Validation of the Spanish Acute Cystitis Symptoms Score (ACSS) in native Spanish-speaking women of Europe and Latin America.

INTRODUCTION AND OBJECTIVES: The Acute Cystitis Symptom Score (ACSS) is a patient self-reporting questionnaire for clinical diagnostics and patient-reported outcome (PRO), which may assess the symptoms and the effect on the quality of life in women with acute cystitis (AC). The current study aimed to create a validated Spanish version of the ACSS questionnaire. MATERIAL AND METHODS: The process of linguistic validation of the Spanish version of the ACSS consisted of the independent forward and backward translations, revision and reconciliation, and cognitive assessment. Clinical evaluation of the study version of the ACSS was carried out in clinics in Spain and Latin America. Statistical tests included the calculation of Cronbach's α, split-half reliability, specificity, sensitivity, diagnostic odds ratio, positive and negative likelihood ratio, and area under the receiver-operating characteristic curve (AUC). RESULTS: The study was performed on 132 patients [age (mean;SD) 45.0;17.8 years] with AC and 55 controls (44.5;12.2 years). Cronbach's α of the ACSS was 0.86, and the split-half reliability was 0.82. The summary scores of the ACSS domains were significantly higher in patients than in controls, 16.0 and 2.0 (p < 0.001), respectively. The predefined cut-off point of ≥6 for a summary score of the "Typical" domain resulted in a specificity of 83.6% and a sensitivity of 99.2% for the Spanish version of the ACSS. AUC was 0.91 [0.85; 0.97]. CONCLUSIONS: The validated Spanish ACSS questionnaire evaluates the symptoms and clinical outcomes of patients with AC. It can be used as a patient's self-diagnosis of AC, as a PRO measure tool, and help to rule out other pathologies in patients with voiding syndrome.

Systematic Review and Meta-Analysis Provide no Guidance on Management of Asymptomatic Bacteriuria within the First Year after Kidney Transplantation.

(1) Background: Urinary tract infections (UTIs) are among the most frequent complications in kidney transplant (KT) recipients. Asymptomatic bacteriuria (ASB) may be a risk factor for UTIs and graft rejection. We aimed to evaluate available evidence regarding the benefit of screening and treatment of ASB within the first year after KT. (2) Evidence acquisition: A systematic literature search was conducted in MEDLINE, the Cochrane Library CENTRAL and Embase. Inclusion criteria were manuscripts in English addressing the management of ASB after KT. The PICO questions concerned Patients (adults receiving a KT), Intervention (screening, diagnosis and treatment of ASB), Control (screening and no antibiotic treatment) and Outcome (UTIs, sepsis, kidney failure and death). (3) Evidence synthesis: The systematic review identified 151 studies, and 16 full-text articles were evaluated. Seven were excluded because they did not evaluate the effect of treatment of ASB. There was no evidence for a higher incidence of lower UTIs, acute pyelonephritis, graft loss, or mortality in patients not treated with antibiotics for ASB. Analysis of comparative non-randomized and observational studies did not provide supplementary evidence to guide clinical recommendations. We believe this lack of evidence is due to confounding risk factors that are not being considered in the stratification of study patients.

Practice Patterns in Fournier's Gangrene in Europe and Implications for a Prospective Registry Study.

BACKGROUND: Fournier's gangrene (FG) is a life-threatening, necrotizing infection. Due to the rareness of the disease, it is challenging to plan robust prospective studies. This study aims to describe current practice patterns of FG in Europe and identify implications for planning a prospective FG registry. METHODS: Online non-validated 17-items survey among urologists treating FG in in European hospitals. Questionnaires were analyzed with LimeSurvey (LimeSurvey GmbH Hamburg, Germany). RESULTS: 229 responses from ten different European countries were submitted, and 117 (51.1%) urologists completed the questionnaire. The departments treat a mean of 4.2 (SD 3.11) patients per year. The urology department mostly takes the lead in treating FG patients (n = 113; 96.6%). The practice in FG is very heterogenic and mostly case-based all over Europe, e.g., vacuum-assisted wound closure (VAC) is mostly used (n = 50; 42.7%) as adjunct wound. The biggest challenges in FG are the short time to diagnosis and treatment, standardization and establishment of guidelines, and disease awareness. Additionally, participants stated that an international registry is an outstanding initiative, and predictive models are needed. CONCLUSIONS: There is no standard of care in the diagnosis, treatment, and long-term care of FG all over Europe. Further research could be conducted with a prospective registry.

Non-Antibiotic Prophylaxis for Recurrent UTIs in Neurogenic Lower Urinary Tract Dysfunction (NAPRUN): Study Protocol for a Prospective, Longitudinal Multi-Arm Observational Study.

INTRODUCTION: Patients with neurogenic lower urinary tract dysfunction (NLUTD) reliant on intermittent self-catheterization for bladder emptying are at an increased risk of recurrent urinary tract infections (rUTI). So far, the most common practice in the prevention of rUTIs is long-term low-dose antibiotic prophylaxis, phytotherapy, and immunomodulation, whereby antibiotic prophylaxis inevitably leads to the emergence of drug-resistant pathogens and difficulty in treating infections. Therefore, non-antibiotic alternatives in the prevention of rUTIs are urgently required. We aim to identify the comparative clinical effectiveness of a non-antibiotic prophylaxis regimen in the prevention of recurrent urinary tract infections in patients with neurogenic bladder dysfunction who practice intermittent self-catheterization. METHODS AND ANALYSIS: In this multi-centre, prospective longitudinal multi-arm observational study, a total of 785 patients practising intermittent self-catheterisation due to NLUTD will be included. After inclusion, non-antibiotic prophylaxis regimens will be instilled with either UroVaxom® (OM-89) standard regimen, StroVac® (bacterial lysate vaccine) standard regimen, Angocin®, D-mannose (oral dose 2 g), bladder irrigation with saline (once per day). The management protocols will be pre-defined, but the selection of the protocol will be at the clinicians' discretion. Patients will be followed for 12 months from the onset of the prophylaxis protocol. The primary outcome is to identify the incidence of breakthrough infections. The secondary outcomes are adverse events associated with the prophylaxis regimens and the severity of breakthrough infections. Other outcomes include the exploration of change in susceptibility pattern via the optional rectal and perineal swab, as well as health-related quality of life over time (HRQoL), which will be measured in a random subgroup of 30 patients. ETHICS AND DISSEMINATION: Ethical approval for this study has been granted by the ethical review board of the University Medical Centre Rostock (A 2021-0238 from 28 October 2021). The results will be published in a peer-reviewed journal and presented at relevant meetings. STUDY REGISTRATION NUMBER: German Clinical Trials Register: Number DRKS00029142.

Epidemiology and antifungal susceptibility of bloodstream fungal isolates in pediatric patients: a Spanish multicenter prospective survey.

Data on fungemia epidemiology and antifungal susceptibility of isolates from children are scarce, leading frequently to pediatric empirical treatment based on available adult data. The present study was designed to update the epidemiological, mycological, and in vitro susceptibility data on fungal isolates from children with fungemia in Spain. All fungemia episodes were identified prospectively by blood culture over 13 months at 30 hospitals. Tests of susceptibility to amphotericin B, flucytosine, fluconazole, itraconazole, posaconazole, voriconazole, anidulafungin, caspofungin, and micafungin were performed at participant institutions by a microdilution colorimetric method. New species-specific clinical breakpoints for fluconazole, voriconazole, and echinocandins were also applied. A total of 203 episodes of fungemia in 200 children were identified. A higher proportion of fungal isolates was from general wards than intensive care units (ICU). Candida parapsilosis (46.8%), Candida albicans (36.5%), Candida tropicalis (5.9%), Candida glabrata (3.9%), and Candida guilliermondii (2.5%) were the leading species. C. parapsilosis was the predominant species except in neonates. C. albicans was the most frequent in neonatal ICU settings (51.9%). Intravascular catheter (79.3%), surgery (35%), prematurity (30%), and neutropenia (11%) were the most frequent predisposing factors. Most Candida isolates (95.1%) were susceptible to all antifungals. When the new species-specific clinical breakpoints were applied, all C. parapsilosis isolates were susceptible to echinocandins except one, which was micafungin resistant. This is the largest published series of fungemia episodes in the pediatric setting. C. parapsilosis is the most prevalent species in Spain, followed by C. albicans and C. tropicalis. Resistance to azole and echinocandin agents is extremely rare among Candida species. The fluconazole resistance rate in Spain has decreased in the last 10 years.

[Erythrovirus B19 infection]. / Infección por Erythrovirus B19.

Erythrovirus B19 has been associated with an expanding range of clinical disorders since its identification as the etiological agent of erythema infectiosum, or fifth disease of childhood: acute arthropathy, dermatologic manifestations, chronic anemia in immunocompromised patients, and transient aplastic crisis in individuals with underlying chronic hemolytic disorders. Furthermore, exposure to and infection by B19 virus can lead to serious complications during pregnancy, which may result in fetal anemia, spontaneous abortion, and hydrops fetalis. Consequently, the B19 immune status of pregnant women should be routinely determined. Because many immunocompromised patients with chronic anemia will respond positively to intravenous immunoglobulin therapy, laboratory confirmation of B19 infection is required. Since Erythrovirus B19 cannot be routinely grown in vitro, diagnostic methods for detecting the presence of B19 by molecular techniques or by investigating the specific immune response should be considered in clinical microbiology laboratories.

Adding support to cross-cultural emotional assessment: validation of the International Affective Picture System in a Chilean sample / Un apoyo a la evaluación transcultural de la emoción: validación del International Affective Picture System en una muestra chilena

El presente estudio tiene como objetivo validar un conjunto de imágenes del International Affective Picture System (IAPS) de Lang, Bradley y Cuthbert, 2005 -un instrumento ampliamente utilizado en investigación afectiva- en una muestra chilena, así como comparar sus resultados con aquellos obtenidos en el estudio estadounidense, en vistas a contribuir a su validación intercultural. Se utilizó una muestra de 135 estudiantes universitarios, quienes evaluaron 188 imágenes en las dimensiones de valencia y arousal, de acuerdo con instrucciones estándar. Los resultados muestran la organización esperada de la afectividad, con variaciones entre sexos en la valoración de valencia, y diferencias entre países en la dimensión de arousal. Se concluye que la adaptación chilena del IAPS es consistente con los estudios previos, lo cual añade evidencia a favor de su validez intercultural.

The present study aimed to obtain a valid set of images of the International Affective Picture System (Lang, Bradley & Cuthbert, 2005) –a widely used instrumentation in emotion research- in a Chilean sample, as well as comparing these results with those obtained from the US study in order to con tribute to its cross-cultural validation. A sample of 135 college students assessed 188 pictures according to standard instructions in valence and arousal dimensions. The results showed the expected organization of affectivity, with variations between sex in valence judgments, and differences between countries in the arousal dimension. It is concluded that the Chilean adaptation of the IAPS is consistent with the previous evidence, adding support to it cross-cultural validity.

Las estrategias para prevenir el consumo de drogas ilícitas deben aplicarse a temprana edad / Factors associated with the consumption of illicit drugs in students aged 9 to 14 years

Cada día más jóvenes consumen drogas y cada vez a menor edad. Debido al estigma social y la penalización, los estudios sobre drogas ilícitas (DI) requieren metodologías que disminuyan la subdeclaración. Con el objetivo de identificar factores asociados con el consumo de DI en escolares, 234 estudiantes de 4º a 7º básico (9-14 años) fueron evaluados por 12 estudiantes del mismo colegio (metodología de pares) sobre consumo de drogas mediante un instrumento validado (entrevista estructurada). Quienes habían consumido drogas ilícitas fueron comparados con los no consumidores para identificar factores asociados con dicha conducta. Resultados: El 22.5% declaró haber consumido tabaco, 18.5% alcohol y el 3.5% drogas ilícitas durante el año previo. El grupo de consumidores de DI, tenía una edad promedio de inicio al consumo de tabaco y alcohol significativamente menor (p < 0.05) que el grupo no consumidor, y valores significativamente mayores para: consumo de drogas lícitas (DL), tabaco y alcohol en el último mes; consumo en el último año de DL y tabaco; número cigarrillos/semana y frecuencia semanal de consumo de alcohol. Conclusión: El creciente consumo infantil de DI se relaciona con un mayor número de niños que consumen DL a edades progresivamente menores. Para prevenir el consumo de DI en adolescentes, las estrategias deben comenzar en edades más tempranas, pues el problema ya está presente a los 9-14 años, centrándose en los niños con las conductas de riesgo señaladas.

Aportes del Darwinismo a la psicología clínica: el paradigma de la psicología evolucionista / Contributions of Darwinism to clinical psychology: the evolutionary psychology paradigm

El presente artículo hace una breve descripción de la integración multidisciplinaria que se ha originado en los últimos años con la inclusión de la Teoría de la Evolución de Darwin a la comprensión de la Psicología . Revisando los principios fundamentales de la Teoría de la Evolución, así como la influencia del Darwinismo al desarrollo de la Psicología moderna, se plantea la necesidad de considerar la influencia evolucionista en el marco de la Psicología Clínica Iberoamericana. Finalmente, se ilustra la utilidad del Darwinismo para la Psicología Clínica, aplicando a la explicación de diferencias sexuales en la selección de pareja y experiencias de celos, el autismo, la depresión y la anorexia nerviosa, lo que amerita una reconsideración del significado de la psicopatología con una mirada adaptacionista.