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1.
PNAS Nexus ; 3(7): pgae221, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38979080

RESUMEN

Throughout the 21st century, economic inequality is predicted to increase as we face new challenges, from changes in the technological landscape to the growing climate crisis. It is crucial we understand how these changes in inequality may affect how people think and behave. We propose that economic inequality threatens the social fabric of society, in turn increasing moralization-that is, the greater tendency to employ or emphasize morality in everyday life-as an attempt to restore order and control. Using longitudinal data from X, formerly known as Twitter, our first study demonstrates that high economic inequality is associated with greater use of moral language online (e.g. the use of words such as "disgust", "hurt", and "respect'). Study 2 then examined data from 41 regions around the world, generally showing that higher inequality has a small association with harsher moral judgments of people's everyday actions. Together these findings demonstrate that economic inequality is linked to the tendency to see the world through a moral lens.

3.
J Chromatogr A ; 1726: 464967, 2024 Jul 05.
Artículo en Inglés | MEDLINE | ID: mdl-38749275

RESUMEN

Infant formulas (IF) can contain harmful chemical substances, such as pesticides and mycotoxins, resulting from the contamination of raw materials and inputs used in the production chain, which can cause adverse effects to infants. Therefore, the quick, easy, cheap, effective, rugged, and safe (QuEChERS) methodology prior ultra-high performance liquid chromatography coupled to triple quadrupole mass spectrometry (UHPL-QqQ-MS/MS) analysis was applied for the determination of 23 contaminants, in 30 samples of Brazilian IF. The method was validated in terms of limit of detection (0.2 to 0.4 µg/kg), limits of quantification (1 and 10 µg/kg), and recovery (64 % to 122 %); precision values, in terms of relative standard deviation (RSD), were ≤ 20 %. Fenitrothion, chlorpyrifos, and bifenthrin were the pesticides detected in the samples, but the values did not exceed the limit set by the European Union (EU), and ANVISA, and they were detected under their limits of quantification. Additionally, suspect screening and unknown analysis were conducted to tentatively identify 32 substances, including some compounds not covered in this study, such as pesticides, hormones, and veterinary drugs. Carbofuran was identified, confirmed and quantified in 10 % of the samples.


Asunto(s)
Contaminación de Alimentos , Fórmulas Infantiles , Límite de Detección , Espectrometría de Masas en Tándem , Espectrometría de Masas en Tándem/métodos , Cromatografía Líquida de Alta Presión/métodos , Brasil , Fórmulas Infantiles/química , Contaminación de Alimentos/análisis , Plaguicidas/análisis , Humanos , Residuos de Plaguicidas/análisis , Reproducibilidad de los Resultados , Micotoxinas/análisis , Lactante , Piretrinas/análisis
4.
Polymers (Basel) ; 16(8)2024 Apr 18.
Artículo en Inglés | MEDLINE | ID: mdl-38675052

RESUMEN

Complete spinal cord injury causes an irreversible disruption in the central nervous system, leading to motor, sensory, and autonomic function loss, and a secondary injury that constitutes a physical barrier preventing tissue repair. Tissue engineering scaffolds are presented as a permissive platform for cell migration and the reconnection of spared tissue. Iodine-doped plasma pyrrole polymer (pPPy-I), a neuroprotective material, was applied to polylactic acid (PLA) fibers and implanted in a rat complete spinal cord transection injury model to evaluate whether the resulting composite implants provided structural and functional recovery, using magnetic resonance (MR) imaging, diffusion tensor imaging and tractography, magnetic resonance spectroscopy, locomotion analysis, histology, and immunofluorescence. In vivo, MR studies evidenced a tissue response to the implant, demonstrating that the fibrillar composite scaffold moderated the structural effects of secondary damage by providing mechanical stability to the lesion core, tissue reconstruction, and significant motor recovery. Histologic analyses demonstrated that the composite scaffold provided a permissive environment for cell attachment and neural tissue guidance over the fibers, reducing cyst formation. These results supply evidence that pPPy-I enhanced the properties of PLA fibrillar scaffolds as a promising treatment for spinal cord injury recovery.

5.
Environ Sci Pollut Res Int ; 31(22): 33058-33068, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38668941

RESUMEN

Two commercial biopesticides were studied to determine their persistence in two soil types, such as sandy clay loam and clay loam soils. For this purpose, an orange oil-based biopesticide was used, being limonene its main ingredient. The other biopesticide was based on cinnamon extract and trans-cinnamaldehyde as its main component. Degradation of these compounds was monitored, and transformation products or metabolites were detected. Limonene and its metabolites were analyzed by gas chromatography (GC) and trans-cinnamaldehyde by ultra-high-performance liquid chromatography (UHPLC). Both techniques were coupled to a high-resolution mass (HRMS) analyzer, such as quadrupole (Q)-Orbitrap. Limonene and trans-cinnamaldehyde were rapidly degraded as result of first-order kinetics. Possible metabolites such as thymol, cymene, isoterpinolene and cymenene for limonene, and hydroxycinnamic acid for trans-cinnamaldehyde were tentatively identified. Moreover, four other metabolites of trans-cinnamaldehyde, some of them not previously described, were also detected.


Asunto(s)
Acroleína , Limoneno , Suelo , Acroleína/análogos & derivados , Cromatografía Líquida de Alta Presión , Suelo/química , Contaminantes del Suelo/análisis , Terpenos , Ciclohexenos
6.
Environ Pollut ; 349: 123924, 2024 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-38580058

RESUMEN

The study evaluated Ceremonia 25 EC®, a plant protection product (PPP) containing difenoconazole, in tomato crops, to identify potential risks associated with PPPs, and in addition to this compound, known metabolites from difenoconazole degradation and co-formulants present in the PPP were monitored. An ultra high performance liquid chromatography coupled to quadrupole-Orbitrap mass analyser (UHPLC-Q-Orbitrap-MS) method was validated with a working range of 2 µg/kg (limit of quantification, LOQ) to 200 µg/kg. Difenoconazole degradation followed a biphasic double first-order in parallel (DFOP) kinetic model in laboratory and greenhouse trials, with high accuracy (R2 > 0.9965). CGA-205374, difenoconazole-alcohol, and hydroxy-difenoconazole metabolites were tentatively identified and semi-quantified in laboratory trials by UHPLC-Q-Orbitrap-MS from day 2 to day 30. No metabolites were found in greenhouse trials. Additionally, 13 volatile co-formulants were tentatively identified by gas chromatography (GC) coupled to Q-Orbitrap-MS, detectable up to the 7th day after PPP application. This study provides a comprehensive understanding of difenoconazole dissipation in tomatoes, identification of metabolites, and detection of co-formulants associated with the applied PPP.


Asunto(s)
Dioxolanos , Fungicidas Industriales , Solanum lycopersicum , Triazoles , Solanum lycopersicum/metabolismo , Solanum lycopersicum/química , Dioxolanos/metabolismo , Triazoles/metabolismo , Triazoles/análisis , Triazoles/química , Fungicidas Industriales/metabolismo , Fungicidas Industriales/análisis , Cromatografía Líquida de Alta Presión , Espectrometría de Masas/métodos , Contaminación de Alimentos/análisis , Residuos de Plaguicidas/análisis , Residuos de Plaguicidas/metabolismo
7.
Pers Soc Psychol Bull ; : 1461672241231727, 2024 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-38468397

RESUMEN

Populism is on the rise across liberal democracies. The sociopsychological underpinnings of this increasing endorsement of populist ideology should be uncovered. In an online cross-sectional survey study among adult samples from five countries (Chile, France, Italy, Romania, and the United Kingdom; N = 9,105), we aimed to replicate an economic distress pattern in which relative deprivation and identity threat are associated with populism. We further tested a cultural backlash pattern-including perceived anomie, collective narcissism, and identity threat as predictors of populism. Multigroup structural equation models supported both economic distress and cultural backlash paths as predictors of populist thin ideology endorsement. In both paths, identity threat to belonging played a significant role as partial mediator. Furthermore, an integrative model showed that the two patterns were not mutually exclusive. These findings emphasize the implication of identity threat to belonging as an explanatory mediator and demonstrate the cross-national generalizability of these patterns.

8.
J Cardiothorac Surg ; 19(1): 143, 2024 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-38504317

RESUMEN

BACKGROUND: Coronary artery obstruction after percutaneous aortic replacement is a complication with high short-term mortality secondary to the lack of timely treatment. There are various predictors of coronary obstruction prior to valve placement such as the distance from the ostia, the degree of calcification, the distance from the sinuses; In such a situation some measures must be taken to prevent and treat coronary obstruction. CASE PRESENTATION: An 84-year-old male, with severe aortic stenosis and high surgical risk, who was treated with TAVR. However, during the deployment of the valve he presented hemodynamic instability secondary to LMCA obstruction. The intravascular image showed obstruction of the ostium secondary to the displacement of calcium that he was successfully treated with a chimney stent technique. CONCLUSIONS: The high degree of calcification and the left ostium near the annulus are conditions for obstruction of the ostium at the time of valve release; In this context, provisional stenting prior to TAVR in patients at high risk of obstruction should be considered as a safe prevention strategy to achieve the success of the procedure.


Asunto(s)
Estenosis de la Válvula Aórtica , Calcinosis , Oclusión Coronaria , Prótesis Valvulares Cardíacas , Reemplazo de la Válvula Aórtica Transcatéter , Masculino , Humanos , Anciano de 80 o más Años , Reemplazo de la Válvula Aórtica Transcatéter/efectos adversos , Reemplazo de la Válvula Aórtica Transcatéter/métodos , Válvula Aórtica/cirugía , Vasos Coronarios/cirugía , Prótesis Valvulares Cardíacas/efectos adversos , Factores de Riesgo , Resultado del Tratamiento , Oclusión Coronaria/etiología , Calcinosis/complicaciones , Calcinosis/cirugía , Estenosis de la Válvula Aórtica/complicaciones , Diseño de Prótesis
10.
Eur Heart J Case Rep ; 8(2): ytae079, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38405198

RESUMEN

Background: The presence of severe aortic stenosis in quadricuspid aortic valve (QAV) is an extremely rare combination, and it is unknown whether transcatheter aortic valve replacement (TAVR) is a safe option due to the low incidence. Case summary: We present two patients diagnosed with severe aortic stenosis with QAV morphology type 1 (Nakamura classification). All patients presented to our hospital for evaluation because of worsening functional class, dyspnoea, or syncope. During tomographic planning, the aortic annulus was measured at the level of the deepest sinus for the selection of the number of devices. Due to the presence of four cusps, the smallest cusp was excluded, and three sinuses were virtualized for placement of the pigtail catheter during the procedure. Without complications, a 23 mm Edwards SAPIEN 3 was deployed through the femoral artery in both patients. Control aortography showed no valve leakage or regurgitation. Discussion: In patients with QAV and aortic stenosis undergoing TAVR, similar to the tricuspid valve, tomographic planning can be used to ensure the success of the procedure. However, unlike the tricuspid valve, where the selection of the device number is based on the measurements of the aortic annulus at the level of the non-coronary sinus, in these QAV cases, we perform the measurements at the level of the deepest aortic sinus (right coronary sinus).

11.
Food Chem ; 442: 138443, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38241992

RESUMEN

Degradation of trans-cinnamaldehyde and limonene in cucumber was evaluated under laboratory and greenhouse conditions. Two commercial biopesticides, one based on cinnamon extract and other from orange oil, were utilized. Compound degradation was monitored using gas chromatography (GC) and ultra-high-performance liquid chromatography (UHPLC) coupled to a quadrupole-high-resolution mass analyzer (Q-Orbitrap). In both studies, trans-cinnamaldehyde followed a second-order degradation kinetics, whereas limonene followed a first-order kinetics. The half-life values (DT50 or t1/2) for trans-cinnamaldehyde ranged from 2.02 to 2.49 h, while for limonene this value ranged from 0.49 to 6.17 h. Non-targeted analysis (suspect and unknown modes) allowed for the detection of trans-cinnamaldehyde and limonene metabolites. Benzyl alcohol, cinnamyl alcohol, cinnamic acid, p-tolylacetic acid and 4-hydoxycinnamic acid were tentatively identified as trans-cinnamaldehyde metabolites. While three limonene metabolites, carvone, limonene-1,2-epoxide, and perillyl alcohol, were tentatively identified. Greenhouse studies have not revealed any metabolites of these compounds because the parent compounds degrade more quickly.


Asunto(s)
Acroleína/análogos & derivados , Cucumis sativus , Limoneno , Cromatografía Líquida de Alta Presión/métodos , Agentes de Control Biológico , Alérgenos , Cromatografía de Gases
12.
Sci Total Environ ; 917: 170150, 2024 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-38242448

RESUMEN

Non-phthalate plasticizers (NPPs) are a suitable alternative to phthalates, which are harmful compounds for human, animal health, and the environment. In this study, 28 commercial non-phthalate plasticizers (NPPs) from different families, including adipates, citrates, phosphates, sebacates, trimellitates, benzoates and cyclohexanoates, were determined. Two novel methods for determining these alternative compounds in soil were developed using gas chromatography coupled to high-resolution mass spectrometry (GC-HRMS-Q-Orbitrap) and liquid chromatography coupled to high-resolution mass spectrometry (LC-HRMS-Q-Orbitrap). Solid-liquid extraction (SLE) with ethyl acetate or acetonitrile, along with water as extraction solvents, were employed. In most cases, the GC method exhibited recoveries ranging from 84.9 % to 110.8 % at 20, 40 and 200 µg/kg, while the LC method achieved recoveries between 73.1 % and 115.4 % at 10, 20, 40 and 200 µg/kg. Most of the relative standard deviation (RSD) values were below 20 % for both methods. The validated methods were then applied to analyse soil samples collected from four different areas in Almeria. The results indicated that the compounds detected most frequently at high concentrations were 1-hydroxycyclohexyl phenyl ketone (HCPK) using GC, in the range 29.1-67.4 µg/kg and 2,2,4-trimethyl-1,3-pentanediol diisobutyrate (TXIB) using LC, in the range 39.9-51.5 µg/kg. Additionally, suspect and unknown analysis were carried out, and other plasticizers as phthalates, were also detected, in addition to other substances present in the analysed samples. All the soils exhibited the presence of a few plasticizers, either phthalic and/or non-phthalic.

13.
Sci Immunol ; 9(91): eadh0152, 2024 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-38181095

RESUMEN

Immune tolerance is maintained in lymphoid organs (LOs). Despite the presence of complex immune cell networks in non-LOs, it is unknown whether self-tolerance is maintained in these tissues. We developed a technique to restrict genetic recombination to regulatory T cells (Tregs) only in skin. Selective depletion of skin Tregs resulted in T cell-mediated inflammation of hair follicles (HFs). Suppression did not rely on CTLA-4, but instead on high-affinity interleukin-2 (IL-2) receptor expression by skin Tregs, functioning exclusively in a cell-extrinsic manner. In a novel model of HF stem cell (HFSC)-driven autoimmunity, we reveal that skin Tregs immunologically protect the HFSC niche. Finally, we used spatial transcriptomics to identify aberrant IL-2 signaling at stromal-HF interfaces in a rare form of human alopecia characterized by HFSC destruction and alopecia areata. Collectively, these results reveal the fundamental biology of Tregs in skin uncoupled from the systemic pool and elucidate a mechanism of self-tolerance.


Asunto(s)
Privilegio Inmunológico , Linfocitos T Reguladores , Humanos , Folículo Piloso , Interleucina-2 , Nicho de Células Madre
14.
Sci Immunol ; 9(91): eadi2848, 2024 01 26.
Artículo en Inglés | MEDLINE | ID: mdl-38277466

RESUMEN

Psoriasis vulgaris and other chronic inflammatory diseases improve markedly with therapeutic blockade of interleukin-23 (IL-23) signaling, but the genetic mechanisms underlying clinical responses remain poorly understood. Using single-cell transcriptomics, we profiled immune cells isolated from lesional psoriatic skin before and during IL-23 blockade. In clinically responsive patients, a psoriatic transcriptional signature in skin-resident memory T cells was strongly attenuated. In contrast, poorly responsive patients were distinguished by persistent activation of IL-17-producing T (T17) cells, a mechanism distinct from alternative cytokine signaling or resistance isolated to epidermal keratinocytes. Even in IL-23 blockade-responsive patients, we detected a recurring set of recalcitrant, disease-specific transcriptional abnormalities. This irreversible immunological state may necessitate ongoing IL-23 inhibition. Spatial transcriptomic analyses also suggested that successful IL-23 blockade requires dampening of >90% of IL-17-induced response in lymphocyte-adjacent keratinocytes, an unexpectedly high threshold. Collectively, our data establish a patient-level paradigm for dissecting responses to immunomodulatory treatments.


Asunto(s)
Interleucina-17 , Psoriasis , Humanos , Interleucina-23 , Piel , Psoriasis/tratamiento farmacológico , Queratinocitos
15.
Acta Parasitol ; 69(1): 415-425, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38165555

RESUMEN

PURPOSE: Antimalarial drug resistance is a global public health problem that leads to treatment failure. Synergistic drug combinations can improve treatment outcomes and delay the development of drug resistance. Here, we describe the implementation of a freely available computational tool, Machine Learning Synergy Predictor (MLSyPred©), to predict potential synergy in antimalarial drug combinations. METHODS: The MLSyPred© synergy prediction method extracts molecular fingerprints from the drugs' biochemical structures to use as features and also cleans and prepares the raw data. Five machine learning algorithms (Logistic Regression, Random Forest, Support vector machine, Ada Boost, and Gradient Boost) were implemented to build prediction models. Implementation and application of the MLSyPred© tool were tested using datasets from 1540 combinations of 79 drugs and compounds biologically evaluated in pairs for three strains of Plasmodium falciparum (3D7, HB3, and Dd2). RESULTS: The best prediction models were obtained using Logistic Regression for antimalarials with the strains Dd2 and HB3 (0.81 and 0.70 AUC, respectively) and Random Forest for antimalarials with 3D7 (0.69 AUC). The MLSyPred© tool yielded 45% precision for synergistically predicted antimalarial drug combinations that were annotated and biologically validated, thus confirming the functionality and applicability of the tool. CONCLUSION:  The MLSyPred© tool is freely available and represents a promising strategy for discovering potential synergistic drug combinations for further development as novel antimalarial therapies.


Asunto(s)
Antimaláricos , Combinación de Medicamentos , Sinergismo Farmacológico , Aprendizaje Automático , Plasmodium falciparum , Antimaláricos/farmacología , Plasmodium falciparum/efectos de los fármacos , Humanos , Quimioterapia Combinada , Malaria Falciparum/tratamiento farmacológico , Malaria Falciparum/parasitología
16.
Am Psychol ; 79(1): 52-64, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38236215

RESUMEN

The advent of mobile smartphones and similar technology has opened new opportunities for studying human mobility within psychology and companion disciplines such as human geography, demography, and sociology. This article examines how such research raises novel ethical concerns. To do so, we outline two research projects: one based in Northern Ireland (The Belfast Mobility Project) and the other in Chile (The Norm-Contact Mobility Project), drawing concrete examples of the ethical challenges encountered throughout both projects, which used global navigational satellite systems as a tool for data collection. We discuss new threats to participant confidentiality and anonymity, problems of "unanticipated" data collection and exploitation, emerging difficulties in achieving properly informed consent, and concerns regarding the representation of vulnerable populations with limited access to smartphones and a legitimate fear of surveillance. We also reflect on the different measures we took to tackle these challenges and discuss the importance of implementing wider changes in the protocols associated with basic ethical research principles. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Miedo , Teléfono Inteligente , Humanos , Recolección de Datos , Consentimiento Informado , Tecnología
17.
J Pers Soc Psychol ; 126(2): 262-281, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37971854

RESUMEN

Intergroup felt understanding-the belief that outgroup members understand and accept ingroup perspectives-has been found to predict positive intergroup outcomes, but the mechanism through which it has its positive effects is unclear. Across eight studies, we tested the hypothesis that felt positive regard-the perception that outgroup members like and respect ingroup members-mediates the positive effects of felt understanding on outcomes like outgroup trust. Studies 1-6 (total N = 1,366) included cross-sectional and experimental designs and a range of intergroup settings such as Sunni-Shia relations in Lebanon, gender relations, and support for "Brexit" in the United Kingdom. Results of meta-analytic structural equation models across these studies provided evidence of the indirect effect of felt understanding via felt positive regard on outcomes including trust and positive relational emotions. Study 7 (N = 307) then tested the causal effect of felt positive regard through a direct manipulation. Findings confirmed that felt positive (vs. negative) regard did lead to more positive intergroup perceptions. Finally, Study 8 (N = 410) tested the indirect effect as a within-person change process using a year-long, two-wave study of the conflict in Chile between Indigenous Mapuche and Non-Indigenous Chileans: Change over time in felt understanding indirectly predicted change over time in trust via change in felt positive regard. We consider the theoretical implications of the findings for how intergroup relations may be improved and the possibilities presented by felt understanding for intervention development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Asunto(s)
Emociones , Procesos de Grupo , Pueblos Sudamericanos , Humanos , Estudios Transversales , Relaciones Interpersonales
18.
J AOAC Int ; 107(1): 93-102, 2024 Jan 04.
Artículo en Inglés | MEDLINE | ID: mdl-37758219

RESUMEN

BACKGROUND: Sulfite is the oldest and most widely used additive in our food supply with antioxidant and preservative properties. Due to its allergenic-like reactions and other adverse health effects, its use is regulated by international regulatory bodies. Therefore, food industries as well as regulatory laboratories must ensure that the maximum concentration of sulfite permitted is not exceeded. The AOAC INTERNATIONAL-approved official method for the quantification of sulfites is the Optimized Monier-Williams Method (AOAC Official Method 990.28), which consists of a time-consuming titration. OBJECTIVE: The present study aims to demonstrate the reliability of the BIOFISH 300 SUL, a simple, fast, and accurate method, as an alternative, for the quantification of total sulfites in shrimp, with a lower LOQ than that of the OMA 990.28, set at 10 mg/Kg. METHODS: The BIOFISH 300 SUL method is a highly specific biosensor based on its proprietary enzyme-based electrode, for the rapid quantification of total sulfite. The test kit consists of an electrochemical reader (biosensor BIOFISH 300) and disposable electrodes (Biotest) that are capable of providing an electrical signal proportional to the amount of sulfite in the sample analyzed. The method mainly consists of the extraction of sulfite from the solid matrix in an aqueous solution, and its subsequent quantification by the device in less than 3 min. RESULTS: Comparative studies between BIOFISH 300 SUL and OMA 990.28 were conducted for naturally contaminated and spiked samples of raw and boiled shrimp with sulfite levels covering the 7-150 mg/kg range in order to determine linearity, recovery, repeatability, intermediate reproducibility, and accuracy. CONCLUSION: The BIOFISH 300 SUL method demonstrated high accuracy and precision for the whole range of quantification (7-150 mg/kg). Its ease of use and fast response make it the ideal technology to be implemented by the industry. HIGHLIGHTS: BIOFISH 300 SUL was adopted as a First Action Official MethodSM by the AOAC Expert Review Panel for Sulfites in Seafood Methods in February 2021 after rigorous review.


Asunto(s)
Decápodos , Análisis de los Alimentos , Animales , Reproducibilidad de los Resultados , Análisis de los Alimentos/métodos , Crustáceos , Alimentos Marinos , Sulfitos
19.
Artículo en Inglés | MEDLINE | ID: mdl-38061553

RESUMEN

INTRODUCTION: Patients with bipolar disorder (BD) are frequently exposed to traumatic events which worsen disease course, but this study is the first multicentre randomised controlled trial to test the efficacy of a trauma-focused adjunctive psychotherapy in reducing BD affective relapse rates. MATERIALS AND METHODS: This multicentre randomised controlled trial included 77 patients with BD and current trauma-related symptoms. Participants were randomised to either 20 sessions of trauma-focused Eye Movement Desensitization and Reprocessing (EMDR) therapy for BD, or 20 sessions of supportive therapy (ST). The primary outcome was relapse rates over 24-months, and secondary outcomes were improvements in affective and trauma symptoms, general functioning, and cognitive impairment, assessed at baseline, post-treatment, and at 12- and 24-month follow-up. The trial was registered prior to starting enrolment in clinical trials (NCT02634372) and carried out in accordance with CONSORT guidelines. RESULTS: There was no significant difference between treatment conditions in terms of relapse rates either with or without hospitalisation. EMDR was significantly superior to ST at the 12-month follow up in terms of reducing depressive symptoms (p=0.0006, d=0.969), manic symptoms (p=0.027, d=0.513), and improving functioning (p=0.038, d=0.486). There was no significant difference in dropout between treatment arms. CONCLUSIONS: Although the primary efficacy criterion was not met in the current study, trauma-focused EMDR was superior to ST in reducing of affective symptoms and improvement of functioning, with benefits maintained at six months following the end of treatment. Both EMDR and ST reduced trauma symptoms as compared to baseline, possibly due to a shared benefit of psychotherapy. Importantly, focusing on traumatic events did not increase relapses or dropouts, suggesting psychological trauma can safely be addressed in a BD population using this protocol.

20.
Eur Heart J Case Rep ; 7(11): ytad554, 2023 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-38034936

RESUMEN

Background: The treatment of choice for patients with severe symptomatic pure native aortic valve regurgitation (PNAVR) is surgical aortic valve replacement (SAVR). However, not all patients are candidates for surgery because of comorbidities or are deemed high risk for surgery. In such cases, transcatheter aortic valve replacement (TAVR) has proved to be better than medical treatment. Case summary: A 78-year-old male with a history of ankylosing spondylitis was admitted with New York Heart Association III heart failure. The echocardiogram showed severe aortic regurgitation and a left ventricular ejection fraction of 52%. Because of high surgical risk and being refractory to medical RX, he was accepted for TAVR. The tomography of anatomical characteristics reported the absence of calcium and dilation of the aortic ring and aortic root. During the TAVR procedure, the patient experienced valve migration, but it was autonomously repositioned in the aortic annulus. As a rescue measure, a second valve was placed. Here, we present a case of valve migration to the left ventricle treated with a valve-in-valve procedure without the need for surgical treatment. Discussion: The absence of annulus calcification in PNAVR increases the risk of post-TAVR paravalvular leak and device embolization. Valve migration generally requires valve recovery and conversion to SAVR.

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