Ellipsoid layer restoration after Ozurdex® treatment in a patient with acute posterior multifocal placoid pigment epitheliopathy.

An atypical case of acute posterior multifocal placoid pigment epitheliopathy with a clear reappearance of the ellipsoid layer of the retina after Ozurdex® intravitreal implantation is presented. A 51-year-old woman reported a 3-week history of left eye photopsia. On slit-lamp examination, yellowish placoid lesions were found on her left eye fundus. Ancillary tests were performed. The patient was diagnosed as a left eye acute posterior multifocal placoid pigment epitheliopathy, and observational approach was decided. Later, the condition started to progress in an ampiginous manner and a decrease of visual acuity caused by an increase in number and size of the lesions was observed. As the disease was progressing with the conservative, observational approach, and the macula was menaced, an intravitreal dexamethasone implant was injected in the left eye with a consequent improvement of the visual acuity and lesion stabilization. The ellipsoid layer, unidentifiable inside the placoid lesions in previous optical coherence tomography tests, reappeared after the treatment. Intravitreal dexamethasone implants can be used to stabilize acute posterior multifocal placoid pigment epitheliopathy lesions and help resolve the condition. Spectral domain optical coherence tomography can also be useful for monitoring these lesions, as the ellipsoid layer may reappear upon resolution.

Cytotoxicity study of bakery product melanoidins on intestinal and endothelial cell lines.

Melanoidins contribute to organoleptic properties of processed foods and exert benefits in health. The aim of this study was to isolate and characterize melanoidins from baked products (common bread, soft bread and biscuits), evaluate their cytotoxicity and determine their suitability as functional additives. Extraction yield, spectrophotometric characteristics, colorimetric properties, antioxidant capacity, and cytotoxicity of melanoidins were assessed. Among the studied products, soft bread had the highest extraction throughput. Melanoidins from biscuit showed the highest antioxidant capacity, closely followed by those of soft bread. Melanoidins did not exert cytotoxic effects on Caco-2 and HUVEC cells (viability was >80%). Nevertheless, incubation of HUVEC cells with melanoidins from common bread and biscuit slightly decreased viability, whereas gastrointestinal digestion of such melanoidins softened the decrease in cell viability. This study point to soft bread as a safe and efficient source of melanoidins, that could be potentially used in the future as functional ingredient.

Proanthocyanidin content, antioxidant capacity and scavenger activity of Portuguese sparkling wines (Bairrada Appellation of Origin).

BACKGROUND: The main object of the present study was to investigate the different proanthocyanidin fraction (monomeric, oligomeric and polymeric fraction) contents, antioxidant capacity and scavenger activity of the most important and representative commercial sparkling wines available in Bairrada Portuguese Appellation of Origin. RESULTS: The white commercial sparkling wines tested had much less total phenolic, proanthocyanidin content, antioxidant capacity and scavenger activity than the sparkling red wines. For all white and red sparkling wines the polymeric fraction of proanthocyanidins was the most abundant fraction quantified. The antioxidant capacity was positively correlated with the different proanthocyanidin fractions studied. However, in general, higher correlations between total polyphenols, different proanthocyanidin fractions and antioxidant capacity were found only for red sparkling wines. CONCLUSION: The results confirm that Portuguese sparkling wines from Bairrada Appellation of Origin are good sources of antioxidants when compared with other wines elaborated from other grapes varieties and from other regions. At same time, good linear correlations between the levels of each different proanthocyanidin fractions and total polyphenols with antioxidant capacity were found for the commercial sparkling wines analysed.

The dose-response effect on polyphenol bioavailability after intake of white and red wine pomace products by Wistar rats.

Wine pomace by-products are an important source of phenolic acids with significant health benefits. However, phenolic acid bioavailability in vivo has been little studied and there are few comparative studies on bioavailability between red and white wine pomace and the effect of intake of different doses. The qualitative and quantitative profile of phenolic acid metabolites in plasma and urine samples from Wistar rats was obtained by gas chromatography/mass detection, after oral administration of four doses (50, 100, 150, and 300 mg) of both the red and the white wine pomace products (rWPP and wWPP, respectively). The antioxidant capacity of the plasma samples assessed by both the ABTS and the FRAP levels was also evaluated. The results showed that neither the bioavailability nor the antioxidant capacity in vivo of the rWPP increased at high doses. However, both parameters were dependent on the intake of the wWPP.

Molecular and morphological influences on the open circuit voltages of organic photovoltaic devices.

We explore the dependence of the dark current of C(60)-based organic photovoltaic (OPV) cells on molecular composition and the degree of intermolecular interaction of several molecular donor materials. The saturation dark current density, J(S), is an important factor in determining the open circuit voltage, V(oc). The V(oc) values of OPVs show a strong inverse correlation with J(S). Donor materials that show evidence for aggregation in their thin-film absorption spectra and polycrystallinity in thin film X-ray diffraction result in a high dark current, and thus a low V(oc). In contrast, donor materials with structures that hinder intermolecular pi-interaction give amorphous thin films and reduced values of J(S), relative to donors with strong intermolecular pi-interactions, leading to a high V(oc). This work provides guidance for the design of materials and device architectures that maximize OPV cell power conversion efficiency.

Exciplex quenching of a luminescent cyclometallated platinum complex by extremely poor Lewis bases.

An intensely phosphorescent Pt complex in cyclohexane is efficiently quenched by exciplex formation with extremely weak Lewis bases such as toluene and other aromatic compounds.

[Characterization of the atmospheric environment in Las Palmas de Gran Canaria and Santa Cruz de Tenerife, Spain: 2000-2004]. / Caracterización del ambiente atmosférico en Las Palmas de Gran Canaria y Santa Cruz de Tenerife: 2000 a 2004.

BACKGROUND: The island factor in the cities of Las Palmas de Gran Canaria and Santa Cruz de Tenerife, their meteorology and the proximity to the African Continent that originates the natural particulate matter transport over the islands, cause some specific features in their air quality. The aim of this paper is to characterize the air pollution from 2000 to 2004 as exposure indicator of both cities inhabitants. METHODS: 24 hour daily average variables of PM10, PM2,5, NO2, SO2 and O3 , 8 hours daily maxima moving averages of O3 y CO and 1 hour maxima of SO2, NO2, O3, CO, PM10 y PM2,5 were calculated. Daily levels of coarse particles were obtained subtracting PM2,5 from PM10. African dust events were identified. RESULTS: In Sta. Cruz de Tf daily means of SO2 (14.0 microg/m(3)N) and ozone levels (44.4 microg/m(3)N ) were higher than Las Palmas de GC levels (8.0 y 28.3 microg/m(3)N). Daily means of NO2 in Las Palmas de GC: 45.8 microg/m(3)N where higher than Sta. Cruz de Tf levels: 30.3 microg/m(3)N. Due to African dust outbreaks, some days in both cities exceeded 600 microg/m(3) of PM10 and 200 of PM2.5 24-h average. CONCLUSIONS: The air quality patterns were characterized by very high levels of African dust outbreaks that affect all PM size fractions. Different O3 seasonality exists respect European cities in addition to an urban-industrial ambient air in Sta. Cruz de TF and clearly urban in Las Palmas de GC. These results have to be considered in order to lay the foundations to suitable surveillance systems, analyse the potential impact on the Canary Islands citizens health and to get conclusions.

Antioxidant profile of red wines evaluated by total antioxidant capacity, scavenger activity, and biomarkers of oxidative stress methodologies.

The study of the antioxidant capacity of foodstuffs requires the use of diverse determination methods to gain a wider picture of their multiple effects. The aim of this work was to evaluate the "antioxidant profile" of red wines applying TAC (total antioxidant capacity) methods: 2,2'-azinobis(3-ethyl-benzthiazoline-6-sulfonic acid) (ABTS), 2,2-diphenyl-1-picrylhydrazyl, N,N-dimethyl-p-phenylenediamine dihydrochloride, oxygen radical absorbance capacity, ferric reducing/antioxidant power, hydroxyl and superoxide radical scavenger activities, and biomarkers of oxidative stress methods such as lipid peroxidation inhibition and inhibition of damage to DNA. Furthermore, levels of total polyphenols (TPP) of wines were also evaluated. Three bottles of 107 different Spanish red wines (total samples 321), made from different grape varieties, aging processes, and vintages, were analyzed. The validation of TAC methods, the first step in this work, provided a good linearity, proportionality, and low detection limits. Among these methods, the ABTS was the most satisfactory for its rapidity, cost, and precision. All wines showed an important capacity to scavenge hydroxyl radicals and were capable of blocking superoxide radicals but with 10 times lower intensity. Wines also showed important protective action on biomarkers of oxidative stress; they were much more active to inhibit lipid peroxidation than DNA oxidation. Few statistically significant correlations among levels of TPP and antioxidant properties of wines were detected. Furthermore, values of these correlations were very low.

Antioxidant and antimicrobial properties of wine byproducts and their potential uses in the food industry.

Wine pomace (WP) is one of the agricultural byproducts that has received most attention from food scientists due to the wide range of interesting compounds that remain after the winemaking process. Different powdered products rich in phenolic compounds, with interesting antioxidant and antimicrobial activities, were obtained from WP by applying processes that are both environmentally friendly and economically affordable for the food industry. The products obtained showed high global antioxidant activities (ABTS assay), successfully delayed the onset of lipid oxidation in the Rancimat test, and showed different antimicrobial properties. Products derived from seed-free WP showed bactericidal effects against total aerobic mesophilic bacteria (TAMB) and lactic acid bacteria (LAB) and inhibited Enterobacteriaceae growth completely. The product derived from whole WP presented bacteriostatic activity against the three microorganism groups tested, whereas the product obtained from grape seed promoted TAMB and LAB growth but delayed Enterobacteriaceae proliferation.

Highly ordered, accessible and nanocrystalline mesoporous TiO2 thin films on transparent conductive substrates.

Highly porous (V(mesopore) = 25-50%) and ordered mesoporous titania thin films (MTTF) were prepared on ITO (indium tin oxide)-covered glass by a fast two-step method. The effects of substrate surface modification and thermal treatment on pore order, accessibility and crystallinity of the MTTF were systematically studied for MTTF deposited onto bare and titania-modified ITO. MTTF exposed briefly to 550 °C resulted in highly ordered films with grid-like structures, enlarged pore size, and increased accessible pore volume when prepared onto the modified ITO substrate. Mesostructure collapse and no significant change in pore volume were observed for MTTF deposited on bare ITO substrates. Highly crystalline anatase was obtained for MTTF prepared on the modified-ITO treated at high temperatures, establishing the relationship between grid-like structures and titania crystallization. Photocatalytic activity was maximized for samples with increased crystallization and high accessible pore volume. In this manner, a simple way of designing materials with optimized characteristics for optoelectronic applications was achieved through the modification of the ITO surface and a controlled thermal treatment.

[From the vegetative state to unresponsive wakefulness: a historical review]. / Del estado vegetativo al estado de vigilia sin respuesta: una revisión histórica.

INTRODUCTION: Over the last few decades, the terminology, diagnostic techniques and treatment of patients with altered levels of consciousness have varied considerably. At the same time, the percentage of patients in this clinical situation has undergone a marked increase. AIMS: The purpose of this study is to present a historical review of the different terms that have been used in the medical literature to describe patients with altered states of consciousness. The article also includes the different diagnostic criteria utilised by research groups that have focused their attention on this population. DEVELOPMENT: The concept of 'vegetative state', a term coined back in the sixties, has since been transformed and replaced by other terms with a less negative connotation, such as 'unresponsive wakefulness syndrome'. In parallel, new clinical categories (minimally conscious state or minimally conscious plus) have appeared since it has been acknowledged that there are patients with a low level of consciousness but who nevertheless show signs that are consistent with interaction with the environment by means of unmistakeably voluntary behaviours in response to orders or gestures. CONCLUSIONS: The wide spectrum of signs and symptoms shown by patients with altered levels of consciousness reflects the clinical and neuropathological heterogeneity of these states. The current tendency is to describe the state clinically, adding the aetiology and the date of the event that caused the clinical picture. This article focuses on the context of an effort made by the scientific community to highlight the needs of this growing population.

Primary frontal hyperhidrosis successfully treated with low doses of botulinum toxin A as a useful alternative to surgical treatment.

Frontal hyperhidrosis appears to be a special and rare form of focal hyperhidrosis. These patients may suffer greatly from the condition so an efficient treatment is highly demanded. Surgical treatment may solve this problem permanently, but the possibility of serious complications and low satisfactory results makes it less advisable than in other types of hyperhidrosis where surgery has shown great benefits. We report a case of primary frontal hyperhidrosis in a young man who refused surgery and was treated with low doses of botulinum toxin type A injected into the forehead. The patient noted a high level of satisfaction, with the abolishment of sweating and a long effect that was maintained for up to 10 months without any complications. In conclusion, we consider that low doses of botulinum toxin A is a well tolerated, safe and very effective treatment for primary frontal hyperhidrosis and it should be offered as an alternative to patients who suffer from this disorder.

Distribution of Added Lead and Cadmium in Human and Bovine Milk.

Distribution of added lead and cadmium to bovine and human milk and whey has been studied. In bovine milk, about 97 and 89% of lead and cadmium, respectively, were recovered in the casein fraction obtained by enzymatic coagulation. However, only 6% of lead and 41% of cadmium were found in the same fraction separated by acid precipitation, indicating that the distribution of both metals is very different depending on the method used for milk fractionation. Moreover, gel filtration of bovine and human skimmed milk and whey after addition of lead and cadmium was carried out. Most of the lead was associated to the casein fraction after gel filtration of skimmed milk, whereas in the chromatography of whey, lead was eluted with the low molecular weight fraction in both species. However, a different pattern in the distribution of cadmium has been observed in the two species studied. In contrast to the binding of cadmium to the low molecular weight fraction in human skimmed milk and whey, it was mainly associated to a component of a molecular weight around 70,000 in bovine skimmed milk. This component was not present in bovine whey indicating that it is separated with casein during fractionation.

A second Zn(II)(2)Cys(6) transcriptional factor encoded by the YNA2 gene is indispensable for the transcriptional activation of the genes involved in nitrate assimilation in the yeast Hansenula polymorpha.

Nitrate assimilation genes encoding a nitrate transporter (YNT1), nitrite reductase (YNI1), a Zn(II)(2)Cys(6) transcriptional factor involved in nitrate induction (YNA1) and the nitrate reductase (YNR1) are clustered in the yeast Hansenula polymorpha. A second gene, termed YNA2 (yeast nitrate assimilation), was located seven nucleotides away from the 3' region of YNR1 gene. The cluster is flanked by an ORF encoding a protein with similarity to glutathione-S-transferase on the YNT1 side and an ORF with similarity to Saccharomyces cerevisiae Rad3p on the YNA2 side. The disruption of YNA2 confers the resulting null mutant strain with inability to grow in nitrate. The YNA2 gene encodes a putative protein of 618 residues bearing in the N-terminus the consensus sequence Cys-X(2)-Cys-X(6)-Cys-X(5-16)-Cys-X(2)-Cys-X(6-8)-Cys characteristic of the Zn(II)(2)Cys(6) transcriptional factors. YNA2 is therefore a member of the H. polymorpha nitrate assimilation gene cluster which is transcribed in the opposite direction to the rest of the members. Yna2p shares about 27% similarity with the H. polymorpha Yna1p Zn(II)(2)Cys(6) transcriptional factor involved in nitrate induction. Unlike the wild-type, the yna2::URA3 strain showed no expression of the nitrate assimilation genes when incubated in nitrate for 2 h. With regard to YNA2 expression, similar YNA2 transcript levels were observed in ammonium and in ammonium plus nitrate, but about a four-fold higher expression was observed in nitrate. However, this induction by nitrate of the YNA2 gene was not observed in the Deltayna1::URA3 strain. On the contrary, the pattern of YNA1 expression was the same in the wild-type as in the yna2::URA3 strain, indicating that YNA2 does not affect YNA1 expression.

The role of Ynt1 in nitrate and nitrite transport in the yeast Hansenula polymorpha.

Ynt1 is the only high-affinity nitrate uptake system in Hansenula polymorpha. Nitrate uptake was directly correlated with the Ynt1 levels and shown to be independent of nitrate reductase (NR) activity levels. Ynt1 failed to transport chlorate and, as a result, strains lacking YNT1 were sensitive to chlorate, as is the wild-type. Nitrite uptake in a wild-type strain was partially inhibited by nitrate to levels shown by a YNT1-disrupted strain in which, in turn, nitrite transport was not inhibited by nitrate. It is concluded that nitrite uptake takes place by two different transport systems: Ynt1 and a nitrite-specific transporter(s). The nitrite-specific transport system was induced by nitrate; consistently, no induction was observed in strains lacking the transcription factor YNA1, which is involved in nitrate and nitrite induction of the nitrate assimilatory structural genes. Ynt1 presents its optimal rate for nitrite uptake at pH 6, while pH 4 was optimal for the specific nitrite uptake system(s). At pH 5.5, the contribution of Ynt1 to high-affinity nitrate and nitrite uptake was around 95% and 60%, respectively. The apparent Km of Ynt1 for nitrate and nitrite is in the microM range, as is the specific nitrite uptake system for nitrite. The analysis of the effect of the reduced nitrogen sources on nitrate assimilation revealed that glutamine inactivates nitrate and nitrite transport, dependent on Ynt1, but not the nitrite-specific system.

Growth of gold nanoparticle arrays in TiO2 mesoporous matrixes.

An interconnected Au nanoparticle arrangement is obtained by electrodeposition from Au(III) soluble complexes within the pore system of block-copolymer templated mesoporous titania films. The resulting Au@TiO2 nanocomposites (5 nm Au particles, 5.5 nm amorphous titania walls) have the electrochemical behavior of a gold electrode of high surface area. The attenuation of Au surface plasmon due to -OH electroadsorption and the existence of mixed localized states in these Au@TiO2 nanocomposites are observed by in situ spectroelectrochemistry.

Caracterización del ambiente atmosférico en las Palmas de Gran Canaria y Santa Cruz de Tenerife. 2000 a 2004 / Characterization of the atmospheric environment in Las Palmas de Gran Canaria and Santa Cruz de Tenerife, Spain. 2000-2004

Fundamento: El carácter insular de las ciudades de Las Palmas de Gran Canaria y Santa Cruz de Tenerife, su meteorología y la proximidad del continente africano que favorece la llegada de material particulado de origen natural sobre las islas, determinan unas especificidades en su calidad del aire. El objetivo de este artículo es la caracterización de la contaminación atmosférica durante los años 2000 a 2004 como indicador de exposición de los habitantes de estas dos ciudades. Métodos: Se elaboraron los siguientes indicadores de contaminación: promedios de 24 horas de PM10, PM2,5, NO2, SO2 y O3; máximo de las 17 medias móviles octohorarias diarias de O3 y CO; máximo horario diario de SO2, NO2, O3, CO, PM10 y PM2,5. También se calcularon los niveles de la moda gruesa de partículas, como la diferencia entre los valores de PM10 y PM2,5 (PM10-2,5). Se identificaron episodios de intrusión africana. Resultados: En Sta Cruz de TF los promedios de SO2 (14µg/m3N) y de O3 (44,4 µg/m3N ) fueron superiores respecto a los de Las Palmas de GC (8 y 28,3 µg/m3N). Los promedios de NO2 en Las Palmas de GC: 45,8 µg/m3N fueron superiores a los de Sta. Cruz de TF: 30,3 µg/m3N. Debido a las intrusiones africanas, algunos días superaron los 600 µg/m3 de PM10 y los 200 de PM2.5 en ambas ciudades. Conclusiones: Se identifica un patrón de calidad del aire con episodios de polvo mineral africano que en superficie afecta a todas las fracciones granulométricas, una estacionalidad diferente a las ciudades europeas respecto al ozono, así como un patrón de contaminación urbano-industrial en Sta. Cruz de Tf y netamente urbano en Las Palmas de GC. Se hace necesario tener en cuenta estos resultados para analizar su posible impacto sobre la salud de los ciudadanos de las Islas Canarias y establecer sistemas adecuados de vigilancia (AU)

Background: The island factor in the cities of Las Palmas de Gran Canaria and Santa Cruz de Tenerife, their meteorology and the proximity to the African Continent that originates the natural particulate matter transport over the islands, cause some specific features in their air quality. The aim of this paper is to characterize the air pollution from 2000 to 2004 as exposure indicator of both cities´ inhabitants. Methods: 24 hour daily average variables of PM10, PM2,5, NO2, SO2 and O3 , 8 hours daily maxima moving averages of O3 y CO and 1 hour maxima of SO2, NO2, O3, CO, PM10 y PM2,5 were calculated. Daily levels of coarse particles were obtained subtracting PM2,5 from PM10. African dust events were identified. Results: In Sta. Cruz de Tf daily means of SO2 (14.0µg/m3N) and ozone levels (44.4 µg/m3N ) were higher than Las Palmas de GC levels (8.0 y 28.3 µg/m3N). Daily means of NO2 in Las Palmas de GC: 45.8 µg/m3N where higher than Sta. Cruz de Tf levels: 30.3 µg/m3N. Due to African dust outbreaks, some days in both cities exceeded 600 µg/m3 of PM10 and 200 of PM2.5 24-h average. Conclusions: The air quality patterns were characterized by very high levels of African dust outbreaks that affect all PM size fractions. Different O3 seasonality exists respect European cities in addition to an urban-industrial ambient air in Sta. Cruz de TF and clearly urban in Las Palmas de GC. These results have to be considered in order to lay the foundations to suitable surveillance systems, analyse the potential impact on the Canary Islands citizens health and to get conclusions (AU)

Cribado de cromosomopatías fetales en España. Cambios hospitalarios en el periodo 2006–2011 / Screening of chromosomal abnormalities in Spain. Hospital changes in the period 2006–2011

Introducción: Hasta 2006, en España no existe una política uniforme para el cribado y diagnóstico prenatal de anomalías cromosómicas. La SEGO (Sociedad Española de Ginecología y Obstetricia) recomienda descartar la edad materna avanzada comoúnica indicación para realizar prueba invasiva y propone el test combinado del primer trimestre. Objetivo: Conocer el grado de implantación de las recomendaciones SEGO y los cambios en la práctica hospitalaria del cribado en España. Material y métodos: Encuesta a hospitales a la que respondieron 54 centros en 2007, que atendieron a 149.320 gestantes y 53 centros en 2011, que atendieron a 147.195 embarazadas. Los resultados se compararon mediante el test de McNemar. Resultados: En total, 26 centros hacían pruebas invasivas por edad materna avanzada en 2007 y 11 en 2011 (p = 0,01); 31 tenían disponible BVC en 2007 y 33 en 2011(p = 0,005); 42 tenían implantado el cribado del primer trimestre en 2007 y 50 en 2011 (p = ns); en 30 el único marcador era TN en 2007 y 36 en 2011 (p = ns); 26 desconocían el tipo de analizador empleado en 2007 y 17 en 2011 (p < 0,01); y en 34 el laboratorio calculaba el índice de riesgo en 2007 y en 36 en 2011 (p = ns). Conclusiones: El cribado combinado del primer trimestre está ampliamente extendido en los hospitales españoles, y la tendencia es a no considerar la edad materna como indicación para prueba invasiva, disponer de BVC, realizar prueba combinada, solo con TN como marcador ecográfico, desconocer el analizador utilizado y que el laboratorio calcule el índice de riesgo(AU)

Introduction: There was no uniform policy for prenatal screening and diagnosis of chromosomal abnormalities in Spain until 2006. The Spanish Society of Obstetrics and Gynaecology (SEGO) recommends rejecting advanced maternal age as the only indication for invasive procedure, and proposes the first trimester combined test. Objective: To determine the level of implementation of the SEGO recommendations and the changes in hospital screening practice in Spain. Methods: A total of 54 Hospitals, that had attended to 149,320 pregnant women, and 53 hospitals with147,195 pregnancies, responded to an e-mail survey, in the year 2007 and 2011, respectively. The McNemar test was used to compare the results. Results: A total 26 hospital centres performed invasive procedures for advanced maternal age only in 2007, and 11 in 2011 (P = .01); 31 had chorionic villus sampling (CVS) available in 2007, and 33 in 2011 (P=.005); in 42 implemented first trimester combined screening in 2007, and 50 in 2011 (p = ns); in 30 hospitals the only ultrasound marker was Nuchal translucency in 2007, and in 36 in 2011 (p = ns); 26 did not know the type of analyser used for determining biochemical markers in 2007, and 17 in 2011 (P<.01); and 34 the laboratory performed risk calculation in 2007 and 36 in 2011 (p = ns). Conclusion: First trimester combined screening test is widely available across Spanish hospitals, and most centres, do not consider advanced maternal age as the only indication for the invasive procedure, have CVS available, perform combined first trimester test only with nuchal translucency as an ultrasound marker, do not know the analyser used for measure biochemical markers, and that the laboratory provide risk calculations(AU)

Del estado vegetativo al estado de vigilia sin respuesta: una revisión histórica / From the vegetative state to unresponsive wakefulness: a historical review

Introducción. A lo largo de estas últimas décadas, la terminología, las técnicas diagnósticas y el tratamiento de los pacientescon niveles alterados de la conciencia han variado de forma considerable. A su vez, el porcentaje de pacientes en estasituación clínica se ha incrementado notablemente. Objetivo. Se presenta una revisión histórica de los diferentes términos que la literatura médica ha utilizado para la descripción de los pacientes con estados alterados de conciencia. El artículo incluye además los diferentes criterios diagnósticosempleados por los grupos de estudio que han centrado su interés en esta población. Desarrollo. Semiológicamente, el concepto de ‘estado vegetativo’ acuñado en los años setenta se ha transformado y se ha sustituido por términos con una connotación menos negativa, como el de ‘síndrome de vigilia sin respuesta’. Paralelamente, han surgido nuevas categorías clínicas (estado de mínima conciencia o de mínima conciencia plus) al reconocerse la existencia de pacientes con bajo nivel de conciencia pero con signos congruentes de interacción con el entorno a través de conductas inequívocamente voluntarias ante órdenes o gestos. Conclusión. El espectro semiológico de los pacientes con niveles alterados de conciencia refleja la heterogeneidad clínica y neuropatológica de estos estados. La tendencia actual es la de hacer una descripción clínica del estado, añadiendo la etiología y la fecha del evento que causó el cuadro clínico. Este artículo se centra en el contexto de un esfuerzo de la comunidad científica por hacer presente las necesidades de esta creciente población (AU)

Introduction. Over the last few decades, the terminology, diagnostic techniques and treatment of patients with alteredlevels of consciousness have varied considerably. At the same time, the percentage of patients in this clinical situation has undergone a marked increase. Aims. The purpose of this study is to present a historical review of the different terms that have been used in the medical literature to describe patients with altered states of consciousness. The article also includes the different diagnostic criteria utilised by research groups that have focused their attention on this population. Development. The concept of ‘vegetative state’, a term coined back in the sixties, has since been transformed and replaced by other terms with a less negative connotation, such as ‘unresponsive wakefulness syndrome’. In parallel, new clinical categories (minimally conscious state or minimally conscious plus) have appeared since it has been acknowledgedthat there are patients with a low level of consciousness but who nevertheless show signs that are consistent with interaction with the environment by means of unmistakeably voluntary behaviours in response to orders or gestures. Conclusions. The wide spectrum of signs and symptoms shown by patients with altered levels of consciousness reflects theclinical and neuropathological heterogeneity of these states. The current tendency is to describe the state clinically, adding the aetiology and the date of the event that caused the clinical picture. This article focuses on the context of an effort made by the scientific community to highlight the needs of this growing population (AU)

Análisis psicométrico del Inventario de Apoyo Familiar para Trabajadores / Psychometrical analysis of the spanish version of the "Inventory of Family Support for Workers"

El objetivo de este trabajo es estudiar las características psicométricas de una escala de apoyo social para trabajadores: el 'Inventario de Apoyo Familiar para Trabajadores' de King, Mattimore, King y Adams (1995). Debido a la ausencia de instrumentos en nuestro idioma, hemos traducido este cuestionario de su original en inglés. Dicho cuestionario consta de dos dimensiones (subescalas): apoyo emocional y apoyo instrumental, en línea con las conceptualizaciones sobre este constructo. Se ha aplicado a una muestra española de 250 trabajadores, hombres y mujeres que viven en 'familias dos carreras'. Hemos obtenido una fiabilidad muy elevada y similar a la ofrecida por los autores, tanto para la subescala de apoyo emocional (Alpha= .96, 29 items) como para el apoyo instrumental (Alpha= .91, 11 items).A fin de aportar datos acerca de la validez del instrumento, hemos estudiado las relaciones entre las puntuaciones de las subescalas y otros constructos teóricamente relacionados, como el conflicto familia-trabajo, la satisfacción e implicación laboral y el bienestar psicológico. Los resultados confirman la hipótesis del 'efecto principal del apoyo' emocional sobre el bienestar psicológico y la hipótesis de la 'especificidad del apoyo' (AU)

The aim of this paper is to test the psychometrical characteristics of a scale of social support for workers: the «Inventory of Family Support for Workers» (IFSW) by King, Mattimore, King and Adams (1995). This questionnaire has been translated from English into Spanish due to the lack of this type of instruments in this language. According to the theoretical construct, two main dimensions (subscales) compose this questionnaire: emotional and instrumental support. It has been applied to a Spanish sample of 250 workers, both men and women, who live into a dual-career family. In a similar way to the original authors, a very high reliability has been obtained for both the emotional support (alpha= .96, 29 items) and the instrumental support (alpha= .91, 11 items) subscales. In order to check the instrument validity data, the relationships between scores in both subscales and other psychological constructs theoretically related have been studied (work-family conflict, job satisfaction, job involvement and psychological well-being). Results confirm the «principal effect» hypothesis of social support on psychological well-being. The «specificity hypothesis» of social support is also supported (AU)