Sleep Disturbances in At-Risk Mental States and First Episode of Psychosis: A Narrative Review on Interventions.

Sleep disturbances are a common yet often overlooked symptom of psychosis that can drastically affect the quality of life and well-being of those living with the condition. Sleep disorders are common in people diagnosed with schizophrenia and have significant negative effects on the clinical course of the illness and the functional outcomes and quality of life of patients. There is a limited number of studies addressing this question in first-episode psychosis (FEP). In this narrative review, we aimed to provide an overview of sleep disorders in populations with FEP and at-risk mental states (ARMS). The review was focused on the various treatments currently used for sleep disorders, including both non-pharmacological and pharmacological treatments. A total of 48 studies were included. We found that sleep disturbances are associated with attenuated psychotic symptoms and other psychopathological symptoms in ARMSs. The association of sleep disturbances with the transition to psychosis has been poorly investigated. Sleep disturbances have an impact on the quality of life and the psychopathological symptoms of people suffering from FEP. The non-pharmacological treatments include cognitive behavioral therapy for insomnia, bright light therapy, cognitive restructuring techniques, sleep restriction therapy, basic sleep hygiene education, and the provision of portable sleep trackers. Other treatments include antipsychotics in acute phases and melatonin. The early intervention in sleep disturbances may improve overall prognosis in emerging psychosis populations.

Optimisation of processing methods to improve success in the derivation of human multipotent mesenchymal stromal cells from cryopreserved umbilical cord tissue fragments.

Wharton's Jelly (WJ)-derived Mesenchymal Stromal Cells (MSC) are currently in the spotlight for the development of innovative MSC-based therapies due to their ease of sourcing, high proliferation capacity and improved immunopotency over MSC from other tissue sources. However, the short time window for derivation from donated fresh umbilical cord (UC) tissue fragments does not allow to consider biological features of the donor beyond serological safety testing. This limits the scope of MSC banking to rapid, prospective derivation of MSC, WJ lines without considering biological and genetic characteristics of the donor that may influence their suitability for clinical use (e.g. HLA type, inherited gene variants). In the present study, we describe a simple, efficient and reproducible approach for the cryopreservation of UC tissue fragments, compatible with established workflows in existing public frameworks for cord blood and tissue collection while guaranteeing pharmaceutical grade of starting materials for further processing under GMP standards. Herein we demonstrated the feasibility of time and cost-saving methods for cryopreservation of unprocessed UC tissue fragments directly at reception of the donated tissues using 10% Me2SO-based cryosolution and a commercial clinical-grade defined cryopreservation medium (Cryostor®), showing the preservation of all Critical Quality Attributes in terms of identity, potency and kinetic parameters. In summary, our study provides evidence that cryopreservation of large unprocessed UC tissue fragments (5-13.5 cm) supports subsequent progenitor cell isolation and derivation of MSC,WJ, preserving their viability, identity, proliferation rates and potency.

Wharton's Jelly Mesenchymal Stromal Cells and Derived Extracellular Vesicles as Post-Myocardial Infarction Therapeutic Toolkit: An Experienced View.

Outstanding progress has been achieved in developing therapeutic options for reasonably alleviating symptoms and prolonging the lifespan of patients suffering from myocardial infarction (MI). Current treatments, however, only partially address the functional recovery of post-infarcted myocardium, which is in fact the major goal for effective primary care. In this context, we largely investigated novel cell and TE tissue engineering therapeutic approaches for cardiac repair, particularly using multipotent mesenchymal stromal cells (MSC) and natural extracellular matrices, from pre-clinical studies to clinical application. A further step in this field is offered by MSC-derived extracellular vesicles (EV), which are naturally released nanosized lipid bilayer-delimited particles with a key role in cell-to-cell communication. Herein, in this review, we further describe and discuss the rationale, outcomes and challenges of our evidence-based therapy approaches using Wharton's jelly MSC and derived EV in post-MI management.

Infectious skin disorders encountered in a pediatric emergency department of a tertiary care hospital in Argentina: a descriptive study.

BACKGROUND: Infectious skin disorders (ISDs) are commonly seen in pediatric emergency departments (PED), however the exact frequency is unknown. We provide an accurate evaluation of the incidence and characteristics of ISDs diagnosed in a PED from Buenos Aires, Argentina, over a 1-year period. METHODS: Prospectively, descriptive study of children evaluated in the PED with ISDs during 2016. ISDs were analyzed on the basis of their incidence, patient demographics, seasonal variations, and hospitalization rates. RESULTS: ISDs were diagnosed in 1680 (67.9%) of the skin consultations (M/F: 1.1; mean age: 4.4 ± 3.7 years). Bacterial infections were observed in 932 (55.5%) cases. Viral infections were seen in 604 patients (35.9%). Fungal and parasite skin infections were diagnosed in 33 (2%) and 111 (6.6%) children, respectively. The most frequent ISDs according to the etiology group were impetigo 377 (22.4%), varicella 397 (23.6%), tinea capitis 10 (0.6%), and scabies 109 (6.5%). A higher frequency of ISDs were reported during the summer (38.4%) and spring (38.2%) months. Bacterial skin infections were more frequent during the summer months, while viral skin infections were more prevalent during spring. Parasitic skin infections were diagnosed more frequently during the winter months. No differences were seen for mycotic skin infections. Hospitalization rate was 1% (all for bacterial skin infections). CONCLUSION: Our data reveal the extremely high frequency of ISDs seen at the PED, underlying the need for closer cooperation between dermatologists and pediatricians.

Automatic RBG-depth-pressure anthropometric analysis and individualised sleep solution prescription.

INTRODUCTION: Sleep surfaces must adapt to individual somatotypic features to maintain a comfortable, convenient and healthy sleep, preventing diseases and injuries. Individually determining the most adequate rest surface can often be a complex and subjective question. OBJECTIVES: To design and validate an automatic multimodal somatotype determination model to automatically recommend an individually designed mattress-topper-pillow combination. METHODS: Design and validation of an automated prescription model for an individualised sleep system is performed through a single-image 2 D-3 D analysis and body pressure distribution, to objectively determine optimal individual sleep surfaces combining five different mattress densities, three different toppers and three cervical pillows. RESULTS: A final study (n = 151) and re-analysis (n = 117) defined and validated the model, showing high correlations between calculated and real data (>85% in height and body circumferences, 89.9% in weight, 80.4% in body mass index and more than 70% in morphotype categorisation). CONCLUSIONS: Somatotype determination model can accurately prescribe an individualised sleep solution. This can be useful for healthy people and for health centres that need to adapt sleep surfaces to people with special needs. Next steps will increase model's accuracy and analise, if this prescribed individualised sleep solution can improve sleep quantity and quality; additionally, future studies will adapt the model to mattresses with technological improvements, tailor-made production and will define interfaces for people with special needs.

Exantema periflexural asimétrico de la infancia, dos formas de presentación / Asymmetric periflexural exanthem of childhood, two forms of presentation

El exantema periflexural asimétrico de la infancia es una entidad benigna, autolimitada, subdiagnosticada, de etiología desconocida, que compromete mayormente niñas de edad preescolar. Tiene predominancia estacional (invierno y primavera). Su diagnóstico es clínico, y se presenta como un exantema escarlatiniforme, morbiliforme o eccematoso, que generalmente comienza en la axila y se extiende centrífugamente hacia el tronco y el miembro superior homolateral. Puede acompañarse de adenopatías regionales y fiebre. No requiere tratamiento específico, salvo el uso de cremas humectantes y antihistamínicos, en caso de presentar prurito. Se describen 2 pacientes con diferentes formas de presentación de esta entidad, una típica y otra infrecuente.

Asymmetric periflexural exanthema of childhood is a benign, self-limited, underdiagnosed disease of unknown etiology that mainly affects girls at preschool age. It has seasonal predominance (winter and spring). The diagnosis is clinical and is presented as scarlatinform, morbiliform or eczematous exanthem that generally begins in the axilla and centrifugally extends to the trunk and the homolateral upper limb. It may be accompanied with regional adenopathies and fever. It does not require specific treatment except for the use of moisturizing and antihistaminic creams in case of pruritus. Two patients with different forms of presentation, one typical and another unfrequent, were described.

Selective electromembrane extraction at low voltages based on analyte polarity and charge.

Electromembrane extraction (EME) at low voltage (0-15 V) of 29 different basic model drug substances was investigated. The drug substances with logP<2.3 were not extracted at voltages less than 15 V. Extraction of drug substances with logP≥2.3 and with two basic groups were also effectively suppressed by the SLM at voltages less than 15 V. Drug substances with logP≥2.3 and with one basic group were all extracted at low voltages and with a strong compound selectivity which appeared to have some influence from the polar surface area of the compound. For this group of substances, recoveries varied between 0 and 23% at 5 V, whereas, recoveries varied between 5.5 and 51% at 15 V. Based on mass transfer differences related to charge, polarity, and polar surface, highly selective extractions of drug substances were demonstrated from human plasma, urine, and breast milk. An initial evaluation at low voltage (5 V) was compared with similar extractions at a more normal voltage level (50 V), and this supported that reliable data can be obtained under these low-voltage (mild) conditions by EME.

Antecedentes y consecuencias del acoso psicológico en el trabajo / Antecedents and consequences of workplace bullying: a longitudinal analysis with a structural equation model

Los estudios sobre antecedentes y consecuencias del mobbing han empleado mayoritariamente diseños transversales, lo cual impide determinar la causalidad de las relaciones. En este trabajo se analizó, mediante modelos de ecuaciones estructurales, la relación entre el mobbing y algunas variables consideradas antecedentes (conflictos interpersonales, conflicto de rol, ambigüedad de rol y apoyo social) o consecuencias (problemas de salud e inclinación al absentismo) del fenómeno. Estudio multicéntrico y longitudinal con dos etapas. 696 trabajadores distribuidos en 66 centros de asistencia a la discapacidad participaron en el estudio. El mobbing se evaluó mediante el cuestionario «Mobbing-UNIPSICO» y el resto de variables mediante escalas de frecuencia. Los modelos tranversales indicaron una relación significativa entre el conflicto de rol, el apoyo social y el mobbing en los dos momentos temporales del estudio. A nivel longitudinal, solo el apoyo social mostró ser un predictor significativo del mobbing, mientras que éste a su vez predecía a nivel tranversal y longitudinal los problemas de salud. Los resultados de este trabajo demuestran el efecto mediador del mobbing entre ciertas condiciones laborales y los problemas de salud, siendo recomendable replicar estos hallazgos en una muestra multiocupacional (AU)

Most studies focusing on the antecedents and consequences of workplace bullying have used a cross-sectional design, which impedes determining the causality of the relationships. In the present work, we analyzed, by means of structural equation models, the relationship between workplace bullying and some variables that are considered antecedents (interpersonal conflicts, role ambiguity, role conflict, and workplace social support) or consequences (health complaints and inclination to absenteeism from work) of this phenomenon. Multicenter study with two phases. The sample consisted of 696 employees from 66 centers. Workplace bullying was assessed by means of the «Mobbing- UNIPSICO» questionnaire, and the other variables with frequency scales. The cross-sectional models indicated a significant association between role conflict, workplace social support, and workplace bullying in both study periods. Concerning the longitudinal relationships, only workplace social support was a significant predictor of workplace bullying, which, in turn, was a cross-sectional and longitudinal predictor of workers’ health complaints. Our results show the mediating effect of workplace bullying between certain work conditions and health complaints, and it is recommendable to replicate these findings in a multi-occupational sample (AU)

[Antecedents and consequences of workplace bullying: a longitudinal analysis with a structural equation model]. / Antecedentes y consecuencias del acoso psicológico en el trabajo.

Most studies focusing on the antecedents and consequences of workplace bullying have used a cross-sectional design, which impedes determining the causality of the relationships. In the present work, we analyzed, by means of structural equation models, the relationship between workplace bullying and some variables that are considered antecedents (interpersonal conflicts, role ambiguity, role conflict, and workplace social support) or consequences (health complaints and inclination to absenteeism from work) of this phenomenon. Multicenter study with two phases. The sample consisted of 696 employees from 66 centers. Workplace bullying was assessed by means of the "Mobbing-UNIPSICO" questionnaire, and the other variables with frequency scales. The cross-sectional models indicated a significant association between role conflict, workplace social support, and workplace bullying in both study periods. Concerning the longitudinal relationships, only workplace social support was a significant predictor of workplace bullying, which, in turn, was a cross-sectional and longitudinal predictor of workers' health complaints. Our results show the mediating effect of workplace bullying between certain work conditions and health complaints, and it is recommendable to replicate these findings in a multi-occupational sample.