has not been analyzed. In the present study, which includes 252 myeloablative HLA-identical allo-transplants, multivariate analysis revealed a lower incidence of grade III-IV acute graft versus host disease (GVHD) in patients transplanted from donors harboring short alleles (OR = 0.26, CI 0.08-0.82, p = 0.021); without affecting chronic GVHD or graft versus leukemia effect, since cumulative incidence of relapse, event free survival and overall survival rates are similar in both groups of patients

Making Waves:Collaboration in the time of SARS-CoV-2 - rapid development of an international co-operation and wastewater surveillance database to support public health decision-making

The presence of SARS-CoV-2 RNA in wastewater was first reported in March 2020. Over the subsequent months, the potential for wastewater surveillance to contribute to COVID-19 mitigation programmes has been the focus of intense national and international research activities, gaining the attention of policy makers and the public. As a new application of an established methodology, focused collaboration between public health practitioners and wastewater researchers is essential to developing a common understanding on how, when and where the outputs of this non-invasive community-level approach can deliver actionable outcomes for public health authorities. Within this context, the NORMAN SCORE “SARS-CoV-2 in sewage” database provides a platform for rapid, open access data sharing, validated by the uploading of 276 data sets from nine countries to-date. Through offering direct access to underpinning meta-data sets (and describing its use in data interpretation), the NORMAN SCORE database is a resource for the development of recommendations on minimum data requirements for wastewater pathogen surveillance. It is also a tool to engage public health practitioners in discussions on use of the approach, providing an opportunity to build mutual understanding of the demand and supply for data and facilitate the translation of this promising research application into public health practice.</p

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study

Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies