Fear of COVID-19: the mediation role between the COVID-19 diagnosis and KAP in Spanish university students.

BACKGROUND: Although health public services recommend prevention strategies for COVID-19 some of these recommendations have not been taken seriously by young people. Understanding why some people comply with these recommendations and others do not seem to be crucial in helping public health services to predict behavior and compliance with rules, especially for young people. Previous studies suggest that knowledge, attitudes, and practices (KAP) are useful to assess compliance with the preventive measures and public health policies. Being afraid has also been found to correlate with more engagement with preventive measures. This study aims to assess the KAP and fear of COVID-19 of Spanish university students and to understand the relation between diagnosis, KAP and the level of fear. METHOD: Participants of this cross-sectional study were 598 college students (69.4% women) from different Spanish Universities. Data were collected for a month using an online questionnaire through Sphinx iQ2. RESULTS: Levels of KAP among Spanish students were satisfactory and results suggest the presence of fear among them. More importantly, fear of COVID-19 mediated the impact of the diagnosis on the KAP. CONCLUSIONS: Feeling fear seems to be the mechanism underlying the relationship between diagnosis and KAP. Diagnosis is associated with KAP when the diagnosis it is accompanied by measures of fear. KAP, diagnosis, or perceived fear of COVID must be taken together in consideration for health interventions and public health campaigns design.

Neural cue-reactivity in pathological gambling as evidence for behavioral addiction: a systematic review.

Increasing incidence of problem gambling has led to prioritizing the problem from the point of view of public health. Additionally, gambling disorder has been recently classified as a behavioral addiction, with implications for both its diagnosis and treatment. However, the shared neural substrate of addictions, to substances and behavioral, is still discussed. Thus, this systematic review aims to provide up-to-date knowledge from the past five years (2017-2022) concerning the neural correlates of gambling related stimuli (cue-reactivity) on the basis of a previous review (Brevers et al., Cognitive, Affective and Behavioral Neuroscience 18:718-729, 2019). A total of five studies were included in the review. Activation of brain areas related to memory, reward and executive functions could be the underlying mechanism of this behavioral addiction. Specifically, nucleus accumbens and striatum (ventral and dorsal), parahippocampal regions, the right amygdala and several prefrontal cortex regions have systematically been found more active in those subjects exposed to gambling-related cues. Also, the insula could play a pivotal role connecting these three systems in a highly integrated neural network with several implications for reward processing modulation, associative learning and top-down attentional regulation to improve saliency of addiction-related cues. These results are consistent with previous findings on other substance addictions, such as alcohol, tobacco, marijuana or cocaine. The study of neural reactivity to stimuli related to addiction could be useful as a biomarker of the severity of the disorder, the efficacy of the treatment, the risk of relapse, in addition to being an objective criterion to measure the effectiveness of prevention campaigns.

Post-traumatic cognitions and quality of life in terrorism victims: the role of well-being in indirect versus direct exposure.

BACKGROUND: The effect of indirect (versus direct) exposure to a traumatic event on the quality of life of terrorist attack victims has received considerable attention in the literature. However, more research is required to examine whether the symptoms and underlying processes caused by both types of exposure are equivalent. Our main hypothesis is that well-being plays a different role depending on indirect vs. direct trauma exposure. METHODS: In this cross-sectional study, eighty direct victims of 11-M terrorist attacks (people who were traveling in trains where bombs were placed) and two-hundred indirect victims (individuals highly exposed to the 11-M terrorist attacks through communications media) voluntarily participated without compensation. To test our hypothesis regarding the mediating role of indirect exposure, we conducted a biased corrected bootstrapping procedure. To test our hypothesis regarding the moderating role of direct exposure, data were subjected to a hierarchical regression analysis. RESULTS: As predicted, for indirect trauma exposure, well-being mediated the relationship between post-traumatic dysfunctional cognitions and trauma symptoms. However, for direct trauma exposure, well-being moderated the relationship between post-traumatic dysfunctional cognitions and trauma symptoms. CONCLUSIONS: The results of our study indicate that the different role of well-being found between indirect (causal factor) and direct exposure (protective factor) should be taken into consideration in interventions designed to improve victims' health.

Disturbances of Wnt/ß-catenin pathway and energy metabolism in early CKD: effect of phosphate binders.

BACKGROUND: Mineral bone disorder (MBD) is an early complication of chronic kidney disease (CKD), with complex interactions in the bone-kidney-energy axis. These events lead to impaired bone remodelling, which in turn is associated with cardiovascular disease. Recently, we reported on a positive effect of phosphate binder treatment on bone remodelling markers and a reduction in serum FGF-23 levels in predialysis-CKD patients. The goal of the present study of this trial was to examine the effects of phosphate binders on energy-regulating hormones and Wnt pathway. METHODS: In this present post hoc analysis of the above randomized, open-label, 8-week trial, which compared the effects of increasing doses of sevelamer-HCl or calcium acetate on various CKD-MBD parameters in 40 normophosphatemic CKD Stage 3-4 patients, we measured serum sclerostin, Dickkopf-1, leptin, adiponectin and serotonin concentrations. RESULTS: Serum sclerostin, Dickkopf-1 and leptin were elevated at baseline despite normal calcium, phosphorus levels and daily urinary phosphorus excretion. There were significant and positive correlations between sclerostin and FGF-23, as well between leptin and Dickkopf-1. Treatment with both phosphate binders led to a significant decrease in phosphate overload. However, sevelamer-HCl, but not with calcium acetate, led to a significant decrease in serum FGF-23, sclerostin and leptin, and to a significant increase in bone alkaline phosphatase levels. CONCLUSIONS: Early stages of CKD are associated with an impairment of the Wnt pathway, as reflected by elevated sclerostin, and a dysregulation of energy-regulating hormones. Many of these disturbances can be ameliorated by phosphate binder treatment, more with sevelamer-HCl than with calcium acetate.

Fibroblast growth factor 23 in hemodialysis patients: effects of phosphate binder, calcitriol and calcium concentration in the dialysate.

BACKGROUND: Fibroblast growth factor 23 (FGF23) concentrations increase early in chronic kidney disease (CKD), and the influence of current CKD-mineral and bone disorder (MBD) therapies on serum FGF23 levels is still under investigation. METHODS: In this post-hoc analysis of a randomized clinical trial, phosphate binders and calcitriol were washed out of 72 hemodialysis patients who were then submitted to bone biopsy, coronary tomography and biochemical measures, including FGF23. They were randomized to receive sevelamer or calcium acetate for 1 year and the prescription of calcitriol and the calcium concentration in the dialysate were adjusted according to serum calcium, phosphate and PTH and bone biopsy diagnosis. RESULTS: At baseline, bone biopsy showed that 58.3% had low-turnover bone disease, whereas 38.9% had high-turnover bone disease, with no significant differences between them with regard to FGF23. Median baseline FGF23 serum levels were elevated and correlated positively with serum phosphate. After 1 year, serum FGF23 decreased significantly. Repeated measures ANOVA analysis showed that the use of a 3.5-mEq/l calcium concentration in the dialysate, as well as the administration of calcitriol and a calcium-based phosphate binder were associated with higher final serum FGF23 levels. CONCLUSIONS: Taken together, our results confirm that the current CKD-MBD therapies have an effect on serum levels of FGF23. Since FGF23 is emerging as a potential treatment target, our findings should be taken into account in the decision on how to manage CKD-MBD therapy.

The evaluation of green companies changes after remembering tip of the tongue experiences.

BACKGROUND: This research explores the extent to which attitudes towards an environmentally-friendly topic (a green company) are affected by a “tip of the tongue” (TOT) experience. METHOD: In this experiment, participants were first exposed to a description of a green company that elicited mostly positive or negative thoughts. As part of an apparently unrelated study, participants were then asked to describe an experience of TOT that either was or was not successfully resolved. The recalling task was independent from the thoughts about the company. Finally, participants reported their attitudes toward the green company for which they initially listed thoughts. RESULTS: Participants who recalled resolving a TOT experience relied on their thoughts about the initial (unrelated) green company more in forming their evaluations than did participants who recalled an unresolved TOT experience. CONCLUSION: Attitudes can be affected by thinking about an unrelated past meta-cognitive experience.

Feelings of ease and attitudes toward healthy foods.

BACKGROUND: The successful impact of health campaigns often depends on the extent to which interventions are effective in changing attitudes. The goal of the present research was to examine to what extent the ease adolescents experience in generating thoughts can influence persuasion in the domain of a health-relevant topic. METHOD: Participants were asked to generate either positive or negative thoughts about the Mediterranean diet. The spontaneous feeling of ease with which participants generated those thoughts was assessed for each participant. The impact of these two independent variables on attitudes toward the Mediterranean diet was examined. RESULTS: Participants who reported relatively higher (vs. lower) subjective ease experiences in the thought-listing task showed a greater effect of thought direction on attitudes toward the diet. CONCLUSION: This study demonstrates the importance of considering not only the thoughts people have with regard to health but also the subjective experiences and metacognitive feelings associated with those thoughts.

The evaluation of green companies changes after remembering tip of the tongue experiences / La evaluación de empresas verdes cambia a partir del recuerdo de experiencias de la punta de la lengua

Background: This research explores the extent to which attitudes towards an environmentally-friendly topic (a green company) are affected by a "tip of the tongue" (TOT) experience. Method: In this experiment, participants were first exposed to a description of a green company that elicited mostly positive or negative thoughts. As part of an apparently unrelated study, participants were then asked to describe an experience of TOT that either was or was not successfully resolved. The recalling task was independent from the thoughts about the company. Finally, participants reported their attitudes toward the green company for which they initially listed thoughts. Results: Participants who recalled resolving a TOT experience relied on their thoughts about the initial (unrelated) green company more in forming their evaluations than did participants who recalled an unresolved TOT experience. Conclusion: Attitudes can be affected by thinking about an unrelated past meta-cognitive experience (AU)

Antecedentes: la presente investigación explora en qué medida las actitudes hacia un tema relativo al medioambiente (una empresa verde) están afectadas por el recuerdo de una experiencia pasada del fenómeno de la "punta de la lengua" (tip of the tongue; TOT). Método: los participantes leyeron una descripción de una empresa ecológica diseñada para producir pensamientos positivos o pensamientos negativos hacia la misma. A continuación se pidió a los participantes que pensaran sobre situaciones pasadas en las que habían experimentado una experiencia de TOT que fueron capaces de resolver resuelta o que no pudieron resolver. Finalmente, todos los participantes indicaron sus actitudes hacia la empresa verde sobre la que habían listado pensamientos inicialmente. Resultados: los participantes que recordaron haber resuelto la experiencia pasada de TOT usaron más los pensamientos que tenían en ese momento hacia la empresa comparado con aquellos que recordaron una experiencia TOT que no fueron capaces de resolver. Conclusión: las actitudes pueden variar en función del recuerdo de experiencias meta-cognitivas pasadas, aunque sean sobre temas no relacionados (AU)

Phosphorus is associated with coronary artery disease in patients with preserved renal function.

High serum phosphorus levels have been associated with mortality and cardiovascular events in patients with chronic kidney disease and in the general population. In addition, high phosphorus levels have been shown to induce vascular calcification and endothelial dysfunction in vitro. The aim of this study was to evaluate the relation of phosphorus and coronary calcification and atherosclerosis in the setting of normal renal function. This was a cross-sectional study involving 290 patients with suspected coronary artery disease and undergoing elective coronary angiography, with a creatinine clearance >60 ml/min/1.73 m(2). Coronary artery obstruction was assessed by the Friesinger score and coronary artery calcification by multislice computed tomography. Serum phosphorus was higher in patients with an Agatston score >10 than in those with an Agatston score ≤ 10 (3.63 ± 0.55 versus 3.49 ± 0.52 mg/dl; p = 0.02). In the patients with Friesinger scores >4, serum phosphorus was higher (3.6 ± 0.5 versus 3.5 ± 0.6 mg/dl, p = 0.04) and median intact fibroblast growth factor 23 was lower (40.3 pg/ml versus 45.7 pg/ml, p = 0.01). Each 0.1-mg/dl higher serum phosphate was associated with a 7.4% higher odds of having a Friesinger score >4 (p = 0.03) and a 6.1% greater risk of having an Agatston score >10 (p = 0.01). Fibroblast growth factor 23 was a negative predictor of Friesinger score (p = 0.002). In conclusion, phosphorus is positively associated with coronary artery calcification and obstruction in patients with suspected coronary artery disease and preserved renal function.

Feelings of ease and attitudes toward healthy food / Experiencia de facilidad y actitudes hacia la alimentación saludable

BACKGROUND: The successful impact of health campaigns often depends on the extent to which interventions are effective in changing attitudes. The goal of the present research was to examine to what extent the ease adolescents experience in generating thoughts can influence persuasion in the domain of a health-relevant topic. METHOD: Participants were asked to generate either positive or negative thoughts about the Mediterranean diet. The spontaneous feeling of ease with which participants generated those thoughts was assessed for each participant. The impact of these two independent variables on attitudes toward the Mediterranean diet was examined. RESULTS: Participants who reported relatively higher (vs. lower) subjective ease experiences in the thought-listing task showed a greater effect of thought direction on attitudes toward the diet. CONCLUSION: This study demonstrates the importance of considering not only the thoughts people have with regard to health but also the subjective experiences and metacognitive feelings associated with those thoughts

ANTECEDENTES: el éxito de las campañas sobre salud depende en parte del grado en que son efectivas cambiando las actitudes de las personas. El objetivo del presente estudio fue examinar en qué medida la facilidad con la que los adolescentes generan sus pensamientos puede influir sobre la persuasión en el dominio de las campañas de promoción de hábitos saludables. MÉTODO: se pidió a los participantes que generaran argumentos positivos o negativos acerca de la dieta mediterránea. Se midió la facilidad con la que los participantes percibieron generar esos pensamientos. El impacto de estas dos variables independientes fue examinado en relación con sus actitudes hacia la dieta mediterránea. RESULTADOS: los participantes que informaron una mayor (vs. menor) facilidad subjetiva a la hora de generar los pensamientos mostraron un mayor efecto de la dirección de los mismos sobre las actitudes hacia la dieta. CONCLUSIONES: este estudio muestra la importancia de considerar no solo los pensamientos que las personas generan en relación con la salud, sino también las experiencias meta-cognitivas asociadas a esos pensamientos

Early control of PTH and FGF23 in normophosphatemic CKD patients: a new target in CKD-MBD therapy?

BACKGROUND AND OBJECTIVES: Levels of parathyroid hormone (PTH) and the phosphaturic hormone FGF23, a fibroblast growth factor (FGF) family member, increase early in chronic kidney disease (CKD) before the occurrence of hyperphosphatemia. This short-term 6-wk dose titration study evaluated the effect of two phosphate binders on PTH and FGF23 levels in patients with CKD stages 3 to 4. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Patients were randomized to receive over a 6-wk period either calcium acetate (n = 19) or sevelamer hydrochloride (n = 21). RESULTS: At baseline, patients presented with elevated fractional excretion of phosphate, serum PTH, and FGF23. During treatment with both phosphate binders there was a progressive decline in serum PTH and urinary phosphate, but no change in serum calcium or serum phosphate. Significant changes were observed for FGF23 only in sevelamer-treated patients. CONCLUSIONS: This study confirms the positive effects of early prescription of phosphate binders on PTH control. Prospective and long-term studies are necessary to confirm the effects of sevelamer on serum FGF23 and the benefits of this decrease on outcomes.

KDIGO CKD-MBD Discussion forum: the Brazilian perspective.

On November 14th, 2009, the Brazilian Society of Nephrology coordinated the Brazilian Discussion Meeting on the new KDIGO (Kidney Disease: Improving Global Outcomes) guidelines. The purpose of this meeting, which was attended by 64 nephrologists, was to discuss these new guidelines from the Brazilian perspective. This meeting was supported by an unrestricted grant of the biotechnology company Genzyme, which did not have access to the meeting room or to the discussion sections. This article brings a summary of the KDIGO guidelines and of the discussions by the attendees.

KDIGO CKD-MBD Discussion forum: the Brazilian perspective / Fórum nacional de discussão das diretrizes do KDIGO para o distúrbio mineral e ósseo da doença renal crônica (DMO-DRC): uma análise crítica frente à relidade Brasileira

No dia 14 de novembro de 2009, a Sociedade Brasileira de Nefrologia promoveu um fórum de discussão das novas diretrizes do KDIGO (Kidney Disease: Improving Global Outcomes). O objetivo desse encontro, onde estiveram presentes 64 participantes, foi discutir estas novas diretrizes diante da realidade brasileira. Esse encontro teve o patrocínio da Empresa de Biotecnologia Genzyme, que não teve acesso à sala de discussão e tampouco aos temas tratados durante o evento. Este artigo traz um resumo das diretrizes do KDIGO e das discussões realizadas pelos participantes.

On November 14th, 2009, the Brazilian Society of Nephrology coordinated the Brazilian Discussion Meeting on the new KDIGO (Kidney Disease: Improving Global Outcomes) guidelines. The purpose of this meeting, which was attended by 64 nephrologists, was to discuss these new guidelines from the Brazilian perspective. This meeting was supported by an unrestricted grant of the biotechnology company Genzyme, which did not have access to the meeting room or to the discussion sections. This article brings a summary of the KDIGO guidelines and of the discussions by the attendees.

Pioureterohidronefrosis / Pioureterohydronephrosis

Se presenta un caso clínico y los hallazgos imagenológicos de una pioureterohidronefrosis en una paciente de 4 años de edad, sin antecedentes patológicos, con historia de 5 días de evolución con dolor abdominal, fiebre de 38,2ºC, dolor en hipocondrio y flanco izquierdo con ocupación del fondo de saco lateral izquierdo al tacto rectal.

A case of a 4 year old girl with no pathologic background, with pyoureterohydronephrosis is presented. The history was 5 days of abdominal pain and fever (38,2 Cº), and an occupation of the left recess in the rectal digital examination.Imagenologic studies demonstrate pyoureterohydronephrosis.

Avaliação da relação entre metabolismo mineral e doença arterial coronariana em pacientes com função renal preservada / Evaluation of the relationship between mineral metabolism and coronary artery disease in patients with preserved renal function

INTRODUÇÃO: Os níveis séricos de fósforo (P) têm sido associados a doenças cardiovasculares e mortalidade em pacientes com doença renal crônica e na população geral. Estudos in vitro demonstram que altas concentrações de fósforo extracellular são capazes de induzir calcificação vascular e disfunção endotelial. O Fibroblast Growth Factor 23 (FGF-23) é um hormônio fosfatúrico e foi relacionado à presença de aterosclerose em pacientes idosos. OBJETIVO: O objetivo deste estudo foi investigar as relações entre P, FGF-23 e outros atores do metabolismo mineral e a ocorrência de doença arterial coronariana em pacientes com função renal preservada. MÉTODOS: Duzentos e noventa pacientes clinicamente estáveis com indicação de cineangiocoronariografia eletiva e clearance de creatinina superior a 60 ml/min/1.73 m2 foram submetidos à Tomografia Computadorizada Multislice para avaliação da calcificação coronariana e coleta de sangue para dosagens bioquímicas. A calcificação coronariana foi quantificada através do Escore de Agatston (EA) e os Escores de Friesinger e Gensini foram calculados para quantificar a obstrução coronariana. RESULTADOS: A média de idade dos pacientes foi 58,1± 9,3 anos, 81% eram hipertensos e 35,5% diabéticos. Os pacientes foram divididos em grupos de acordo com o EA utilizando-se como ponto de corte o valor de 10 Unidades Hounsfield (HU). O P sérico foi maior no grupo de pacientes com EA > 10 HU (3,63 0,55 vs 3,49 0,52mg/dL; p=0,019). Cada 1 mg/dL de elevação no P sérico associou-se a um aumento de 92% no risco de apresentar o EA > 10HU [Odds Ratio (OR) =1,92, CI 1,56-3,19; p=0,01]. Quando os pacientes foram divididos de acordo com a mediana do Escore de Friesinger (4 pontos), o grupo com valores superiores à mediana apresentou P sérico maior (3,6 0,5 vs. 3,5 0,6 mg/dl; p=0,04) e FGF-23 menor (mediana 40,3 pg/mL intervalo interquartil 24,1-62,2 vs. 45,7 pg/mL intervalo interquartil 31,7-76,1; p=0,01) quando comparado àquele com valores...

INTRODUCTION: Serum phosphorus (P) has been associated with cardiovascular diseases and mortality in chronic kidney disease patients and in the general population. In vitro studies suggest that excessive phosphorus induces vascular calcification and endothelial dysfunction. Fibroblast growth factor 23 (FGF-23) is a phosphaturic hormone and has been correlated to atherosclerosis in the community. AIM: This study intended to investigate the associations between P, FGF-23 and other mineral metabolism players and coronary artery disease in patients with preserved renal function. METHODS: Two-hundred ninety patients with a creatinine clearance higher than 60ml/min/1,73m2 undergoing elective coronary angiography were submitted to Multislice Computed Tomography in order to evaluate coronary calcification and blood was collected for biochemical analyses. Coronary artery calcification was quantified using the Agatston Score (AS). Friesinger (FS) and Gensini Scores (GS) were calcutalet to quantify coronary obstruction. RESULTS: Considering the whole population, mean age was 58.1±9.3 anos, 81% were hypertensive and 35.5% were diabetics. Patients were divided according to AS using the value of 10 Hounsfield Units (HU) as the cutoff.point. Serum phosphorus was higher in patients with an AS > 10HU when compared to the group with an AS 10 HU (3.63 0.55 vs 3.49 0.52mg/dL, p=0.019). Each 1 mg/dL of elevation in the serum phosphorus implied a 92% additional risk of presenting an AS > 10 HU [Odds Ratio (OR) =1.92, CI 1.56-3.19; p=0.01]. Patients were also divided using the median Friesinger score (4 points) as the cutoff value. Serum phosphorus was higher (3.6 0.5 vs. 3.5 0.6 mg/dl, p=0.04) and intact FGF-23 was lower (median 40.3 interquartile range 24.1-62.2 pg/mL vs. 45.7 interquartile range 31.7- 76.1 pg/mL, p=0.01) in the FS > 4 group. Patientis in the higher Gensini Score tertile presented elevated serum phosphorus when compared to the other groups (p<0,05). In the...