Clinical distinction between cognitive disengagement syndrome and ADHD presentations in a nationally representative sample of Spanish children and adolescents.

BACKGROUND: This study sought to determine whether cognitive disengagement syndrome (CDS, formerly sluggish cognitive tempo) has different external correlates relative to ADHD-inattentive presentation (INP), ADHD-hyperactive/impulsive presentation (HIP), and ADHD-combined presentation (CP). METHODS: Parents of a nationally representative sample of 5,525 Spanish youth (ages: 5-16, 56.1% boys) completed measures of CDS, ADHD-inattention (IN), and ADHD-hyperactivity/impulsivity (HI) and other measures. Scores greater/less than the top 5% on CDS, ADHD-IN, and ADHD-HI were used to create control (n = 5,013, 90.73%), CDS-only (n = 131, 2.37%), ADHD-INP-only (n = 83, 1.50%), ADHD-HIP-only (n = 113, 2.05%), ADHD-CP-only (n = 48, 0.97%), CDS + ADHD-INP (n = 44, 0.80%), CDS + ADHD-HIP (n = 25, 0.45%), and CDS + ADHD-CP (n = 68, 1.23%) groups. RESULTS: Forty-nine percent of youth with clinically elevated CDS did not qualify for any ADHD presentation, whereas 64% of youth with clinically elevated ADHD did not qualify for CDS. The CDS-only group was higher than the ADHD-INP-only, ADHD-HIP-only, and ADHD-CP-only groups on anxiety, depression, somatization, daytime sleep-related impairment, nighttime sleep disturbance, and peer withdrawal, whereas the CDS-only and ADHD-INP-only groups did not differ on ODD (ADHD-HIP-only and ADHD-CP-only higher) and academic impairment (ADHD-CP-only higher than CDS-only and ADHD-HIP-only lower than CDS-only). The CDS-only group also had higher rates of anxiety, depression, and bipolar disorder diagnoses than the ADHD-only group. CONCLUSIONS: A distinction was found between CDS and each ADHD presentation, thus providing support for CDS as a syndrome that frequently co-occurs with yet is distinct from each ADHD presentation.

Cognitive Disengagement Syndrome Symptoms from Early Childhood to Adolescence in a Nationally Representative Spanish Sample.

OBJECTIVE: The identification of a common set of symptoms for assessing cognitive disengagement syndrome (CDS, formerly sluggish cognitive tempo) for early childhood (ages 5-8), middle childhood (ages 9-12), and adolescence (ages 13-16) is needed to advance research on the developmental psychopathology of CDS (i.e. a common symptom set with comparable internal and external validity for each age group). METHOD: Parents of a nationally representative sample of 5,525 Spanish children and adolescents (ages 5 to 16, 56.1% boys) completed measures of CDS, attention-deficit/hyperactivity disorder-inattention (ADHD-IN), and other measures. RESULTS: First, the 15 CDS symptoms showed convergent and discriminant validity relative to the ADHD-IN symptoms within each age group. Second, CDS showed stronger first-order and unique associations than ADHD-IN with anxiety, depression, somatization, daytime sleep-related impairment, and nighttime sleep disturbance, whereas ADHD-IN showed stronger first-order and unique associations than CDS with ADHD-hyperactivity/impulsivity, oppositional defiant disorder, and academic impairment. Third, CDS showed stronger first-order and unique associations than ADHD-IN with a history of having an anxiety, depression, or bipolar disorder diagnosis, whereas ADHD-IN showed stronger first-order and unique associations with having an ADHD diagnosis. CONCLUSIONS: The identification of a common set of CDS symptoms spanning early childhood to adolescence allows for the advancement of research on CDS, with a particular need now for longitudinal studies and examination of CDS with other functional outcomes and across other cultural contexts.

Soft Drinks and Symptoms of Depression and Anxiety in Overweight Subjects: A Longitudinal Analysis of an European Cohort.

BACKGROUND: Studies about the association of carbonated/soft drinks, coffee, and tea with depression and anxiety are scarce and inconclusive and little is known about this association in European adults. Our aim was to examine the association between the consumption of these beverages and depressive and anxiety symptom severity. METHODS: A total of 941 European overweight adults (mean age, 46.8 years) with subsyndromal depression that participated in the MooDFOOD depression prevention randomized controlled trial (Clinical Trials.gov identifier: NCT2529423; date of the study: from 2014 to 2018) were analyzed. Depressive and anxiety symptom severity and beverage consumption were assessed using multilevel mixed-effects ordinal logistic regression models for each beverage consumption (carbonated/soft drink with sugar, carbonated/soft drink with non-nutritive sweeteners, coffee, and tea) with the three repeated measures of follow-up (baseline and 6 and 12 months). A case report form for participants' sociodemographic and clinical characteristics, the Food Frequency Questionnaire, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder 7-Item Scale, the MINI International Neuropsychiatric Interview 5.0, the Short Questionnaire to Assess Health-Enhancing Psychical Activity, and the Alcohol Use Disorders Identification Test were the research tools used. RESULTS: Daily consumption of carbonated/soft drinks with sugar was associated with a higher level of anxiety. Trends towards significance were found for associations between both daily consumption of carbonated/soft drinks with sugar and non-nutritive sweeteners and a higher level of depression. No relationship was found between coffee and tea consumption and the level of depression and anxiety. CONCLUSIONS: The high and regular consumption of carbonated/soft drink with sugar (amount of consumption: ≥1 unit (200 mL)/day) tended to be associated with higher level of anxiety in a multicountry sample of overweight subjects with subsyndromal depressive symptoms. It is important to point out that further research in this area is essential to provide valuable information about the intake patterns of non-alcoholic beverages and their relationship with affective disorders in the European adult population.

Longitudinal associations between executive function impairments and suicide risk in patients with major depressive disorder: A 1-year follow-up study.

Impaired executive function (EF) is a key feature of patients with major depressive disorder (MDD) that several studies have linked to suicidal ideation and suicide attempts. This is the first longitudinal study to examine the association between impaired EF and suicide risk in adult patients with MDD. Longitudinal prospective study with 3 assessment points: baseline, 6 and 12 months. The Columbia-Suicide Severity Rating Scale (C-SSRS) was used to assess suicidality. The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to assess EF. The association between EF impairments and suicidality was analyzed using mixed-effects models. Out of 167 eligible outpatients, 104 were included in the study. Of these, 72 were re-evaluated at 6 months and 60 at 12 months, obtaining 225 complete observations of the EF. Impaired decision-making and risk-taking behavior were associated with suicidal ideation. Difficulty in impulse control was related to suicidal ideation and to greater severity of suicidal ideation. Impaired spatial planning and working memory was linked to suicide attempts. Our results add to previous literature that the association between EF impairments and suicidality is maintained over the long term, supporting it as a longitudinal risk factor and a possible neurocognitive marker of suicide in patients with MDD.

Development and Evaluation of a Digital Health Intervention to Prevent Type 2 Diabetes in Primary Care: The PREDIABETEXT Study Protocol for a Randomised Clinical Trial.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a highly prevalent disease associated with an increased risk of comorbidities, premature death, and health costs. Prediabetes is a stage of glucose alteration previous to T2DM, that can be reversed. The aim of the study is to develop and evaluate a low-intensity, multifaceted, digital intervention to prevent T2DM. The intervention comprises: (1) the use of mobile health technology to send tailored text messages promoting lifestyle changes to people at risk of T2DM and (2) the provision of online education to primary healthcare physicians and nurses about management of prediabetes. METHODS: In stages 1-4 we will design, develop and pilot-test the intervention. In Stage 5 we will conduct a phase II, six-month, three-arm, cluster randomized, clinical trial with 42 primary care professionals and 420 patients at risk of T2DM. Patients will be allocated to a control group (usual care), intervention A (patient messaging intervention), or intervention B (patient messaging intervention plus online education to their primary healthcare professionals). The primary outcome will be glycated haemoglobin. All the procedures obtained ethical approval in June 2021 (CEI-IB Ref No: IB4495/21PI). DISCUSSION: Digital health interventions can effectively prevent T2DM and reduce important T2DM risk factors such as overweight or hypertension. In Spain, this type of intervention is understudied. Moreover, there is controversy regarding the type of digital health interventions that are more effective. Findings from this study may contribute to address T2DM prevention, through a low-cost and easily implementable intervention.

Survival of Breast Cancer by Stage, Grade and Molecular Groups in Mallorca, Spain.

The aims of this study are: (1) to determine cause-specific survival by stage, grade, and molecular groups of breast cancer, (2) to identify factors which explain and predict the likelihood of survival and the risk of dying from this cancer; and (3) to find out the distribution of breast cancer cases by stage, grade, and molecular groups in females diagnosed in the period 2006-2012 in Mallorca (Spain). We collected data regarding age, date and diagnostic method, histology, laterality, sublocation, pathological or clinical tumor size (T), pathological or clinical regional lymph nodes (N), metastasis (M) and stage, histologic grade, estrogen and progesterone receptors status, HER-2 expression, Ki67 level, molecular classification, date of last follow-up or date of death, and cause of death. We identified 2869 cases. Cause-specific survival for the entire sample was 96% 1 year after diagnosis, 91% at 3 years and 87% at 5 years. Relative survival was 96.9% 1 year after diagnosis, 92.6% at 3 years and 88.5% at 5 years. The competing-risks regression model determined that patients over 65 years of age and patients with triple negative cancer have worse prognoses, and as stages progress, the prognosis for breast cancer worsens, especially from stage III.

Prostate Cancer Survival by Risk and Other Prognostic Factors in Mallorca, Spain.

Studies about the survival of patients with prostate cancer by stage or risk of progression are scarce. The aims of this study were (1) to determine the cause-specific survival by risk in prostate cancer patients in Mallorca diagnosed in the period 2006-2011; (2) to identify the factors that explain and predict the likelihood of survival and the risk of dying from this type of cancer; and (3) to determine the distribution of prostate cancer by risk in the patients in Mallorca diagnosed in the period 2006-2011. Incident prostate cancer cases diagnosed between 2006 and 2011 were identified through the Mallorca Cancer Registry. We collected age; date and method of diagnosis; date of follow-up or death; T, N, M and stage according to the TNM 7th edition; Gleason score; prostate-specific antigen (PSA); histology according to the International Classification of Diseases for Oncology (ICD-O) 3rd edition, comorbidities and treatments. We calculated risk in four categories: low, medium, high and very high. The end point of follow-up was 31 December 2014. Multiple imputation (MI) was performed to estimate cases with unknown risk. We identified 2921 cases. Five years after diagnosis, survival after MI was 89% globally, and was 100% for low-risk cases, 96% for medium risk, 93% for high risk and 69% for very-high-risk cases. Cases with histology other than adenocarcinoma, with high (and especially very high) risk, as well as with systemic, mixed and observation/unspecified treatments had worse prognoses.

The Influence of the Competences of the Professionals in Charge of Family Evidence-Based Programmes on Internalizing and Externalizing Symptoms in Adolescents.

This study analyses the influence of trainers' intrapersonal and group management competences on the effectiveness of the Universal Strengthening Families Program 11-14 (SFP 11-14). More specifically, it assesses the effect of these competences on internalizing and externalizing symptoms in adolescents. The analysed data is made up of ratings given by the 174 mothers participating in SFP 11-14. The results confirm the effectiveness of SFP 11-14 in reducing internalizing and externalizing symptoms in adolescents. Using linear regression models, evidence is provided of the influence of the trainers' expertise, in terms of their competences, in improving internalizing symptoms in adolescents (through a reduction in levels of anxiety, depression, and somatization and in the global internalization scale). Emphasis is placed on how trainer competences can impact on the effectiveness of evidence-based programmes, stressing that this should be taken into account by the public authorities and other stakeholders in the assessment and design of family evidence-based programmes.

Diagnóstico ultrasonográfico del embarazo ectópico como urgencia ginecobstétrica / Sonographic diagnosis of ectopic pregnancy as a gynecological-obstetric emergency

Se realizó un estudio descriptivo longitudinal transversal que incluyó a las pacientes intervenidas quirúrgicamente con embarazo ectópico en el Hospital General Docente Abel Santamaría Cuadrado de la provincia Pinar del Río, durante el período comprendido desde el 1 de enero de 2010 hasta el 31 de diciembre de 2010. Se incluyeron todas las pacientes egresadas a las que se les había realizado ultrasonografía y poseían un diagnóstico histológico posoperatorio de esta entidad. El embarazo ectópico durante el período estudiado fue más frecuente en grupo de mujeres comprendidas entre los 20-29 años, del color de piel blanca, con un alto predomino en la localización tubárica, y con una condición física del EE roto, cuya forma de presentación ultrasonográfica más frecuentemente observada fue la de líquido libre intraabdominal, y de imagen de masa anexial...(AU)

A descriptive, longitudinal, cross-sectional study which included patients operated on ectopic pregnancy at Abel Santamaria Cuadrado University Hospital, Pinar del Rio was conducted from January 1st, 2010 to December 31, 2010. All patients discharged from the hospital with sonographic diagnosis and having post-operative histological diagnosis of this entity were included in the study. The ectopic pregnancy was more frequent found, (in the period of the study) in women from 20 to 29 years old, tubal localization prevailed in Caucasian race having a physical condition of broken ectopic pregnancy, the most frequent presentation observed in sonographic images were intrabdominal free fluids and a mass in annexa...(AU)

Diagnóstico ultrasonográfico del embarazo ectópico como urgencia ginecobstétrica / Sonographic diagnosis of ectopic pregnancy as a gynecological-obstetric emergency

Se realizó un estudio descriptivo longitudinal transversal que incluyó a las pacientes intervenidas quirúrgicamente con embarazo ectópico en el Hospital General Docente "Abel Santamaría Cuadrado" de la provincia Pinar del Río, durante el período comprendido desde el 1 de enero de 2010 hasta el 31 de diciembre de 2010. Se incluyeron todas las pacientes egresadas a las que se les había realizado ultrasonografía y poseían un diagnóstico histológico postoperatorio de esta entidad. El embarazo ectópico durante el período estudiado fue más frecuente en grupo de mujeres comprendidas entre los 20-29años, del color de piel blanca, con un alto predomino en la localización tubárica, y con una condición física del EE roto, cuya forma de presentación ultrasonográfica más frecuentemente observada fue la de líquido libre intraabdominal, y de imagen de masa anexial.

A descriptive, longitudinal, cross-sectional study which included patients operated on ectopic pregnancy at "Abel Santamaria Cuadrado" University Hospital, Pinar del Rio was conducted from January 1st, 2010 to December 31, 2010. All patients discharged from the hospital with sonographic diagnosis and having post-operative histological diagnosis of this entity were included in the study. The ectopic pregnancy was more frequent found, (in the period of the study) in women from 20 to 29 years old, tubal localization prevailed in Caucasian race having a physical condition of broken ectopic pregnancy, the most frequent presentation observed in sonographic images were intrabdominal free fluids and a mass in annexa.

Anomalía vaginal: a propósito de un caso interesante / Vaginal abnormality: an interesting case report

Las malformaciones uterovaginales (MUV), se deben a una alteración en el proceso de embriogénesis del sistema reproductor femenino. La ecografía tiene un rol importante en el estudio inicial de las mismas, la RMN tiene ventajas importantes, es un estudio no invasivo, con una sensibilidad de casi 100%. La histerosalpingografía es la técnica clásica para el estudio de las MUV que proporciona información sobre el canal cervical, endometrial y la permeabilidad tubárica. Se demuestra la utilidad de la ecografía transabdominal en el manejo imagenológico de una MUV y sus complicaciones principales al presentar el caso de una paciente de 12 años de edad que acudió a consulta con fiebre elevada, dolor hipogástrico y oliguria/disuria sin menarquia. Al examen físico se palpó tumoración suprapúbica, abombamiento perineal e himen no tunelizado, se constató edema facial e hipertensión arterial. La ecografía reveló una moderada dilatación de los sistemas excretores de ambos riñones, la cavidad vesical notablemente distendida, visualizándose masa hipoecoica retrovesical en fosa ilíaca derecha, sin septos ni contenido, relacionada con hematometra secundaria a himen imperforado, causando hidronefrosis obstructiva bilateral que condujo a retención urinaria y de fallo renal agudo. Se realizó corrección quirúrgica de la MUV obteniéndo una evolución clínico imagenológica satisfactoria.

Uterovaginal malformations (UVM) are due to an alteration in the process of embryogenesis of the female reproductive system. The imaging has a very important role during initial studies of these abnormalities; magnetic resonance imaging has significant advantages in non-invasive studies with a sensitivity of almost 100%. Hysterosalpingography is the classic technique to the study of UVM that provides information about cervical, endometrial canals and tubal permeability. The usefulness of the transabdominal imaging in the management of a UVM and main complications was showed when presenting a case of a 12 years old patient attending to the office with high fever, hypogastric pain and oliguria/dysuria without menarche. At physical examination a suprapubic tumor was palpated, a perineal dome, a non-tunneled hymen, facial edema and hypertension were observed. Imaging revealed a moderate dilatation of the excretory systems in both kidneys, vesical cavity was notable distended, visualizing a retrovesical hypoecoid mass in the right iliac fossa, without septa or contents related to a hematometra due to an imperforate hymen provoking bilateral obstructive hydronephrosis which led to a urinary retention of acute renal failure. Surgical correction of the UVM was carried out having a satisfactory imaging-clinical progression.

Anomalía vaginal: a propósito de un caso interesante / Vaginal abnormality: an interesting case report

Las malformaciones uterovaginales (MUV), se deben a una alteración en el proceso de embriogénesis del sistema reproductor femenino. La ecografía tiene un rol importante en el estudio inicial de las mismas, la RMN tiene ventajas importantes, es un estudio no invasivo, con una sensibilidad de casi 100 por cinto. La histerosalpingografía es la técnica clásica para el estudio de las MUV que proporciona información sobre el canal cervical, endometrial y la permeabilidad tubárica. Se demuestra la utilidad de la ecografía transabdominal en el manejo imagenológico de una MUV y sus complicaciones principales al presentar el caso de una paciente de 12 años de edad que acudió a consulta con fiebre elevada, dolor hipogástrico y oliguria/disuria sin menarquia. Al examen físico se palpó tumoración suprapúbica, abombamiento perineal e himen no tunelizado, se constató edema facial e hipertensión arterial. La ecografía reveló una moderada dilatación de los sistemas excretores de ambos riñones, la cavidad vesical notablemente distendida, visualizándose masa hipoecoica retrovesical en fosa ilíaca derecha, sin septos ni contenido, relacionada con hematometra secundaria a himen imperforado, causando hidronefrosis obstructiva bilateral que condujo a retención urinaria y de fallo renal agudo. Se realizó corrección quirúrgica de la MUV obteniéndo una evolución clínico imagenológica satisfactoria...(AU)

Uterovaginal malformations (UVM) are due to an alteration in the process of embryogenesis of the female reproductive system. The imaging has a very important role during initial studies of these abnormalities; magnetic resonance imaging has significant advantages in non-invasive studies with a sensitivity of almost 100 per cent. Hysterosalpingography is the classic technique to the study of UVM that provides information about cervical, endometrial canals and tubal permeability. The usefulness of the transabdominal imaging in the management of a UVM and main complications was showed when presenting a case of a 12 years old patient attending to the office with high fever, hypogastric pain and oliguria/dysuria without menarche. At physical examination a suprapubic tumor was palpated, a perineal dome, a non-tunneled hymen, facial edema and hypertension were observed. Imaging revealed a moderate dilatation of the excretory systems in both kidneys, vesical cavity was notable distended, visualizing a retrovesical hypoecoid mass in the right iliac fossa, without septa or contents related to a hematometra due to an imperforate hymen provoking bilateral obstructive hydronephrosis which led to a urinary retention of acute renal failure. Surgical correction of the UVM was carried out having a satisfactory imaging-clinical progression...(AU)