Preliminary analysis of a shortened picture version of the Free and Cued Selective Reminding Test.

INTRODUCTION: A picture version of the Free and Cued Selective Reminding Test (FCSRT) would assist in the assessment of memory function in patients with low levels of schooling. A shortened version would improve the test's applicability. OBJECTIVES: To analyse the diagnostic usefulness of a shortened picture version of the FCSRT for distinguishing patients with amnestic mild cognitive impairment (aMCI) from controls, without excluding participants with a low level of schooling. METHODS: Phase I study of a diagnostic evaluation (convenience sampling; pre-test prevalence 50%). A blinded researcher independently administered the FCSRT to 30 patients with aMCI and 30 controls matched for age, sex, level of schooling and literacy, using images and omitting the usual 30-minutes delayed recall item. Three variables were recorded: free recall, total recall, and cue efficiency. Diagnostic accuracy was calculated using receiver operating characteristic curves and the area under the curve. The Youden index was used to identify optimal cut-off points. RESULTS: Of all participants, 41.7% had not completed primary education. There were no differences between groups as regards sociodemographic variables. Area under the curve was excellent for free recall (0.99), total recall (0.95), and cue efficiency (0.93). The optimal cut-off points were 21/22, 43/44, and < 0.77, respectively. CONCLUSIONS: This preliminary analysis shows that a shortened picture version of the FCSRT may be useful and applicable for the diagnosis of aMCI without excluding individuals with a low level of schooling.

Clinical and molecular characterization of hereditary spastic paraplegia in a spanish Southern region.

INTRODUCTION: Spastic paraplegia (SPG) is a syndrome characterised by lower limb spasticity, occurring alone or in association with other neurological manifestations. Despite of the new molecular technologies, many patients remain yet undiagnosed. OBJECTIVE: The purpose of this study was to describe the clinical presentation and molecular characteristics of a cohort of 27 patients from 18 different families with SPG in the south of Spain. METHODS: We used a targeted next-generation sequencing (NGS) approach to study a proband from each family. RESULTS: Variants in SPG11 gene were the most common cause of SPG in our area. We made a genetic diagnosis in 52% of cases, identified 3 novel variants and reclassified one uncertain variant in SPG11 gene as pathogenic variant. We identified a patient with two truncanting mutations in SPG11 gene and late onset disease and report another missense mutation outside of motor domain of KIF1A gene in a family with pure SPG. CONCLUSION: Our study contributes to enhance the scientific knowledge of SPG. It is important to note the large group of cases (48%) that were not genetically diagnosed in our cohort. Therefore NGS approach is an efficient diagnostic tool, but it still large the number of non-diagnosed subjects, suggesting further genetic heterogeneity.

Non-motor symptom burden in patients with Parkinson's disease with impulse control disorders and compulsive behaviours: results from the COPPADIS cohort.

The study was aimed at analysing the frequency of impulse control disorders (ICDs) and compulsive behaviours (CBs) in patients with Parkinson's disease (PD) and in control subjects (CS) as well as the relationship between ICDs/CBs and motor, nonmotor features and dopaminergic treatment in PD patients. Data came from COPPADIS-2015, an observational, descriptive, nationwide (Spain) study. We used the validated Questionnaire for Impulsive-Compulsive Disorders in Parkinson's Disease-Rating Scale (QUIP-RS) for ICD/CB screening. The association between demographic data and ICDs/CBs was analyzed in both groups. In PD, this relationship was evaluated using clinical features and treatment-related data. As result, 613 PD patients (mean age 62.47 ± 9.09 years, 59.87% men) and 179 CS (mean age 60.84 ± 8.33 years, 47.48% men) were included. ICDs and CBs were more frequent in PD (ICDs 12.7% vs. 1.6%, p < 0.001; CBs 7.18% vs. 1.67%, p = 0.01). PD patients had more frequent previous ICDs history, premorbid impulsive personality and antidepressant treatment (p < 0.05) compared with CS. In PD, patients with ICDs/CBs presented younger age at disease onset, more frequent history of previous ICDs and premorbid personality (p < 0.05), as well as higher comorbidity with nonmotor symptoms, including depression and poor quality of life. Treatment with dopamine agonists increased the risk of ICDs/CBs, being dose dependent (p < 0.05). As conclusions, ICDs and CBs were more frequent in patients with PD than in CS. More nonmotor symptoms were present in patients with PD who had ICDs/CBs compared with those without. Dopamine agonists have a prominent effect on ICDs/CBs, which could be influenced by dose.

Effectiveness of a multimodal training programme to improve general practitioners' burnout, job satisfaction and psychological well-being.

BACKGROUND: The changes in the models of care for mental disorders towards a community focus and deinstitutionalisation might have risen General practitioners' (GPs) workload, increasing their mental health concerns and the need for solutions. Pragmatic research into improving GPs' work-related health and psychological well-being is limited by focusing mainly on stressors and through not providing systematic attention to the development of positive mental health via interventions that develop psychological resources and capacities. The aim of this study was twofold: a) to determine the effectiveness of an intensive multimodal training programme for GPs designed to improve their management of mental-health patients; and b) to ascertain if the program could be also useful to improve the GPs management of their own burnout, job satisfaction and psychological well-being. METHOD: Eighteen GPs constituted a control group that underwent the routine clinical Mental health support programme for primary care. An experimental group (N = 20) additionally received a Multimodal training programme (MTP) with an Integrated Brief Systemic Therapy (IBST) approach. Through questionnaires and a clinical interview, level of burnout, professional satisfaction, psychopathological state and various indicators of the quality of administrative and healthcare management were analysed at baseline and 10 months after the programme. RESULTS: In relation to government of mental-health patients indicators, on the one hand MTP group showed statistically significant improvements in certain administrative health parameters, but on the other it did not improve opinions and attitudes towards mental illness. Regarding GPs management of their own burnout, job satisfaction and psychological well-being assessments, the MTP presented better scores on global psychopathological state and better evolution of satisfaction at work; psychopharmacology use dropped in both groups; in contrast, the MTP did not improve burnout levels. CONCLUSIONS: Findings of this preliminary study are promising for the MTP (with an IBST approach) practice in primary care. More research evidence is required from larger samples and randomized controlled trials to support both the hypothetical adoption of MTP (with an IBST approach) as a part of a continuing professional-training programme for GPs' management of mental-health patients and its positive effects on work-related health factors.

Preliminary analysis of a shortened picture version of the Free and Cued Selective Reminding Test. / Evaluación preliminar de una versión pictórica y abreviada del Free and Cued Selective Reminding Test.

INTRODUCTION: A picture version of the Free and Cued Selective Reminding Test (FCSRT) would assist in the assessment of memory function in patients with low levels of schooling. A shortened version would improve the test's applicability. OBJECTIVES: To analyse the diagnostic usefulness of a shortened picture version of the FCSRT for distinguishing patients with amnestic mild cognitive impairment (aMCI) from controls, without excluding participants with a low level of schooling. METHODS: Phase I study of a diagnostic evaluation (convenience sampling; pre-test prevalence 50%). A blinded researcher independently administered the FCSRT to 30 patients with aMCI and 30 controls matched for age, sex, level of schooling and literacy, using images and omitting the usual 30-minute delayed recall item. Three variables were recorded: free recall, total recall, and cue efficiency. Diagnostic accuracy was calculated using receiver operating characteristic curves and the area under the curve. The Youden index was used to identify optimal cut-off points. RESULTS: Of all participants, 41.7% had not completed primary education. There were no differences between groups as regards sociodemographic variables. Area under the curve was excellent for free recall (0.99), total recall (0.95), and cue efficiecy (0.93). The optimal cut-off points were 21/22, 43/44, and < 0.77, respectively. CONCLUSIONS: This preliminary analysis shows that a shortened picture version of the FCSRT may be useful and applicable for the diagnosis of aMCI without excluding individuals with a low level of schooling.

Trastorno límite de la personalidad e ingesta de cuerpos extraños / Borderline personality disorder and foreign body ingestion

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[Minor cutaneous ambulatory surgery and cryotherapy. Comparative study between a dermatologist and family physicians]. / Cirugía menor ambulatoria dermatológica y crioterapia. Estudio comparativo entre un dermatólogo y médicos de familia.

INTRODUCTION: Lack of diagnostic skill in cutaneous surgery may lead to erroneous and potentially detrimental therapies. This study compares the diagnosis and treatment in cutaneous surgery, including cryotherapy, between a dermatologist and family physicians. METHODS: It is an observational, prospective study on a random sample of patients that consulted the dermatologist for candidate lesions. Each lesion was independently evaluated by a dermatologist and a family physician, both of whom assigned the clinical diagnosis and therapeutic advice. Concordance for diagnosis, recommended treatment and indication for cryotherapy was calculated by Cohen's kappa coefficient. RESULTS: Six hundred forty-six lesions were evaluated. Global kappa indexes were 0.69 (95 % CI, 0.65-0.73) for diagnostic concordance, 0.62 (95 % CI, 0.56-0.67) for recommended treatment and 0.73 (95 % CI, 0.67-0.78) for indication of cryotherapy. Diagnostic concordance was significantly better for melanocytic nevus, achrocordon and for lesions with multiple and monomorphous presentation, and worse for isolated pigmented lesions. For recommended treatment concordance was better for multiple and monomorphous lesions and worse for skin cancer and seborrheic keratosis. For indication of cryotherapy concordance was worse for skin cancer, melanocytic nevus, acrochordon and seborrheic keratosis. Family physicians made an erroneous indication for cryotherapy in 5.88 % of cases, including 3 non melanoma skin cancers. CONCLUSIONS: Concordance between dermatologists and family physicians for minor cutaneous surgery is generally good. Family physicians should be more careful in evaluating solitary pigmented lesions and patients at risk for skin cancer.

Psychometric evaluation of the Spanish version of CONNECT: a measure of continuity of care in mental health services.

This article provides the results of the psychometric testing of the Spanish version of CONNECT(-S), a measure of continuity of care in mental health services. CONNECT-S is a multidimensional measure designed for use with seriously mentally ill respondents. Consisting of 12 scales and one single-item indicator, it addresses qualities of interaction in current relationships between mental health service providers and consumers in five conceptual domains: (1) practitioner knowledge of their clients, (2) creating flexibility, (3) practitioner availability, (4) practitioner co-ordination, and (5) smoothing transitions. One-hundred-and-fifty participants took part in the study. Participants were recruited from mental health outpatient clinics in both the Puerto Rican (n = 109) and the San Antonio (n = 41) samples. Internal consistency for scales in a combined site estimate ranged from 0.68 to 0.96. Test-retest reliability ranged from fair to substantial in all but one scale. Concurrent validity hypotheses based on a priori predictions were mostly supported. The Spanish translation and adaptation of CONNECT-S provided sound psychometric results across both sites. CONNECT-S addresses the gap in measurement of continuity of care for the two largest US Latino subgroups, Mexican Americans and Puerto Ricans; and provides an encouraging starting point for a measure that is both relevant and culturally sensitive.

Cirugía menor ambulatoria dermatológica y crioterapia. Estudio comparativo entre un dermatólogo y médicos de familia / Minor cutaneous ambulatory surgery and cryotherapy. Comparative study between a dermatologist and family physicians

Introducción. En cirugía dermatológica, una menor habilidad diagnóstica podría conducir a tratamientos erróneos y potencialmente perjudiciales. En este trabajo se compara el diagnóstico y la decisión terapéutica en cirugía dermatológica, incluyendo la crioterapia, entre un dermatólogo y médicos de familia. Métodos. Estudio prospectivo observacional, sobre una muestra no seleccionada de pacientes que consultan al dermatólogo por lesiones candidatas. Cada lesión fue evaluada independientemente por un dermatólogo y un médico de familia, consignando ambos el diagnóstico clínico y el consejo terapéutico. Se calculó la concordancia para el diagnóstico, tratamiento recomendado e indicación de crioterapia mediante el estadístico kappa de Cohen. Resultados. Se evaluaron 646 lesiones. Los índices kappa globales fueron 0,69 (intervalo de confianza [IC] del 95 %, 0,65-0,73) en concordancia diagnóstica, 0,62 (IC del 95 %, 0,56-0,67) en tratamiento recomendado y 0,73 (IC del 95 %, 0,67-0,78) en indicación de crioterapia. La concordancia diagnóstica resultó significativamente mejor en nevus melanocítico, acrocordón y en lesiones con presentación múltiple y monomorfa, y peor en lesiones pigmentadas aisladas. En tratamiento recomendado fue mejor para lesiones múltiples y monomorfas, y peor en cáncer de piel y queratosis seborreica. En indicación de crioterapia fue peor en cáncer de piel, nevus melanocítico, acrocordón y queratosis seborreica. Los médicos de familia indicaron crioterapia incorrectamente en el 5,88 % de casos, incluyendo tres cánceres de piel no melanoma. Conclusiones. La concordancia entre dermatólogos y médicos de familia en cirugía menor dermatológica es en general buena. Los médicos de familia deberían ser cautos en lesiones pigmentadas solitarias y pacientes de riesgo para cáncer de piel

Introduction. Lack of diagnostic skill in cutaneous surgery may lead to erroneous and potentially detrimental therapies. This study compares the diagnosis and treatment in cutaneous surgery, including cryotherapy, between a dermatologist and family physicians. Methods. It is an observational, prospective study on a random sample of patients that consulted the dermatologist for candidate lesions. Each lesion was independently evaluated by a dermatologist and a family physician, both of whom assigned the clinical diagnosis and therapeutic advice. Concordance for diagnosis, recommended treatment and indication for cryotherapy was calculated by Cohen's kappa coefficient. Results. Six hundred forty-six lesions were evaluated. Global kappa indexes were 0.69 (95 % CI, 0.65-0.73) for diagnostic concordance, 0.62 (95 % CI, 0.56-0.67) for recommended treatment and 0.73 (95 % CI, 0.67-0.78) for indication of cryotherapy. Diagnostic concordance was significantly better for melanocytic nevus, achrocordon and for lesions with multiple and monomorphous presentation, and worse for isolated pigmented lesions. For recommended treatment concordance was better for multiple and monomorphous lesions and worse for skin cancer and seborrheic keratosis. For indication of cryotherapy concordance was worse for skin cancer, melanocytic nevus, acrochordon and seborrheic keratosis. Family physicians made an erroneous indication for cryotherapy in 5.88 % of cases, including 3 non melanoma skin cancers. Conclusions. Concordance between dermatologists and family physicians for minor cutaneous surgery is generally good. Family physicians should be more careful in evaluating solitary pigmented lesions and patients at risk for skin cancer

Uso tutelado de la tomografía por emisión de positrones con 18FDG / Monitorized use of 18FDG Positron emission tomography

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Ultrasound-assisted extraction of volatile compounds from wine samples: optimisation of the method.

This study describes a liquid-liquid extraction technique for extracting volatile compounds from wine using dichloromethane and ultrasounds. This technique permits the simultaneous extraction of different samples with high reproducibility. After the preliminary tests, several parameters (sample volume, solvent volume and extraction time) were optimised using a factorial design to obtain the most relevant variables. The analytical characteristics were obtained such as calibration graphs, detection limits ranging from 0.0238 mg L(-1) for 1-pentanol to 0.261 mg L(-1) for octanoic acid, quantification limits and relative standard deviation from 2.1 to 6.2%. Extraction yields were calculated giving a range 9.16-1.2%. The optimised conditions were applied to the extraction of samples of young wines from the Denominación de Origen Calificada Rioja category using gas chromatography and a flame ionisation detector.

Maltrato por abuso de poder entre escolares, ¿de qué estamos hablando? / What do we mean when we talk about peer bullying in schools?

Se describe la naturaleza del maltrato por abuso de poder entre iguales en la escuela distinguiendo las características que lo definen y las que suelen estar presentes sin ser necesarias, analizando algunos de los tópicos, no siempre reales, que acompañan al fenómeno. Se revisan, fundamentalmente a partir de datos españoles, la incidencia del problema, sus escenarios y participantes, y sus repercusiones para los implicados, así como las representaciones acerca de este problema que manifiestan escolares y profesores participantes en estudios cualitativos realizados por los autores. Por último, se reflexiona sobre el papel de distintos participantes -especialmente el del centro educativo- en la intervención y prevención del maltrato por abuso de poder

The nature of peer bullying in schools is described, differentiating between its defining characteristics and others usually but not necessarily present. Topics on the phenomenon, sometimes unreal, are analysed. On the basis of Spanish data, incidence of bullying in schools, its settings and participants, and its consequences for the ones involved are sumarised, together with students´ and teachers´ representations of this problem, resulting from qualitative studies carried out by the authors. Finally, the role of different participants, specially the school, inthe intervention and prevention ob bullying, is discussed

Ethnic differences in social network help-seeking strategies among Latino and Euro-Aamerican dementia caregivers.

This research explores the help-seeking behavior of Euro-American and Latino caregivers who provide homecare assistance to an older adult with dementia. A community sample of 89 caregiver-care recipient pairs (39 Latino and 50 Euro-American) was interviewed. Descriptive, bivariate, and multivariate analyses were conducted to examine ethnic differences in use of an informal social network for help with caregiving tasks. Caregiver experiences that may impact help-seeking behaviors such as perceived availability of support network, satisfaction with support received and caregiver distress were also considered. Latino caregivers reported less help-seeking than did the Euro-American caregivers. Overall, ethnicity accounted for 16% of the variation in help-seeking behaviors. Ethnicity accounted for a significant portion of the variation in most of the help-seeking characteristics examined even after adjusting for socioeconomic variables. In the multivariate model, the effects of ethnicity on help-seeking persisted, while the effects of other likely predictors did not. The size of social network may not be synonymous with the seeking of support by caregivers. Likewise, higher levels of distress among Latino caregivers did not result in increased help-seeking behaviors. There remains a need to identity what other factors may contribute to the cultural variability in caregivers' use of informal support.

Successful use of tissue plasminogen activator in catheter-related intracardiac thrombus of a premature infant.

The incidence of clinically apparent neonatal thrombosis is about 0.1 to 0.2% in the neonatal intensive care unit (NICU). The optimal treatment modalities for neonates with thromboses are not known. We report on our experience with recombinant tissue type plasminogen activator (rt-PA) in a premature infant with an intracardiac thrombus.

Separation and determination of volatile compounds in synthetic wine samples by gas chromatography using UV-visible molecular absorption spectrometry as detector.

This paper shows the separation and determination of eight compounds containing the OH group (ethanol, pentanol, 3-methyl-1-butanol, hexanol, phenol, benzyl-alcohol, phenylethanol and geraniol) in synthetic wine by gas chromatography using UV-Vis molecular absorption spectrometry as detection system. All the parameters affecting the separation and determination were optimised using some methods of experiment design. The analytical characteristics of each compound were calculated and detection limits ranging from 2.3 to 74 mg l(-1) have been obtained.

Culture and schizophrenia: a cross-ethnic growth curve analysis.

This study examined the longitudinal trajectory of a sociocentric construct among African-Americans, Latinos, and nonminorities. Participants were 163 individuals diagnosed with schizophrenia who were admitted to community-based psychosocial programs. Previous research had established empathy and social competence as sociocentric cultural mediators of a benign symptom profile for ethnic minorities. Data on sociocentric indicators were collected every 6 months for over 3 years. Growth curve methodology was used to examine the empathy and social competence outcomes over time and across ethnic groups. The results revealed a dynamic course for both sociocentric mediators. However, the dynamic growth curve for empathy was related to ethnicity; for social competence it was not. Empathy levels for African-Americans decreased and then attenuated, whereas empathy levels for Latinos decreased over the entire study. Nonminorities showed very little change overall. The nature of sociocentric phenomena is dynamic and complex. These qualities can apparently be cultivated or diminished over time.

Theory and computer simulation for the equation of state of additive hard-disk fluid mixtures.

A procedure previously developed by the authors to obtain the equation of state for a mixture of additive hard spheres on the basis of a pure fluid equation of state is applied here to a binary mixture of additive hard disks in two dimensions. The equation of state depends on two parameters which are determined from the second and third virial coefficients for the mixture, which are known exactly. Results are compared with Monte Carlo calculations which are also reported. The agreement between theory and simulation is very good. For the fourth and fifth virial coefficients of the mixture, the equation of state gives results which are also in close agreement with exact numerical values reported in the literature.