Efficacy of Omalizumab for the treatment of Bullous Pemphigoid. Spanish multicenter real-world experience.

BACKGROUND: Bullous Pemphigoid (BP) is the most common autoimmune blistering disease. Most patients are elderly and associate multiple comorbidities. Topical and systemic corticosteroids are considered as the first-line treatment for BP and immunosuppressors are used as steroid-sparing treatments but both have side effects and contraindications which are even more common in this elderly population. New treatments targeting interleukins and receptors related to BP pathogenesis have been proposed to decrease this side effects while achieving equal or better effectiveness response rates.Omalizumab is a monoclonal antibody that targets IgE that has been proposed for the treatment of BP due to the evidence that IgE autoantibodies play an essential role in BP pathogenesis. OBJECTIVES AND METHODOLOGY: To assess the efficacy and security of Omalizumab for the treatment of BP, we carried out a multicenter, retrospective, observational study including patients diagnosed of BP who received omalizumab for at least 3 months from 15 tertiary hospitals in Spain. IgE levels prior to treatment was measured and we evaluate the possible correlation with clinical response. We excluded patients treated with Omalizumab for less than 3 months as we consider this duration is insufficient for a comprehensive assessment of its efficacy. To evaluate the effectiveness of the treatment we used the percentage of BSA improvement. RESULTS: We included 36 patients. The vast majority associate multiple comorbidities and all patients had used other systemic therapies apart from corticoids before Omalizumab.83% experienced some kind of treatment response and 42% of all patient treated achieved complete response.We did not find any correlation between higher levels and a better response (p=0,1791).All patients tolerated Omalizumab without reported side-effects. CONCLUSIONS: Omalizumab is a good therapeutic alternative for BP as it obtained clinical response in most patients and nearly half of the cases achieving complete response. It showed no side effects which is crucial in elderly patients suffering from BP.

Cardiovascular Screening Practices and Statin Prescription Habits in Patients with Psoriasis among Dermatologists, Rheumatologists and Primary Care Physicians.

Patients with psoriasis have a higher prevalence of cardiovascular risk factors. This study evaluated cardiovascular screening practices and statin prescribing habits among dermatologists, rheumatologists and primary care physicians (PCPs) through an online questionnaire, which was distributed through the Spanish scientific societies of the above-mentioned specialties. A total of 299 physicians (103 dermatologists, 94 rheumatologists and 102 PCPs) responded to the questionnaire. Of these, 74.6% reported screening for smoking, 37.8% for hypertension, 80.3% for dyslipidaemia, and 79.6% for diabetes mellitus. Notably, only 28.4% performed global screening, defined as screening for smoking, hypertension, dyslipidaemia, and diabetes mellitus by the same physician, and 24.4% reported calculating 10-year cardiovascular disease (CVD) risk, probably reflecting a lack of comprehensive cardiovascular risk assessment in these patients. This study also identified unmet needs for awareness of cardiovascular comorbidities in psoriasis and corresponding screening and treatment recommendations among PCPs. Of PCPs, 61.2% reported not being aware of the association between psoriasis and CVD and/or not being aware of its screening recommendations, and 67.6% did not consider psoriasis as a risk-enhancing factor when deciding on statin prescription. Thirteen dermatologists (12.6%) and 35 rheumatologists (37.2%) reported prescribing statins. Among those who do not prescribe, 49.7% would be willing to start their prescription.

From Molecular Insights to Clinical Perspectives in Drug-Associated Bullous Pemphigoid.

Bullous pemphigoid (BP), the most common autoimmune blistering disease, is characterized by the presence of autoantibodies targeting BP180 and BP230 in the basement membrane zone. This leads to the activation of complement-dependent and independent pathways, resulting in proteolytic cleavage at the dermoepidermal junction and an eosinophilic inflammatory response. While numerous drugs have been associated with BP in the literature, causality and pathogenic mechanisms remain elusive in most cases. Dipeptidyl peptidase 4 inhibitors (DPP4i), in particular, are the most frequently reported drugs related to BP and, therefore, have been extensively investigated. They can potentially trigger BP through the impaired proteolytic degradation of BP180, combined with immune dysregulation. DPP4i-associated BP can be categorized into true drug-induced BP and drug-triggered BP, with the latter resembling classic BP. Antineoplastic immunotherapy is increasingly associated with BP, with both B and T cells involved. Other drugs, including biologics, diuretics and cardiovascular and neuropsychiatric agents, present weaker evidence and poorly understood pathogenic mechanisms. Further research is needed due to the growing incidence of BP and the increasing identification of new potential triggers.

The association of Self-concept with Substance Abuse and Problematic Use of Video Games in University Students: A Structural Equation Model. / Relación entre autoconcepto, consumo de sustancias y uso problemático de videojuegos en universitarios: un modelo de ecuaciones estructurales.

This study aims to define and contrast an explanatory model of consumption of alcohol, tobacco consumption, and problematic use of video games based on self-concept and its dimensions in a sample of university students. The research was conducted with a sample of 490 students from the province of Granada (Spain), aged between 20 and 29 years (M = 22.80 ± 3.63), with a homogeneous distribution by gender. The instruments used were the Self-concept Form-5 Questionnaire (García & Musitu, 1999), the Alcohol Use Disorders Identification Test (Saunders, Aasland, Babor, De la Fuente, & Grant, 1993), the Fagerström Test for Nicotine Dependence (Heatherton, Kozlowski, Frecker, & Fagerström, 1991) and the Questionnaire for Experiences Related to Video Games (Chamarro et al., 2014). A model of structural equations was estimated, which was adjusted properly, χ2(8) = 19.843, p = .011; CFI = .963, NFI = .943, IFI = .965, RMSEA = .055. As main results, a positive relationship between social and physical self-concept and consumption of alcohol was obtained, as well as a negative relationship between social self-concept and problematic use of videogames. Academic dimension was negatively related to alcohol and video game use. Furthermore, alcohol consumption was positively related to tobacco consumption and use of video games. It is concluded that levels of self-concept may represent a risk factor in substance abuse and digital leisure, and their study and consideration are appropriate.

El presente estudio pretende definir y contrastar un modelo explicativo del consumo de alcohol, tabaco y uso problemático de videojuegos en función del autoconcepto y sus dimensiones en una muestra de estudiantes universitarios. Participaron 490 estudiantes de la provincia de Granada (España), con una edad comprendida entre los 20 y 29 años (M = 22,80 ± 3,63) y una distribución homogénea según su sexo. Los instrumentos empleados fueron el Cuestionario de Autoconcepto Forma-5 (García y Musitu, 1999), Test para la Identificación de Trastornos en el Uso de Alcohol (Saunders, Aasland, Babor, De la Fuente y Grant, 1993), Test para la Dependencia a la Nicotina (Heatherton, Kozlowski, Frecker y Fagerström, 1991) y el Cuestionario de Experiencias Relacionadas con Videojuegos (Chamarro et al., 2014). Se llevó a cabo un modelo de ecuaciones estructurales que se ajustó de forma adecuada (χ2 = 19,843; gl = 8; p = .011; CFI = .963 NFI = .943; IFI = .965; RMSEA = .055). Los resultados revelan una relación positiva entre el autoconcepto social y físico con el consumo de alcohol, y negativa entre la dimensión social y el uso de videojuegos. La dimensión académica se relacionó negativamente con el consumo de alcohol y el uso de videojuegos. Asimismo, el consumo de alcohol se relacionó positivamente con el consumo de tabaco y el uso de videojuegos. Se concluye que los niveles de autoconcepto pueden representar un factor de riesgo en el consumo de sustancias y el ocio digital de pantalla, siendo conveniente su estudio y consideración.

[Physical activity, obesity and self-esteem in chilean schoolchildren]. / Actividad física, obesidad y autoestima en escolares chilenos: Análisis mediante ecuaciones estructurales.

BACKGROUND: Obesity is a worldwide epidemic disease and a problem for the Chilean society. AIM: To analyze the relationship between physical condition, body mass index (BMI), level of physical activity and self-esteem. Material ad Methods: Questionnaires to assess self-esteem (Rosemberg scale) and levels of physical activity (Physical Activity Questionnaire for older Children, PAQ-C) were answered by 515 children aged 10.5 ± 0.5 years from 27 schools of Santiago de Chile. BMI was calculated. Course-Navette test was carried out, vertical jump and hand dynamometry were measured. For statistical analysis, structural equations were used. RESULTS: An acceptable goodness of fit for the models was found. There was a positive relationship between BMI and hand dynamometry, as well as a negative relationship between BMI and maximal oxygen consumption, jumping ability, physical activity and self-esteem. Finally, self-esteem was positively related to physical activity engagement. CONCLUSIONS: In these children, self-esteem was related to physical activity variables.

Monocyte-to-High-Density Lipoprotein Ratio Is Associated with Systemic Inflammation, Insulin Resistance, and Coronary Subclinical Atherosclerosis in Psoriasis: Results from 2 Observational Cohorts.

Systemic inflammation or insulin resistance drive atherosclerosis. However, they are difficult to capture for assessing cardiovascular risk in clinical settings. The monocyte-to-high-density lipoprotein ratio (MHR) is an accessible biomarker that integrates inflammatory and metabolic information and has been associated with poorer cardiovascular outcomes. Our aim was to evaluate the association of MHR with the presence of subclinical atherosclerosis in patients with psoriasis. The study involved a European and an American cohort including 405 patients with the disease. Subclinical atherosclerosis was assessed by coronary computed tomography angiography. First, MHR correlated with insulin resistance through homeostatic model assessment for insulin resistance, with high-sensitivity CRP and with 18F-fluorodeoxyglucose uptake in spleen, liver, and bone marrow by positron emission tomography/computed tomography. MHR was associated with both the presence of coronary plaques >50% of the artery lumen and noncalcified coronary burden, beyond traditional cardiovascular risk factors (P < .05). In a noncalcified coronary burden prediction model accounting for cardiovascular risk factors, statins, and biologic treatment, MHR added value (area under the curve base model = 0.72 vs area under the curve base model plus MHR = 0.76, P = .04) within the American cohort. These results suggests that MHR may detect patients with psoriasis who have subclinical burden of cardiovascular disease and warrant more aggressive measures to reduce lifetime adverse cardiovascular outcomes.

Environmental enrichment improves novel object recognition and enhances agonistic behavior in male mice.

Environmental enrichment (EE) is an experimental paradigm in which rodents are housed in complex environments containing objects that provide stimulation, the effects of which are expected to improve the welfare of these subjects. EE has been shown to considerably improve learning and memory in rodents. However, knowledge about the effects of EE on social interaction is generally limited and rather controversial. Thus, our aim was to evaluate both novel object recognition and agonistic behavior in NMRI mice receiving EE, hypothesizing enhanced cognition and slightly enhanced agonistic interaction upon EE rearing. During a 4-week period half the mice (n = 16) were exposed to EE and the other half (n = 16) remained in a standard environment (SE). On PND 56-57, animals performed the object recognition test, in which recognition memory was measured using a discrimination index. The social interaction test consisted of an encounter between an experimental animal and a standard opponent. Results indicated that EE mice explored the new object for longer periods than SE animals (P < .05). During social encounters, EE mice devoted more time to sociability and agonistic behavior (P < .05) than their non-EE counterparts. In conclusion, EE has been shown to improve object recognition and increase agonistic behavior in adolescent/early adulthood mice. In the future we intend to extend this study on a longitudinal basis in order to assess in more depth the effect of EE and the consistency of the above-mentioned observations in NMRI mice.

Association of the Complement System with Subclinical Atherosclerosis in Psoriasis: Findings from an Observational Cohort Study.

Psoriasis is a chronic and inflammatory disease that affects the skin and joints and is associated with multiple comorbidities and cardiovascular risk factors. Consequently, patients with psoriasis have an increased risk of cardiovascular diseases such as atherosclerosis, a chronic pathology that shares common inflammatory and immune-response mechanisms with psoriasis, including vascular inflammation and complement activation. To better understand the relationship between atherosclerosis and psoriasis, a proteomics study followed by a bioinformatics analysis was carried out, with a subsequent validation step using ELISA and western blotting. When the plasma from patients with psoriasis alone was compared with that from patients with psoriasis and atherosclerosis, 31 proteins of interest related to the complement system and oxygen transport were identified. After the validation phase, 11 proteins appeared to define the presence of subclinical atherosclerosis in patients with psoriasis, indicating the importance of complement cascades in the development of atherosclerotic plaques in individuals with psoriasis. These results are a step forward in understanding the pathological pathways implicated in the cardiovascular risk associated with this population, which may represent an interesting starting point for developing predictive tools that improve the follow-up of these patients and design more effective therapies.

PhnY and PhnZ comprise a new oxidative pathway for enzymatic cleavage of a carbon-phosphorus bond.

The sequential activities of PhnY, an α-ketoglutarate/Fe(II)-dependent dioxygenase, and PhnZ, a Fe(II)-dependent enzyme of the histidine-aspartate motif hydrolase family, cleave the carbon-phosphorus bond of the organophosphonate natural product 2-aminoethylphosphonic acid. PhnY adds a hydroxyl group to the α-carbon, yielding 2-amino-1-hydroxyethylphosphonic acid, which is oxidatively converted by PhnZ to inorganic phosphate and glycine. The PhnZ reaction represents a new enzyme mechanism for metabolic cleavage of a carbon-phosphorus bond.

Phosphite utilization by the marine picocyanobacterium Prochlorococcus MIT9301.

Primary productivity in the ocean's oligotrophic regions is often limited by phosphorus (P) availability. In low phosphate environments, the prevalence of many genes involved in P acquisition is elevated, suggesting that the ability to effectively access diverse P sources is advantageous for organisms inhabiting these regions. Prochlorococcus, the numerically dominant primary producer in the oligotrophic ocean, encodes high-affinity P transporters, P regulatory proteins and enzymes for organic phosphate utilization, but its ability to use reduced P compounds has not been previously demonstrated. Because Prochlorococcus strain MIT9301 encodes genes similar to phnY and phnZ, which constitute a novel marine bacterial 2-aminoethylphosphonate (2-AEPn) utilization pathway, it has been suggested that this organism might use 2-AEPn as an alternative P source. We show here that although MIT9301 was unable to use 2-AEPn as a sole P source under standard culture conditions, it was able to use phosphite. Phosphite utilization by MIT9301 appears to be mediated by an NAD-dependent phosphite dehydrogenase encoded by ptxD. We show that phosphite utilization genes are present in diverse marine microbes and that their abundance is higher in low-P waters. These results strongly suggest that phosphite represents a previously unrecognized component of the marine P cycle.

Proteorhodopsin lateral gene transfer between marine planktonic Bacteria and Archaea.

Planktonic Bacteria, Archaea and Eukarya reside and compete in the ocean's photic zone under the pervasive influence of light. Bacteria in this environment were recently shown to contain photoproteins called proteorhodopsins, thought to contribute to cellular energy metabolism by catalysing light-driven proton translocation across the cell membrane. So far, proteorhodopsin genes have been well documented only in proteobacteria and a few other bacterial groups. Here we report the presence and distribution of proteorhodopsin genes in Archaea affiliated with the order Thermoplasmatales, in the ocean's upper water column. The genomic context and phylogenetic relationships of the archaeal and proteobacterial proteorhodopsins indicate its probable lateral transfer between planktonic Bacteria and Archaea. About 10% of the euryarchaeotes in the photic zone contained the proteorhodopsin gene adjacent to their small-subunit ribosomal RNA. The archaeal proteorhodopsins were also found in other genomic regions, in the same or in different microbial lineages. Although euryarchaeotes were distributed throughout the water column, their proteorhodopsins were found only in the photic zone. The cosmopolitan phylogenetic distribution of proteorhodopsins reflects their significant light-dependent fitness contributions, which drive the photoprotein's lateral acquisition and retention, but constrain its dispersal to the photic zone.

[Nicotine and animal models: what does the environmental enrichment paradigm tell us?]. / Nicotina y modelos animales: ¿qué nos aporta el paradigma de enriquecimiento ambiental?

The Environmental Enrichment (EE) paradigm is a housing condition which aims is to provide physical, cognitive and sensorial stimulation to rodents. Animals are housed in larger cages containing inanimate objects such as tunnels, toys and running wheels. The main aim of the current work is to tackle the arguments which suggest that EE may diminish vulnerability to developing addiction to nicotine and other drugs of abuse and to review recent experimental studies performed in relation to this subject. We discuss the major changes induced by EE at physical, neurobiological and behavioral levels and review the results of recent studies which indicate that EE promotes both neurochemical (potentiation of the increase in dopamine release induced by nicotine in the brain cortex) and behavioral changes (increased ability to discriminate the presence of reward and decreased impulsivity), thus supporting the hypothesis put forward. In light of these results, EE can be proposed as a model for the study of vulnerability to addiction to different drugs of abuse, including cocaine and nicotine, though further studies are needed in order to establish the neurobiological implications of the effects of exposure to enriched environments and their possible relationship with changes in brain reward systems.

Combined Therapy with Laser and Autologous Topical Serum for Facial Rejuvenation: A Multiple Case Series Report.

Background: Lasers require several sessions to achieve significant results and may lead to adverse reactions. Platelet-rich plasma (PRP) therapy is a good adjuvant to laser therapies; however, repeated blood extractions and invasive injections are needed. A 100% autologous topical formulation based on the patient's proteins has been recently developed, known as Endoret-Serum (ES). Unlike other PRPs, ES provides a home care, storable, and topical needle-free application. Objective: Preliminarily assess the clinical performance of a single session of the combined therapy with nonablative laser and ES in the management of cutaneous pigmented and vasculature lesions. Materials and Methods: Nine patients with clinical signs of skin aging received a single session of nonablative laser. ES was topically applied twice daily. They were clinically assessed after 1 and 8 weeks. VISIA-CR System was used for high-resolution topographic analysis. Subjects were asked to complete a self-assessment questionnaire and an impression of improvement survey. An investigator's global assessment scale was fulfilled. Results: The combined treatment improved cutaneous spots, wrinkles, and texture after 8 weeks, whereas significant pore reduction was observable at 1 week. Ultraviolet (UV) spots and porphyrins decreased at 1 week, whereas red area improvement was noticeable after 8 weeks. Overall wrinkle amelioration, periorbital hyperpigmentation decrease, softened skin, and tone recovery was observed. Patients referred to be very satisfied and felt that their cutaneous condition was much better. At the end of the study, subjects presented minimal dermatological symptoms like pigmented lesions, redness, or capillaries. No side effects were reported. Conclusion: Results presented herein suggest that one session of laser in combination with ES provides a good clinical outcome.

Linking Emotional Intelligence, Physical Activity and Aggression among Undergraduates.

Several indicators are strongly related to health and well-being in university students, such as emotional intelligence and physical activity. At the same time, some qualities threaten it and are incompatible with students' adaptation to society in general, such as aggressive behaviours. The aim of this research is to analyse the relationship established between emotional intelligence using TMMS-24, physical activity, using IPAQ, and aggression behaviours in university students. For this purpose, a descriptive, cross-sectional and non-experimental study was developed with 932 undergraduates (M = 20.55; SD = 3.673). The findings highlight how emotional intelligence and physical activity practice decrease violent behaviour in university students. In addition, men tend to have more aggressive behaviours than women as well as the relation between physical activity and emotional intelligence is stronger in all its dimensions. Results highlight the importance of including emotional intelligence programs in order to enable undergraduate well-being.

Widespread known and novel phosphonate utilization pathways in marine bacteria revealed by functional screening and metagenomic analyses.

Phosphonates (Pn), compounds with a direct C-P bond instead of the more common C-O-P ester bond, constitute a significant fraction of marine dissolved organic phosphorus and recent evidence suggests that they may be an alternative source of P for marine microorganisms. To further characterize the microorganisms and pathways involved in Pn utilization, we screened bacterioplankton genomic libraries for their ability to complement an Escherichia coli strain unable to use Pns as a P source. Using this approach we identified a phosphonatase pathway as well as a novel pair of genes that allowed utilization of 2-aminoethylphosphonate (2-AEPn) as the sole P source. These pathways are present in diverse bacteria common in marine plankton including representatives of Proteobacteria, Planctomycetes and Cyanobacteria. Analysis of metagenomic databases for Pn utilization genes revealed that they are widespread and abundant among marine bacteria, suggesting that Pn metabolism is likely to play an important role in P-depleted surface waters, as well as in the more P-rich deep-water column.

An Analysis of Personal Learning Environments and Age-Related Psychosocial Factors of Unaccompanied Foreign Minors.

Spain is one of the countries with the greatest influx of immigrants and, specifically, of unaccompanied foreign minors (UFMs). The educational and social inclusion of unaccompanied foreign minors poses both a challenge and a threat to current policy. Nonetheless, studies linking educational aspects to the phenomenon of the integration of these children are scarce and do not specify the most influential educational tools and strategies. In this sense, a descriptive, quantitative and cross-sectional research study is presented. The aim of this study is to examine whether variables such as age and the use of applications and social networks determine the personal learning environments (PLE) of unaccompanied foreign minors. The sample of the present study was formed by 624 individuals (♂ = 92.1% (n = 575); ♀ = 7.9% (n = 49)) aged between 8 and 17 years old. The majority came from Morocco and resided in the cities of Ceuta and Melilla. The "PLE and Social Integration of UFMs" questionnaire was used as the study instrument. Amongst the main findings, significant differences are highlighted in the personal learning environments as a function of age-related psychosocial factors as they pertain to unaccompanied foreign minors. Four factors were seen to exist in relation to the personal learning environments of unaccompanied foreign minors: self-concept of the learning process, planning and management of learning, use of resources and tools, and communication and social interaction. The same trend was observed in the four factors, with older age groups reporting better scores. On the other hand, results show that the use of applications and social networks have a significant and favourable impact on personal learning environment construction.

[Androgen deprivation therapy in advanced prostate cancer. Multicenter study.] / Terapia de deprivación androgénica en cáncer de próstata avanzado. Estudio multicéntrico.

OBJECTIVES: Advanced prostate cancer (PC) is a frequent entity. The objectives of this paper are the presentation of a sample of patients with PC undergoing treatment with androgen deprivation therapy (ADT) in usual clinical practice and the determination of parameters associated with the development of resistance to castration (CRPC). MATERIAL AND METHODS: Multicenter, observational, retrospective study that analyzes patients treated with ADT from January 2016 to January 2017. Descriptive analysis of the most relevant clinical variables and univariante analysis and progression times by Kaplan-Meier test. RESULTS: Sample of 952 patients. At PC diagnosis median age 74 years. Median PSA at PC diagnosis 23 ng/ml, when begining ADT 20.2 ng/ml. 80.2% of patients were biopsied at PC diagnosis: 28.2% Gleason score group 1, 38.7% groups 2 and 3 and 33.1% groups 4 and 5. Initial treatment of PC: 75.9% ADT, radical prostatectomy 8.4% and radiotherapy 15.1%. Of the 952 patients, 281 (29.6%) fulfilled CRPC criteria.In this group 21.7% achieved undetectable PSA (group in which it was 59.9%. Increased probability of progression to CRPC in: PSA >30ng/ml at PC diagnosis (p=0.000, OR 2.78), Gleason score group 4-5 (p=0.000, OR 2.33), and not to reach undetectable PSA after ADT (p <0.001, OR 3.32). The initial ADT group presents progression to metastatic CRPC more rapidly in unfavourable histology and when not reached undetectable PSA after ADT. CONCLUSIONS: We present a sample of patients with advanced PC in treatment with ADT that shows heterogeneity in usual clinical practice. In our sample, elevated PSA at PC diagnosis, unfavorable histology and failure to achieve a PSA<0.1 ng/ml after ADT is presented as an indicator of progression to the CRPC stage.

OBJETIVO: El cáncer de próstata (CP) avanzado es una entidad frecuente. Los objetivos de este trabajo son la presentación de una serie de pacientes con CP en tratamiento con Terapia de Deprivación Androgénica (TDA) en práctica clínica habitual y la determinación de parámetros asociados al desarrollo de resistencia a la castración (CPRC).MATERIAL Y MÉTODOS: Estudio multicéntrico,  observacional, retrospectivo que analiza pacientes tratados con TDA desde enero 2016 hasta enero 2017. Análisis descriptivo de las variables clínicas más relevantes, análisis univariante y supervivencia libre de progresión mediante test Kaplan-Meier. RESULTADOS: Muestra 952 pacientes. Al diagnóstico del CP edad mediana 74 años. Mediana de PSA al diagnóstico de CP 23 ng/ml, al inicio TDA 20,2 ng/ml. El 80,2% de pacientes tenían biopsia al diagnóstico del CP: 28,2% grado pronóstico Gleason grupo 1, 38,7% grados 2 y 3 y 33,1% grados 4 y 5. Tratamiento inicial del CP: 75,9% TDA, prostatectomía radical 8,4% y radioterapia 15,1%.De los 952 pacientes, 281 (29,6%) cumplían criterios de CPRC. En este grupo el 21,7% alcanzó PSA indetectable (<0,1 ng/ml) con la TDA 20,2  frente al grupo no CPRC en el que lo alcanzaron el 59,9%. Encontramos mayor probabilidad de progresión a CPRC en pacientes con PSA al diagnóstico de CP >30 ng/ml (p=0,000, OR 2,78), grado pronóstico Gleason grupos 4-5 (p=0,000, OR 2,33) y en aquellos que no alcanzan PSA indetectable tras TDA (p<0,01, OR 3,32) variables que se relacionan con los tiempos de progresión a CPRC y especialmente al estadio metastásico. CONCLUSIONES: Se presenta una serie de pacientes CP avanzado en tratamiento con TDA que muestra heterogeneidad de características y de manejo según práctica clínica habitual. En nuestra serie el PSA elevado al diagnóstico, histología desfavorable y no alcanzar un PSA<0,1 ng/ml tras la TDA se presentan como indicadores de progresión a estadio CPRC.

The Relationship between Emotional Regulation and School Burnout: Structural Equation Model According to Dedication to Tutoring.

School burnout constitutes a current phenomenon which generates diverse negative consequences in the personal and academic lives of students. Given this situation, it is necessary to develop actions that permit us to regulate this harmful mental state and that are administered from within the school context. A descriptive and cross-sectional study is presented that pursues the objective of examining a structural equation model which brings together burnout and emotional regulation. The model assumes that students receive tutoring at school in order to tackle these types of problems. For this, the sample constituted a total of 569 students from the province of Granada (men = 52.3% (n = 298); women = 47.7% (n = 271)). Mean age was reported as 10.39 ± 0.95 years and the School Burnout Inventory (BMI) and the Emotional Regulation Scale were utilized as the principal instruments. As main findings it was observed that students who received one hour of weekly tutoring showed a positive relationship between expressive suppression as a strategy of emotional regulation, cynicism, and exhaustion as consequences of school burnout. In the same way, a direct association existed between burnout-related exhaustion and cognitive repair. Given that significant relationships could not be observed between these variables in students who do not receive tutoring, higher use of emotional regulation was confirmed amongst tutored students when faced with this negative mental state.