Early outcomes of robotic modified retromuscular Sugarbaker technique for end colostomy parastomal hernia repair.

AIM: The modified retromuscular Sugarbaker or Pauli technique is a technique for parastomal hernia repair, which requires the dissection of the retromuscular space and a transversus abdominis release for stoma lateralization and placement of a retromuscular mesh. Given the limited evidence regarding the robotic approach to this technique, this study aims to evaluate the outcomes of this newly introduced procedure, focusing on the rate of 30-day complications and recurrence rates. METHODS: Retrospective case series report. Patients included underwent an elective robotic modified retromuscular Sugarbaker technique for the repair of a parastomal hernia associated with an end colostomy. All surgeries were performed at a tertiary referral center from September 2020 to December 2023. RESULTS: A total of 21 patients underwent a robotic modified retromuscular Sugarbaker in our study. The parastomal hernias operated on were classified according to the European Hernia Society as 9.5% (2/21) type I, 52.4% (11/21) type II, 23.8% (5/21) type III, 14.3% (3/21) type IV. Early complications observed included 14.3% (3/21) seroma, 9.5% (2/21) surgical site infection, 19% (4/21) postoperative ileus, and one case of large bowel obstruction due to colitis (4.8%), which was managed conservatively. No Clavien-Dindo grade III complications were reported. The overall recurrence rate was 9.5% (2/21) with a median follow-up of 12.5 months (IQR: 3.9-21.3). Both recurrences occurred during the early phases of the learning curve and were possibly attributed to insufficient lateralization of the stoma. CONCLUSION: Robotic modified retromuscular Sugarbaker for parastomal hernia repair is a challenging procedure with promising early outcomes.

Performance Evaluation of a Novel Combination of Four- and Five-Carbon [Butyric and Valeric] Short-Chain Fatty Acid Glyceride Esters in Broilers.

A novel combination of Butyric and Valeric acid glycerol esters with oregano oil in a dry powder form was evaluated for performance improvements in broilers. The dosing regimen (500 g/Ton feed in starter and grower; 250 g/Ton in finisher feed) was considered low compared to conventional practices using non-esterified Butyric and Valeric short-chain fatty acids (SCFA). Six trials were conducted at various trial facilities in Italy, United Kingdom, Spain, and Poland. Supplemented broilers weighed significantly more than the control birds at 28 days of age (+3.4%; 1459 g vs. 1412 g; p = 0.0006) and at 42 days of age (+2.5%; 2834 g vs. 2763 g; p = 0.0030). Supplementation significantly reduced mortality from 1.9% to 0.8% during the finisher phase (from 29 to 42 days of age); however, average mortality was 3.2% for the whole 42-day growth period and was not affected. Further, supplemented broilers grew more (66.4 vs. 64.5 g/day; p = 0.0005), ate more feed (104.7 vs. 103.1 g/day; p = 0.0473), converted feed significantly more efficiently (1.58 vs. 1.60; p = 0.0072), leading to better EPEF value (410 vs. 389; p = 0.0006) than the control broilers. Meta-analysed trial performance data for novel SCFA formulations such as these are not commonly available, and serve to facilitate efficacy determination from an end-user perspective. The use of short- and medium-chain fatty acid esters in optimal low-dose combinations to reliably augment gut health and performance appears promising in commercial broiler production, and may lead to further improvements in industry practices and reduced antibiotic use.

Análise de Apoios Catalães para Jovens Adultos com Deficiência Intelectual e/ou Autismo no Contexto Brasileiro / Analysis of Catalan Support for Youth/Adults with Intellectual Disability and/or Autism in the Brazilian Context

RESUMO: Este estudo teve como objetivo analisar apoios catalães oferecidos para jovens adultos com Deficiência Intelectual (DI) e/ou Transtorno do Espectro Autista (TEA) no contexto brasileiro, com o propósito de discutir sobre a oferta de programas públicos centrados nas pessoas com deficiência, sobretudo ao término do processo de escolarização. Para isso, foram aplicadas avaliações com estudantes jovens adultos brasileiros com DI e/ou TEA para caracterização dos seus níveis de intensidades de apoio e escolarização, bem como foram realizadas entrevistas com profissionais catalãs que identificaram apoios que poderiam ser úteis para a realidade educacional dos participantes envolvidos no estudo. Assim, foi evidenciada a disparidade entre as duas realidades, demostrando a necessidade do desenvolvimento de normativas e institucionalização de apoios para esse público, principalmente na transição do Ensino Médio à vida adulta e independente, além da formação continuada para docentes e envolvimento de profissionais interdisciplinares no contexto escolar para dar apoio efetivo aos estudantes.

ABSTRACT: The study aimed to analyze supports offered to Catalan young adults with Intellectual Disability (ID) and/or Autism Spectrum Disorder (ASD) in the Brazilian context, with the purpose of discussing the offer of public programs focused on people with disabilities, especially at the end of the schooling process. For this, evaluations were applied with Brazilian young adult students with ID and/or ASD to characterize their levels of support and schooling intensities, as well as interviews with Catalan professionals who identified support that could be useful for the educational reality of the participants involved in the study. Thus, the disparity between the two realities was evidenced, demonstrating the need for the development of normative and institutionalization of support for this public, especially in the transition from High School to adult and independent life, in addition to continuing education for teachers and the involvement of interdisciplinary professionals in the school context to provide effective support to students.

Family-centered approach in Early Childhood Intervention of a vulnerable population from an Ecuadorian rural context.

Introduction: Studies about the implementation of the Family Centered Practices approach in Early Childhood Intervention refer as outcomes that have an impact on the Quality of Family Life, on children's development, and also on family empowerment. In Ecuador, despite an absence of Early Childhood Intervention policies and programs, a university has developed training in Family Centered Practices for graduate students. A formative component is to implement a Routines Based Model with families of children with disabilities. The aim of the study is to analyze the impact on the Family Quality of Life, children's development and self-perceived competence of families after the Routines Based Model has been implemented in their natural environment. Method: Eight families from a rural area and their children with disabilities were included in the study. The Family Quality of Life Scale-Early Childhood Intervention and the Screening of the Battelle Developmental Inventory were applied at the beginning and end of the process. A qualitative interview established the family perspective upon the outcomes in their family and their children. Results: There is evidence of a significant increase in the families' Quality of Life and in the children's development at the end of the process. At the interview the families declared themselves more competent to understand and contribute to the development of their children. Discussion: The results provide knowledge of the implementation of a Routine Based Model in vulnerable contexts. Also contributes in the understanding of the family perspective on the outcomes and perceived benefits for the children and the family itself as a measure of quality of the intervention and training. Implications of the results for initial and ongoing training of early care professionals with vulnerable populations are discussed.

Effect of a Bacillus-Based Probiotic on Performance and Nutrient Digestibility When Substituting Soybean Meal with Rapeseed Meal in Grower-Finisher Diets.

The objective of the present study was to test the hypothesis of B. subtilis and B. licheniformis supplementation to a negative control diet in comparison to a standard control diet, had the potential to improve the performance and nutrient digestibility of growing-finishing pigs. For this purpose, 384 fattening pigs of 85 d of age were allotted to three treatments: a standard diet, a negative control (NC) diet (5% soybean meal replaced by 5% rapeseed meal), or a NC diet + probiotic. After reaching a body weight of approximately 110 kg, all animals going to the slaughterhouse (87% of total pigs) were selected to measure carcass quality. Moreover, the apparent total tract digestibility of protein was evaluated at the end of the grower period. The results of this study indicate that supplementation of the tested Bacillus-based probiotic significantly improved average daily gain (ADG, +14.6%) and Feed:gain ratio (F:G, -9.9%) during the grower phase compared to the NC diet. The improvement observed during the grower phase was maintained for the whole fattening period (ADG, +3.9%). Probiotic supplementation significantly improved the total apparent faecal digestibility of dry matter and crude protein in pigs at the end of the grower period. The improvements observed with the additive tested could indicate that supplementation of the Bacillus-based probiotic was able to counteract the lower level of crude protein and standardised ileal digestible amino acids in the NC diet by means of improved protein digestibility.

Analysis of the Structural Validity of the Reduced Version of Metacognitive Awareness of Reading Strategies Inventory.

The application of metacognitive strategies is considered a basic skill of the student at any educational level. In the present study, we evaluate the reduced version of the Metacognitive Awareness of Reading Strategies Inventory (MARSI-R) in Spanish, a self-report instrument designed to measure the metacognitive awareness of students and their perception of the strategies that they use while they are reading school materials. MARSI-R is formed by three subscales: (a) global reading strategies (GRS), (b) problem-solving strategies, and (c) strategies to support reading. We conducted a confirmatory factor analysis (CFA) in a Spanish student sample (N = 570) and the results shown relative inadequate fit for the proposed theoretical three-factor model. More important, the three subscales presented a high level of inter-correlation, which raises the need to assess to what extent the construct should be considered as unidimensional. We conducted two additional CFA models: a unidimensional model and a bifactor S-1 model, and the results indicated the presence of a strong general factor related to the GRS subscale. These results have important implications, since they imply that it is more appropriate to use the total score of the instrument derived of the S-1 model instead of the scores derived from each subscale. The bifactor S-1 model has allowed us to develop a closer approximation between the psychometric model and the theoretical model.

Adherence to Healthy Lifestyle Habits Is a Determinant of the Effectiveness of Weight Loss among Patients Undergoing Endoscopic Bariatric Therapies.

Endoscopic bariatric therapies (EBTs) are promising strategies for the treatment of obesity. However, there is still great variability in its effectiveness in weight loss. Thus, we investigated whether adherence to healthy lifestyle habits is a significant determinant of weight loss effectiveness among patients undergoing EBTs. Additionally, the role of eating behaviors and psychological traits in the effectiveness of weight loss was studied. A cohort of 361 participants (81.4% women; age 41.8 ± 9.5 years; BMI 37.8 ± 4.3 kg/m2) was followed for 1 year after EBT. Anthropometric parameters, adherence to healthy lifestyle habits, emotional eating, and psychological traits (anxiety and depression) were evaluated. General linear models were used to compare outcome variables according to weight loss effectiveness groups (poor vs. good weight-loss-responders). Additionally, a hierarchical linear regression model was used to determine whether adherence to healthy lifestyle habits, emotional eating, or psychological traits were significant predictors of excess weight loss (%EWL). One year after EBT, weight loss differed significantly between good and poor weight-loss-responders (67.5% EWL [95% CI: 64.2, 70.8] vs. 28.2% EWL [95% CI: 25.5, 30.9], p < 0.001). Participants who adhered to good lifestyle habits had 4.37 more odds [95% CI: 2.19, 8.88] of being good weight-loss-responders. We also observed that eating four to five meals/day and practicing muscle-strengthening activities >2 times/week were the two lifestyle habits that most significantly determined weight loss response. Furthermore, our results revealed that while adherence to healthy lifestyle habits was a significant determinant of %EWL 3, 6, and 12 months after EBT (p < 0.001), emotional eating was a significant determinant of %EWL only 3 and 6 months after the intervention (p < 0.01 and p < 0.05, respectively). Regarding psychological traits, we observed that neither anxiety nor depression were significant determinants of %EWL. Our results revealed that adherence to healthy lifestyle habits is a significant determinant for weight loss effectiveness among patients with obesity undergoing EBT. These findings highlight the importance of implementing an adequate nutritional intervention program, especially since patients who adhere to good lifestyle habits are able to achieve a weight loss that would be comparable with bariatric surgery.

Immune Mechanism of Epileptogenesis and Related Therapeutic Strategies.

Immunologic and neuroinflammatory pathways have been found to play a major role in the pathogenesis of many neurological disorders such as epilepsy, proposing the use of novel therapeutic strategies. In the era of personalized medicine and in the face of the exhaustion of anti-seizure therapeutic resources, it is worth looking at the current or future possibilities that neuroimmunomodulator or anti-inflammatory therapy can offer us in the management of patients with epilepsy. For this reason, we performed a narrative review on the recent advances on the basic epileptogenic mechanisms related to the activation of immunity or neuroinflammation with special attention to current and future opportunities for novel treatments in epilepsy. Neuroinflammation can be considered a universal phenomenon and occurs in structural, infectious, post-traumatic, autoimmune, or even genetically based epilepsies. The emerging research developed in recent years has allowed us to identify the main molecular pathways involved in these processes. These molecular pathways could constitute future therapeutic targets for epilepsy. Different drugs current or in development have demonstrated their capacity to inhibit or modulate molecular pathways involved in the immunologic or neuroinflammatory mechanisms described in epilepsy. Some of them should be tested in the future as possible antiepileptic drugs.

Development and Validation of a Short Questionnaire on Dietary and Physical Activity Habits for Patients Submitted to Bariatric Endoscopic Therapies.

PURPOSE: Individuals with obesity frequently regain weigh after endoscopic bariatric therapies (EBT) unless they adhere to healthy habits. The objective was to create and validate a short, self-administered questionnaire (EMOVE) to assess healthy dietary and physical activity (PA) habits' adherence to be used in clinical practice. MATERIALS AND METHODS: In this prospective, unicentric study, 463 patients completed the short, Spanish EMOVE questionnaire, to be validated following the Medical Outcome Trust Criteria. Conceptual and measurement model, reliability (internal consistency and test-retest [subgroup of 93 patients]), construct validity, responsiveness, interpretability, and burden were evaluated. Patients enrolled from January 2017 through August 2018 and auto-filled the EMOVE at baseline and at 3, 6, and 12 months. RESULTS: Patients submitted to intragastric ballon for 6 and 12 months or POSE were 82.7% women with a mean age of 42.7 years, and a mean BMI of 37.1 kg/m2. Four factors were extracted with exploratory factor analysis related to intake frequency, portions and proportions, time and place of eating, and physical activity. EMOVE showed adequate internal consistency (α = 0.73), very good test-retest (r = 0.91, CI: 0.86-0.94; p < 0.001), moderate construct validity of dietary (r = 0.24, CI: 0.11-0.37, p < 0.001), and PA habits (r = 0.44, CI 0.30-0.58; p < 0.001). Stable responsiveness, with correlations from 0.29 to 0.39 (p < 0.001) between the EMOVE scores and the % of total weight loss at 3, 6, and 12 months. Participants categorized as having good or excellent habits (score ≥ 30 points) lost significantly more weight (p < 0.05). Finally, the administration burden was 2.96 min. CONCLUSION: The EMOVE is a useful tool in Spanish language to easily assess the level of adherence to healthy dietary and PA habits to be used routinely in clinical practice.

Assessment of Oral Skills in Adolescents.

There is broad consensus on the need to foster oral skills in middle school due to their inherent importance and because they serve as a tool for learning and acquiring other competences. In order to facilitate the assessment of communicative competence, we hereby propose a model which establishes five key dimensions for effective oral communication: interaction management; multimodality and prosody; textual coherence and cohesion; argumentative strategies; and lexicon and terminology. Based on this model, we developed indicators to measure the proposed dimensions, thus generating a self-report tool to assess oral communication in middle school. Following an initial study conducted with 168 students (mean age = 12.47 years, SD = 0.41), we selected 22 items with the highest discriminant power, while in a second study carried out with a sample of 960 students (mean age 14.11 years, SD = 0.97), we obtained evidence concerning factorial validity and the relationships between oral skills, emotional intelligence and metacognitive strategies related to metacomprehension. We concluded that the proposed model and its derived measure constitute an instrument with good psychometric properties for a reliable and valid assessment of students' oral competence in middle school.

Neurotoxicity of Olindias sambaquiensis and Chiropsalmus quadrumanus extracts in sympathetic nervous system.

Cnidarians are equipped with nematocysts, which are specialized organelles used to inoculate venom during prey capturing and defense. Their venoms are rich in toxins and a potential source of bioactive compounds, however, poorly explored so far. In this work, the activity of the methanolic extracts from the hydromedusa Olindias sambaquiensis and the cubozoan jellyfish Chiropsalmus quadrumanus were studied in sympathetic neurotransmission. For that, bisected rat vas deferens - a classic model of sympathetic neurotransmission - were incubated with the extracts for further myographic and histopathological analysis. The O. sambaquiensis extract, at 0.1 µg/mL, facilitated the neurogenic contractions of the noradrenergic-rich epididymal portion, while reducing the noradrenaline (NA) potency, which suggests an interaction with postsynaptic α1-adrenoceptors. On the other hand, a higher concentration (1 µg/mL) leads to time- and frequency-dependent blockade of nerve-evoked contractions without significantly changing the response to exogenous NA. In turn, the C. quadrumanus extract at 0.1 µg/mL induced blockade of nerve-evoked noradrenergic contractions while reducing the potency to exogenous NA. Both extracts did not affect the purinergic neurotransmission or induce muscle damages. Our results demonstrate that O. sambaquiensis and C. quadrumanus extracts significantly interfere with the noradrenergic neurotransmission without altering purinergic response or smooth muscle structure on rat vas deferens. Such results bring to light the pharmacological potential of O. sambaquiensis and C. quadrumanus molecules for therapeutics focusing on noradrenergic neurotransmission.

Neurotoxicity of Olindias sambaquiensis and Chiropsalmus quadrumanus extracts in sympathetic nervous system

Cnidarians are equipped with nematocysts, which are specialized organelles used to inoculate venom during prey capturing and defense. Their venoms are rich in toxins and a potential source of bioactive compounds, however, poorly explored so far. In this work, the activity of the methanolic extracts from the hydromedusa Olindias sambaquiensis and the cubozoan jellyfish Chiropsalmus quadrumanus were studied in sympathetic neurotransmission. For that, bisected rat vas deferens - a classic model of sympathetic neurotransmission - were incubated with the extracts for further myographic and histopathological analysis. The O. sambaquiensis extract, at 0.1 μg/mL, facilitated the neurogenic contractions of the noradrenergic-rich epididymal portion, while reducing the noradrenaline (NA) potency, which suggests an interaction with postsynaptic α1-adrenoceptors. On the other hand, a higher concentration (1 μg/mL) leads to time- and frequency-dependent blockade of nerve-evoked contractions without significantly changing the response to exogenous NA. In turn, the C. quadrumanus extract at 0.1 μg/mL induced blockade of nerve-evoked noradrenergic contractions while reducing the potency to exogenous NA. Both extracts did not affect the purinergic neurotransmission or induce muscle damages. Our results demonstrate that O. sambaquiensis and C. quadrumanus extracts significantly interfere with the noradrenergic neurotransmission without altering purinergic response or smooth muscle structure on rat vas deferens. Such results bring to light the pharmacological potential of O. sambaquiensis and C. quadrumanus molecules for therapeutics focusing on noradrenergic neurotransmission.

Contribution of sex on the underlying mechanism of the gambling disorder severity.

Significant increasing prevalences have been observed in gambling disorder (GD) in the last decades. This study analyzed the underlying mechanisms of the gambling severity with path analysis (implemented through Structural Equation Modeling, SEM), and assessed the potential moderator effect of the patients' sex. A sample of n = 512 treatment-seeking patients was assessed for sociodemographics and clinical state previously to the treatment. Results obtained in two separate SEM (for men and women) revealed differences in the direct effects and the mediational links. Among the male subsample, higher GD severity was directly related to the higher cognitive bias and the younger age of onset of the problematic gambling, while impulsivity levels and age of onset achieved an indirect effect on the disordered gambling mediated by the cognitive bias. Among females, GD severity was directly increased by younger age of onset, higher cognitive bias and lower self-directedness, while lower socioeconomic positions, and higher levels in harm avoidance achieved an indirect effect on the gambling severity mediated also by the distortions related to the gambling activity. These results provide new empirical evidence for a better understanding of the GD etiology, suggesting that the underlying complex links mediating the GD severity are strongly related to the patients' sex. The results can also contribute to design more effectiveness and precise therapy programs of patient-centered care.

Línguas de Sinais como Línguas de Interlocução: o Lugar das Atividades Comunicativas no Contexto Escolar1 / Sign Languages as Languages ​​of Interlocution: the Place of Communicative Activities in the School Context / Las Lenguas de Signos como Lenguas de Interlocución: el Lugar de las Actividades Comunicativas en el Contexto Escolar1

RESUMO: O desenvolvimento escolar do aluno surdo depende de seu domínio de uma língua de sinais. Todavia, uma língua de sinais não é cotidianamente desenvolvida no ambiente familiar; assim, esse domínio precisa ser alcançado no espaço escolar, no qual se espera que o aluno surdo tenha pares em sua língua e possa interagir por meio dela. Contudo, o ambiente escolar tem pouca tradição de trabalhar com o desenvolvimento de língua oral/língua de sinais, focalizando atividades com língua escrita como meta. Sobre o aluno surdo, pouco se discute acerca do desenvolvimento da língua de sinais no espaço escolar. O professor bilíngue foca seu trabalho no ensino da língua majoritária como segunda língua na modalidade escrita, trabalhando com a língua de sinais, sem uma proposta clara de desenvolvimento dessa língua. Debates sobre práticas para aprimoramento da oralidade para o desenvolvimento do sujeito ouvinte indicaram a oportunidade de refletir sobre esses aspectos em relação aos alunos surdos. O foco deste artigo está, então, no debate desse tema, visando a formação de professores para aprimoramento dos usos da língua de sinais no espaço escolar.

ABSTRACT: The academic development of the deaf student depends on his/her mastery of a sign language. However, a sign language is not developed daily in the family environment; thus, this domain needs to be achieved in the school space, in which it is expected that the deaf student has peers in his/her language and can interact through it. All the same, the school environment has little tradition of working with the development of oral/sign language, focusing on activities with written language as a goal. Regarding the deaf student, little is discussed about the development of sign language in the school space. The bilingual teacher focuses his/her work on teaching the majority language as a second language in the written modality, working with sign language, without a clear proposal for the development of that language. Debates on practices to improve orality for the development of the hearing subject indicated the opportunity to reflect on these aspects in relation to deaf students. The focus of this paper is, therefore, on the debate on this theme, aiming at the training of teachers to improve the uses of sign language in the school space.

RESUMEN: El desarrollo escolar del alumno sordo depende de su dominio de la lengua de signos. Sin embargo, habitualmente, la lengua de signos no se adquiere en el entorno familiar; así, su dominio debe lograrse en el espacio escolar, en el que se espera que el alumno sordo tenga pares en esta lengua y pueda interactuar por medio de ella. Sin embargo, el contexto escolar cuenta con poca tradición de trabajo en el desarrollo de la lengua oral / de signos, focalizándose en actividades con la lengua escrita como meta. Con respecto al estudiante sordo, hay pocos estudios en los que se analice cómo tiene lugar el desarrollo de la lengua de signos en el espacio escolar. El docente bilingüe centra su trabajo en la enseñanza de la lengua mayoritaria como segunda lengua en la modalidad escrita, trabaja con la lengua de signos, pero no siempre sabe cómo promover el desarrollo de esta. La discusión sobre la relevancia de las prácticas para mejorar el desarrollo de la oralidad en los alumnos oyentes nos ofrece la oportunidad de reflexionar sobre estos aspectos en relación con los aprendices sordos. El objetivo de este artículo es, por lo tanto, la discusión sobre este tema para capacitar a los docentes respecto a la mejora de los usos de la lengua de signos en el espacio escolar.

Skin Cancer Prevalence in Outdoor Workers of Ski Resorts.

BACKGROUND: Snow reflectivity and altitude increase the exposure of ski resort workers to solar ultraviolet radiation. The aim was to assess the presence of skin cancer in ski resorts workers and compare it with other groups of outdoor workers reviewing published studies. METHODS: An observational cross-sectional prospective study was conducted in the three largest ski resorts in Spain: Baqueira Beret, Lleida; Formigal, Huesca and Sierra Nevada, Granada. All outdoor workers including ski instructors were invited to participate in the study. The participants completed a validated questionnaire about sun exposure and underwent a skin examination. RESULTS: 219 workers were included in the study (80% male; mean age 43.8 (SD 11.31) years). Actinic keratosis (AK) but no other skin cancers were detected in 32 participants (14.62%). Those with AK worked in the Southernmost ski resort, were more likely to have light colour hair, and were older and with higher photoaging grade than those without them. CONCLUSION: Compared to other studies, outdoor workers on ski resorts show a higher prevalence of AK than general population but a lower prevalence than other groups of outdoor workers.

Prospective comparative study between two first-line regimens for Helicobacter pylori eradication: Non-bismuth quadruple versus bismuth quadruple therapy.

BACKGROUND: The Maastricht V Consensus recommends quadruple therapies as first-line Helicobacter pylori treatment in high clarithromycin (CLA) resistance areas. AIMS: To compare efficacy, side effects and compliance between quadruple concomitant non-bismuth vs bismuth quadruple therapy. METHOD: Prospective study enrolling H. pylori-positive patients. Omeprazol and a three-in-one formulation of bismuth-metronidazol-tetracycline (OBMT-3/1) for 10 days, or combination of omeprazol-clarithromycin-amoxicillin-metronidazol (OCAM) for 14 days, were prescribed. Eradication outcome was assessed by urea breath test or histology. Side effects and compliance were recorded during the treatment period with specific questionnaires. RESULTS: 404 patients were recruited (median age 53 years; 62.87% women). In 382 (183 with OCAM, 199 with OBMT-3/1) the post-treatment test result was available. The eradication rates were 85.94% (CI95%: 80.20-90.52) with OCAM and 88.21% (CI95%: 83.09-92.22) with OBMT-3/1 (p=0.595) in intention-to-treat analysis, whilst in per protocol analysis they were 91.12% (CI95%: 85.78-94.95) and 96.17% (CI95%: 92.28-98.45) respectively (p=0.083). Compliance over 90% was 91.35% with OCAM and 92.04% with OBMT-3/1 (p=0.951). Some side effect was present in 94.02% with OCAM and in 88.89% with OBMT-3/1 (p=0.109), being longer (12 vs 7 days, p<0.0001) and more severe (p<0.0001) with OCAM. CONCLUSIONS: In a high CLA-resistance area, there are no differences between OBMT-3/1 and OCAM in H. pylori eradication and compliance rates, but OBMT-3/1 achieves a higher safety profile.

Moderator effect of sex in the clustering of treatment-seeking patients with gambling problems.

BACKGROUND: There are no studies based on a person-centered approach addressing sex-related differences in the characteristics of treatment-seeking patients with gambling disorder (GD). The main objective of the current study is to identify empirical clusters of GD based on several measures of the severity of gambling behavior, and considering the potential role of patient sex as a moderator. METHODS: An agglomerative hierarchical clustering method was applied to an adult sample of 512 treatment-seeking patients (473 men and 39 women) by using a combination of the Schwarz Bayesian Information Criterion and log-likelihood function. RESULTS: Three clusters were identified in the subsample of men: cluster M1 (low-mild gambling severity level, 9.1%), cluster M2 (moderate level, 60.9%), and cluster M3 (severe level, 30.0%). In the women subsample, two clusters emerged: cluster W1 (mild-moderate level, 64.1%), and cluster W2 (severe level, 35.9%). The most severe GD profiles were related to being single, multiple gambling preference for nonstrategic plus strategic games, early onset of the gambling activity, higher impulsivity levels, higher dysfunctional scores in the personality traits of harm avoidance, and self-directedness, and higher number of lifespan stressful life events (SLE). Differences between the empirical men and women clusters were found in different sociodemographic and clinical measurements. CONCLUSIONS: Men and women have distinct profiles regarding gambling severity that can be identified by a clustering approach. The sociodemographic and clinical characterization of each cluster by sex may help to establish specific preventive and treatment interventions.

A systematic and comprehensive review of internet use in cancer patients: Psychological factors.

OBJECTIVES: Online resources are changing patient-professional relationship and care delivery by empowering patients to engage in decisions in order to cope with their illness and modify behaviors. This review analyses the psychological factors associated with spontaneous and health professional-guided internet use in cancer patients. METHODS: Searches were performed in the PubMed (MEDLINE), PsycINFO, and Scopus databases. Studies were included if they involved cancer patients or focused on the relationship between cancer patients and health professionals, describing either patients' spontaneous use of interne or a guided-structured eHealth psychosocial intervention. RESULTS: Seventy-seven scientific papers were finally included. Results described emotional and behavioral outcomes in cancer patients who accessed online information. Internet has long been used spontaneously not only as a source of medical information or symptom management but also for decision making or emotional and social support. Health professionals can guide internet use, providing specific web-based recommendations and developing intervention programs to better meet patients' needs, such as educational or information programs. CONCLUSION: Online access is a complementary form of care that physicians can provide. Patients benefit from online resources, especially when both they and their health professionals increase their engagement with online interventions such as integrated systems or online communities.