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1.
Fam Process ; 2024 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-38520285

RESUMEN

Eating disorders (ED) and affective disorders (AD) in adolescent population and several investigations have pointed out that specific family dynamics play a major role in the onset, course, and maintenance of both disorders. The aim of this study was to extend the literature of this topic by exploring differences between parents' personality traits, coping strategies, and expressed emotion comparing groups of adolescents with different mental conditions (anorexia nervosa vs. affective disorder vs. control group) with a case-control study design. A total of 50 mothers and 50 fathers of 50 girls with anorexia nervosa (AN), 40 mothers and 40 fathers of 40 girls with affective disorder (AD), and 50 mothers and 50 fathers of 50 girls with no pathology that conformed the control group (CG) were measured with the Temperament and Character Inventory (TCI), the COPE Inventory, the Family Questionnaire (FQ), and psychopathology variables, anxiety, and depression. Both parents of girls with AN showed a significant difference in personality, coping strategies, and expressed emotion compared to both parents in the CG, while they presented more similarities to parents of girls in the AD group. Identifying personality traits, expressed emotion, coping strategies, and psychopathology of parents and their daughters will allow improvements in the interventions with the adolescents, parents, and families.

2.
Eat Weight Disord ; 26(7): 2153-2163, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33159301

RESUMEN

PURPOSE: The aim of this article was to validate the Spanish version of the Home Environment Survey (HES-S) and was divided in two studies: (1) to assess the reliability, convergent validity of HES-S in a survey of 145 parents of children with overweight/obesity; (2) to study the magnitude of the association between children's BMI status with the latent scores theoretically defined by the HES model. METHODS: To test the scale and the model, a confirmatory factor analysis (CFA) and a path analysis were carried out among a sample of 156 parents of preadolescents (106 overweight/obesity and 50 normal-weight children). No CFA or EFA were carried out in the validation of the original instrument. RESULTS: Study 1, both the Physical Activity and the Eating Habits components of the scale showed adequate levels of internal consistency for the majority of the scales, except for two. One of them, Healthy Eating Parental Policies (HEP) subscale was reduced after excluded two items, although it did not improve substantially. This model indicated that there was a significant association between the two Eating Habits scales and the child's weight status, but child's weight was not associated with the Physical Activity components. Convergent validity was confirmed by correlations with related variables: family eating habits (F-EAT), parent's physical activity (IPAQ), and children's physical activity (assessed via accelerometers during one week). Study 2, our results replicated the original four factor structure proposed for physical activity (CFI = 0.99; RMSEA = 0.03), but the original factor structure of the eating habits component was not supported. In addition, the relationship of the child's weight status, the Physical Activity components, and the two scales of Eating Habits (Parental Modeling and Policies) was explored with a path analysis showing good fit indices (CFI = 0.95; RMSEA = 0.06). Child's BMI was negatively associated with Healthy Eating Parental Role Modeling (r = - 0.21) and with Healthy Eating Parental Policies (r = - 0.19), but not with the factors of Child's Physical Activity model. CONCLUSION: To our knowledge, this is the first instrument to assess obesogenic family environment in Spanish speaking countries, which is a relevant dimension within a health perspective so as to implement new policies and strategies in obesity tertiary prevention. Overall, the confirmatory factor analysis of the HES-S has only provided additional support for one part related to Physical Activity. In addition, Child's BMI was correlated with scales of Eating Habits but not with Child's Physical Activity factor. These results clearly suggest that further research is warranted. LEVEL III: Case-control analytic study.


Asunto(s)
Obesidad , Sobrepeso , Índice de Masa Corporal , Niño , Conducta Alimentaria , Humanos , Padres , Reproducibilidad de los Resultados , Encuestas y Cuestionarios
3.
Eat Weight Disord ; 25(3): 751-759, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31077019

RESUMEN

PURPOSE: The prevalence of childhood obesity continues to increase worldwide. The aims of this study were to (1) assess the psychological well-being and rates of teasing of Spanish children with obesity (OG) and compare them with their non-overweight peers (NG), and (2) analyze the mediating role of weight-related teasing on the relation between children's BMI z score and psychological well-being. METHODS: The cross-sectional study included 50 preadolescents with obesity, matched with non-overweight children according to age, sex, and socioeconomic status, who were assessed via self-report instruments measuring anxiety, depression, self-esteem, and teasing. RESULTS: The OG reported higher anxiety, depression, and teasing, and lower self-esteem. SEM revealed that children who scored worse on instruments assessing psychological well-being had higher BMI z scores. Weight-related teasing predicted poor psychological well-being scores and weight-related teasing mediated the relation between BMI and psychological well-being. CONCLUSIONS: The high rates of anxiety, depression, and weight-related teasing, as well as the low self-esteem, which was observed amongst the children with obesity, raise concerns about the quality of life of this population. Furthermore, the finding that weight-related teasing mediated the relationship between BMI and psychological well-being adds to a growing body of research, highlighting the harmful effects of weight-related stigma. Overall, these results highlight the importance of early intervention to assess for, and address, the presence of weight-related teasing and psychological well-being difficulties in preadolescents with obesity. LEVEL OF EVIDENCE: Level III, case-control study.


Asunto(s)
Obesidad Infantil/psicología , Grupo Paritario , Calidad de Vida/psicología , Autoimagen , Ansiedad/psicología , Índice de Masa Corporal , Estudios de Casos y Controles , Niño , Estudios Transversales , Depresión/psicología , Femenino , Humanos , Masculino , España
4.
Plant Biol (Stuttg) ; 19(4): 660-670, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28419758

RESUMEN

The potential resilience of shrub species to environmental change deserves attention in those areas threatened by climate change, such as the Mediterranean Basin. We asked if leaves produced under different climate conditions through the winter season to spring can highlight the leaf traits involved in determining potential resilience of three Cistus spp. to changing environmental conditions and to what extent intraspecific differences affect such a response. We analysed carbon assimilation, maximum quantum efficiency of PSII photochemistry (Fv /Fm ) and leaf morphological control of the photosynthetic process in leaves formed through the winter season into spring in C. creticus subsp. eriocephalus (CE), C. salvifolius (CS) and C. monspeliensis (CM) grown from seed of different provenances under common garden conditions. Intraspecific differences were found in Fv /Fm for CE and CS. Carbon assimilation-related parameters were not affected by provenance. Moreover, our analysis highlighted that the functional relationships investigated can follow seasonal changes and revealed patterns originating from species-specific differences in LMA arising during the favourable period. Cistus spp. have great ability to modify the structure and function of their leaves in the mid-term in order to cope with changing environmental conditions. The Fv /Fm response to chilling reveals that susceptibility to photoinhibition is a trait under selection in Cistus species. Concerning carbon assimilation, differing ability to control stomatal opening was highlighted between species. Moreover, seasonal changes of the functional relationships investigated can have predictable consequences on species leaf turnover strategies.


Asunto(s)
Carbono/metabolismo , Cistus/metabolismo , Fotoquímica/métodos , Hojas de la Planta/metabolismo , Cistus/anatomía & histología , Cambio Climático , Fotosíntesis , Hojas de la Planta/anatomía & histología , Semillas/metabolismo
5.
Rev Clin Esp (Barc) ; 217(4): 201-206, 2017 May.
Artículo en Inglés, Español | MEDLINE | ID: mdl-28314656

RESUMEN

OBJECTIVES: To assess the safety and efficacy of a basal-plus (BP) regimen with insulin glargine (as basal insulin) and insulin glulisine (as prandial insulin) with the main meal for elderly patients with type 2 diabetes mellitus (DM2) and high cardiovascular risk, following standard clinical practice. PATIENTS AND METHODS: An observational, retrospective study was conducted in 21 centres of internal medicine in Spain. The study included patients aged 65 years or older with DM2, undergoing treatment with a BP regimen for 4 to 12 months before inclusion in the study and a diagnosis of cardiovascular disease or high cardiovascular risk. The primary endpoint was the change in glycated haemoglobin (HbA1c) from the introduction of the glulisine to inclusion in the study. RESULTS: The study included 198 patients (mean age, 74±6.4 years; males, 52%). After at least 4 months of treatment with the BP regimen, started with the addition of glulisine, the mean HbA1c value decreased significantly (9±1.5% vs. 7.7±1.1%; P<.001), and almost 24% of the patients reached HbA1c levels of 7.5-8%. Furthermore, blood glucose levels under fasting conditions decreased significantly (190.6±73.2mg/dl vs. 138.9±38.2mg/dl; P<.001). A total of 35 patients (17.7%) had some hypoglycaemia during the month prior to the start of the study, and 2 cases (1.01%) of severe hypoglycaemia were detected. CONCLUSIONS: The BP strategy could significantly improve blood glucose control in patients 65 years of age or older with DM2 and high cardiovascular risk and is associated with a low risk of severe hypoglycaemia.

6.
Span J Psychol ; 19: E89, 2016 Dec 05.
Artículo en Inglés | MEDLINE | ID: mdl-27917731

RESUMEN

This paper reviews the use of video games for measuring intelligence differences and reports two studies analyzing the relationship between intelligence and performance on a leisure video game. In the first study, the main focus was to design an Intelligence Test using puzzles from the video game. Forty-seven young participants played "Professor Layton and the curious village"® for a maximum of 15 hours and completed a set of intelligence standardized tests. Results show that the time required for completing the game interacts with intelligence differences: the higher the intelligence, the lower the time (d = .91). Furthermore, a set of 41 puzzles showed excellent psychometric properties. The second study, done seven years later, confirmed the previous findings. We finally discuss the pros and cons of video games as tools for measuring cognitive abilities with commercial video games, underscoring that psychologists must develop their own intelligence video games and delineate their key features for the measurement devices of next generation.


Asunto(s)
Inteligencia/fisiología , Pruebas Neuropsicológicas , Desempeño Psicomotor/fisiología , Juegos de Video , Adolescente , Adulto , Femenino , Humanos , Masculino , Adulto Joven
7.
Neuroscience ; 286: 345-52, 2015 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-25499315

RESUMEN

The precuneus has received considerable attention in the last decade, because of its cognitive functions, its role as a central node of the brain networks, and its involvement in neurodegenerative processes. Paleoneurological studies suggested that form changes in the deep parietal areas represent a major character associated with the origin of the modern human brain morphology. A recent neuroanatomical survey based on shape analysis suggests that the proportions of the precuneus are also a determinant source of overall brain geometrical differences among adult individuals, influencing the brain spatial organization. Here, we evaluate the variation of cortical thickness and cortical surface area of the precuneus in a sample of adult humans, and their relation with geometry and cognition. Precuneal thickness and surface area are not correlated. There is a marked individual variation. The right precuneus is thinner and larger than the left one, but there are relevant fluctuating asymmetries, with only a modest correlation between the hemispheres. Males have a thicker cortex but differences in cortical area are not significant between sexes. The surface area of the precuneus shows a positive allometry with the brain surface area, although the correlation is modest. The dilation/contraction of the precuneus, described as a major factor of variability within adult humans, is associated with absolute increase/decrease of its surface, but not with variation in thickness. Precuneal thickness, precuneal surface area and precuneal morphology are not correlated with psychological factors such as intelligence, working memory, attention control, and processing speed, stressing further possible roles of this area in supporting default mode functions. Beyond gross morphology, the processes underlying the large phenotypic variation of the precuneus must be further investigated through specific cellular analyses, aimed at considering differences in cellular size, density, composition, and structural covariance compared to other brain areas.


Asunto(s)
Cognición/fisiología , Lóbulo Parietal/anatomía & histología , Adulto , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Imagen por Resonancia Magnética , Masculino , Pruebas Neuropsicológicas , Factores Sexuales , Adulto Joven
8.
Rehabilitación (Madr., Ed. impr.) ; 40(4): 180-187, jul. 2006. tab
Artículo en Es | IBECS | ID: ibc-046538

RESUMEN

Introducción. El objetivo de este trabajo fue elaborar un sistema de clasificación de pacientes en rehabilitación ambulatoria, común para Atención Primaria (AP) y Atención Especializada (AE). Métodos. La elaboración siguió dos etapas:1. Estudio descriptivo de las patologías atendidas a nivel ambulatorio durante el año 2002 en los Centros de Especialidades y un Centro Hospitalario y en las Unidades de Fisioterapia de AP del área sanitaria 1 de la Comunidad de Madrid. Se revisó una muestra aleatoria de 945 historias clínicas de un total de 47.204. 2. Revisión bibliográfica de publicaciones en MEDLINE de sistemas de clasificación de patologías en rehabilitación. Las patologías atendidas en AE se clasificaron en función del diagnóstico principal y en AP en función del motivo de derivación de la consulta del médico de familia a la Unidad de Fisioterapia. Se reagruparon en función de la prevalencia y se codificaron siguiendo los criterios de la Clasificación Internacional de Enfermedades, 9.ª revisión Modificación Clínica (CIE-9-MC) y criterios de la Clasificación Internacional de Atención Primaria (CIAP). Se constituyó un grupo de trabajo con profesionales que participan en el proceso de rehabilitación ambulatoria en el área sanitaria 1 de la Comunidad de Madrid, para consensuar el sistema de clasificación de patologías. Resultados. Elaboración de un sistema de clasificación de patologías en pacientes ambulatorios en rehabilitación, común para AP y AE. Conclusiones. Establecer un único sistema de clasificación de pacientes en el proceso de rehabilitación ambulatoria permite describir el tipo de pacientes que demanda atención y comparar las patologías atendidas en los diferentes centros de los dos niveles asistenciales


Introduction. The objective of the study has been to develop a classification system of patients for use in out-patient rehabilitation for Primary Care (PC) and Specialized Care (SC). Methods. It was developed in two phases:1. Descriptive study of diseases attended in out-patient care during the year 2002 in the speciality centers, hospital center and physiotherapy units of health district 1 primary care of the Community of Madrid. A random sample of 945 clinical records out of a total of 47204 were reviewed. 2. Review of the available literature in MEDLINE in order to find patient classification systems in rehabilitation and to analyze its possible application in our setting. The classification was performed using the principal diagnosis of the patient according to International Classification of Diseases 9th revision Clinical Modification (ICD-9-MC) for patients treated in speciality centers and hospitals centers or International Classification of Primary Care (ICPC) for patients treated in primary care. Secondly, the diseases were grouped based on the prevalence. A workgroup reviewed the patients classification system. The workgroup was constituted by health professionals involved in the process of rehabilitation in out-patient care in health district 1 of the Community of Madrid. Results. Development of a patients classification system in out-patient rehabilitation, common for PC and SC. Conclusions. To establish an unique patients classification system in the process of out-patient rehabilitation makes it possible to describe the type of patients that demands health services and to compare the diseases attended in different centers


Asunto(s)
Masculino , Femenino , Humanos , Centros de Rehabilitación/estadística & datos numéricos , Heridas y Lesiones/clasificación , Heridas y Lesiones/rehabilitación , Atención Ambulatoria/estadística & datos numéricos , Triaje , Servicio de Fisioterapia en Hospital/estadística & datos numéricos , Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud
9.
Medifam (Madr.) ; 13(4): 277-284, abr. 2003. ilus, tab
Artículo en Es | IBECS | ID: ibc-23961

RESUMEN

Fundamentos: existen varios estudios sobre experiencias y efectividad de programas de cirugía menor (CM) en Atención Primaria (AP) pero hay mucho desconocimiento acerca de los costes de estas actividades para poder establecer comparaciones entre los diferentes niveles asistenciales y áreas geográficas. Objetivo: medir los costes de un año de práctica de CM en un centro de AP.Diseño: estudio de evaluación económica, descriptivo, retrospectivo. Material y métodos: se desarrolló en AP sobre 479 pacientes tratados con diferentes procedimientos de CM desde enero a diciembre de 1998. Se incluyeron pacientes con patologías dérmicas y de uña que recibieron procedimientos quirúrgicos programados. Se excluyeron aquéllos con lesiones dérmicas que necesitaron tratamiento inmediato, sospecha de lesión maligna, queloides previos, riesgo de lesión neurológica, alergia a anestésicos locales, tratamiento anticoagulante. Medimos por separado costes de crioterapia y costes de otros procedimientos de CM. Resultados: fueron evaluadas 336 sesiones de criocirugía en 267 pacientes con un coste total anual de 589.857 ptas. (3.545,11). El coste medio por procedimiento fue 1.755 ptas. (10,55). El coste medio por paciente fue 2.209 ptas. (13,28).También fueron evaluadas 212 sesiones de otros procedimientos de CM en 212 pacientes con un coste total anual de 1.627.228 ptas. (9.779,8). El coste medio por paciente y procedimiento fue 7.676 ptas. (46,13).Conclusiones: la falta de estudios de costes sobre CM en especializada en nuestra región impide comparar nuestros resultados. Aunque en nuestra opinión, los programas de CM en AP muestran un bajo coste, se precisa utilizar metodologías estandarizadas de evaluación económica para poder comparar resultados tanto en AP como especializada. (AU)


Asunto(s)
Humanos , Procedimientos Quirúrgicos Menores/economía , Atención Primaria de Salud , Estudios Retrospectivos , Costos y Análisis de Costo , Criocirugía/economía
10.
Gut ; 51(4): 522-8, 2002 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-12235074

RESUMEN

BACKGROUND AND AIMS: Sigma ligands display antisecretory activity against various secretagogues, suggesting antidiarrhoeal properties. In this study, we evaluated: (i) the antidiarrhoeal effect of JO 2871, a high affinity sigma ligand, in three models of toxigenic diarrhoea in mice; and (ii) the site and mechanism of action of this compound. METHODS: Faeces were collected after toxin or vehicle administration in male DBA2 or NMRI mice. Diarrhoea was determined by cumulative stool weight (mg) over a 120 minute period. Diarrhoea was induced by intravenous administration of Salmonella enteriditis lipopolysaccharide (LPS), or oral administration of Escherichia coli heat stable (E coli-sta) or Clostridium difficile toxins. Two sigma ligands, igmesine and JO 2871, were administered either orally or intravenously, 60 and 30 minutes before the toxins, respectively. JO 2871 was also given orally 30 minutes after E coli-sta. In addition, JO 2871 was administered intracerebroventricularly five minutes before LPS and E coli-sta. BMY 14802 (1000 microg/kg orally), a sigma receptor antagonist, or cyclosomatostatin (CSS 1 microg/kg intravenously), a somatostatin antagonist, were given five minutes prior to JO 2871 in LPS, E coli-sta, and C difficile toxin treated mice. Gastric emptying and intestinal transit were evaluated after oral JO 2871 and BMY 14802 and intravenous CSS. RESULTS: Stool weight measured 120 minutes after administration of the toxins was significantly increased. Oral JO 2871 and igmesine dose dependently inhibited toxigenic diarrhoea in all models. ED(50) values obtained using JO 2871 (1-20 microg/kg) were more than 40 times lower than those obtained with igmesine. Oral JO 2871 given after E coli-sta also inhibited diarrhoea in a dose dependent manner (ED(50) 50 microg/kg). Both sigma ligands were active by the intravenous route on LPS and E coli-sta induced stool weight increases. JO 2871 administered intracerebroventricularly failed to block this effect at any dose tested. Both BMY 14802 and CSS reversed the antidiarrhoeal effect of oral JO 2871. JO 2871, BMY 14802, and CSS did not affect transit parameters. CONCLUSIONS: JO 2871 exerts a potent oral antidiarrhoeal effect, acting peripherally through sigma sites and somatostatin release.


Asunto(s)
Antidiarreicos/uso terapéutico , Diarrea/tratamiento farmacológico , Pentazocina/uso terapéutico , Animales , Toxinas Bacterianas/farmacología , Cinamatos/uso terapéutico , Ciclopropanos/uso terapéutico , Defecación , Diarrea/fisiopatología , Relación Dosis-Respuesta a Droga , Ligandos , Masculino , Ratones , Ratones Endogámicos DBA , Ratones Endogámicos , Pentazocina/análogos & derivados , Péptidos Cíclicos/farmacología , Pirimidinas/farmacología , Receptores sigma/efectos de los fármacos
11.
J Pharmacol Exp Ther ; 298(3): 1269-79, 2001 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-11504830

RESUMEN

The interaction of neuroactive steroids with the sigma(1)-receptor was investigated in Swiss mice submitted to the forced swimming test. The sigma(1)-agonists igmesine and (+)-SKF-10,047 and the steroid dehydroepiandrosterone sulfate (DHEAS) showed some antidepressant-like activity by shortening the immobility time, these effects being blocked by the sigma(1)-antagonist BD1047 or progesterone. The sigma(1)-agonist PRE-084 or pregnenolone sulfate failed to affect the immobility time. In adrenalectomized/castrated (AdX/CX) mice, the effects of igmesine and DHEAS were significantly potentiated, and PRE-084 or pregnenolone sulfate induced significant decreases of immobility time. The augmented effects in AdX/CX were fully blocked by BD1047. The effects of the classical antidepressants, desipramine or fluoxetine, were unchanged in AdX/CX mice. The effect of stress on the sigma(1)-receptor binding and neurosteroid levels was then examined in different brain structures, in terms of in vivo (+)-[(3)H]SKF-10,047 binding to sigma(1)-sites and neurosteroids levels. In the hippocampus, but not in the cortex or cerebellum, inhibition of in vivo (+)-[(3)H]SKF-10,047 binding was measured in parallel to the extent of progesterone levels according to the endocrine conditions. These data confirmed the antidepressant ability of sigma(1)-receptor agonists and revealed that the endogenous steroidal levels tonically interfere with the efficacy of the sigma(1)-system. It was observed that local modifications in progesterone levels are directly related to the changes of in vivo sigma(1)-binding. Such observations may be of major importance in view of the therapeutic use of selective sigma(1)-agonists in depression.


Asunto(s)
Antidepresivos/farmacología , Conducta Animal/efectos de los fármacos , Receptores Opioides delta/agonistas , Esteroides/farmacología , Adrenalectomía , Animales , Química Encefálica/efectos de los fármacos , Deshidroepiandrosterona/metabolismo , Relación Dosis-Respuesta a Droga , Masculino , Ratones , Orquiectomía , Fenazocina/análogos & derivados , Fenazocina/metabolismo , Radioinmunoensayo , Esteroides/sangre , Esteroides/metabolismo , Natación/psicología
12.
Aten Primaria ; 27(4): 227-33, 2001 Mar 15.
Artículo en Español | MEDLINE | ID: mdl-11262331

RESUMEN

OBJECTIVE: To evaluate improvement in therapeutic management of allergic rhinitis. DESIGN: Study of level of quality (longitudinal, prospective, intervention). SETTING: Primary care. PATIENTS AND OTHERS PARTICIPANTS: First evaluation (second quarter of 1995): 73 out of 305 patients were sampled (confidence 5%, accuracy 10%). Second evaluation (second quarter of 1996). Sample of 51 patients from a total of 210. INTERVENTIONS: Explicit criteria and standard procedure, based on consensus, for rhinitis treatment and an overall indicator of the general quality of rhinitis management were analysed. Criterion 1 (C1): correctly scaled treatment; criterion 2 (C2): initial treatment of choice with inhaled corticoids; criterion 3 (C3): correct use of oral corticoids or immunotherapy; criterion 4 (C4): coadjutant therapy according to predominant symptoms. Corrective measures: ongoing training and routine use of guide to practice. STATISTICS: index of compliance with criteria, Chi squared and Fisher's Z tests of a tail to compare both evaluations. MEASUREMENTS AND MAIN RESULTS: First evaluation: index of compliance with C1 = 59% (CI +/- 11), C2 = 41% (CI +/- 11), C3 = 90% (CI +/- 6) and C4 = 83% (CI +/- 8). Criteria and summary indicator obtained better results in patients attended by allergists. Second evaluation with overall improvement: C1 = 68.6% (CI +/- 13), C2 = 57% (CI +/- 13), C3 = 94% (CI +/- 6), C4 = 98% (CI +/- 3). Significant differences for C4 and C2 (p < 0.05). Overall quality and quality of criteria improved for patients attended in our environment. The summary indicator went up from 35.6% to 57% (p = 0.019), with the quality levels (C1-C4) becoming the same as those of the patients with allergy attended and with significant differences in the first evaluation disappearing. CONCLUSIONS: Ongoing training and routine use of guides to practice enables the therapeutic management of allergic rhinitis in primary care to be improved.


Asunto(s)
Rinitis Alérgica Perenne/terapia , Rinitis Alérgica Estacional/terapia , Algoritmos , Humanos , Atención Primaria de Salud , Estudios Prospectivos
13.
Aten. prim. (Barc., Ed. impr.) ; 27(4): 227-233, mar. 2001.
Artículo en Es | IBECS | ID: ibc-2199

RESUMEN

Objetivo. Evaluar mejora del manejo terapéutico de la rinitis alérgica. Diseño. Estudio de nivel de calidad (longitudinal, prospectivo, de intervención).Emplazamiento. Atención primaria. Pacientes u otros participantes. Primera evaluación (segundo trimestre de 1995): entre 305 pacientes se muestrearon 73 (confianza, 5 por ciento; precisión, 10 por ciento). Segunda evaluación (segundo trimestre de 1996). Tamaño muestral de 51 pacientes de un total de 210.Intervenciones. Se analizaron criterios explícitos y normativos de proceso basados en consenso de tratamiento de rinitis y un indicador resumen de calidad de manejo global. Criterio 1 (C1): tratamiento correctamente escalonado. Criterio 2 (C2): tratamiento inicial electivo con corticoides inhalados. Criterio 3 (C3): correcta utilización de corticoides orales o inmunoterapia. Criterio 4 (C4): terapia coadyuvante según síntomas predominantes. Medidas correctoras: formación continuada y uso rutinario de guía para la práctica. Estadística: índice cumplimiento criterios, 2 y Z de Fisher con test de una cola para comparar ambas evaluaciones. Mediciones y resultados principales. Primera evaluación: índice cumplimiento C1 = 59 por ciento (IC ñ 11); C2 = 41 por ciento (IC ñ 11); C3 = 90 por ciento (IC ñ 6), y C4 = 83 por ciento (IC ñ 8). Los criterios y el indicador resumen obtuvieron mejores resultados en los pacientes atendidos por alergólogos. Segunda evaluación con mejora global: C1 = 68,6 por ciento (IC ñ 13); C2 = 57 por ciento (IC ñ 13); C3 = 94 por ciento (IC ñ 6), y C4 = 98 por ciento (IC ñ 3). Diferencias significativas para C4 y C2 (p < 0,05). La calidad global y de criterios mejoró entre los pacientes atendidos en nuestro ámbito. El indicador resumen pasó del 35,6 por ciento al 57 por ciento (p = 0,019), igualándose los niveles de calidad (C1-C4) a los de pacientes atendidos en alergia y desapareciendo las diferencias significativas de la primera evaluación. Conclusiones. La formación continuada y la utilización rutinaria de guías para la práctica permite mejorar el manejo terapéutico de la rinitis alérgica en atención primaria. (AU)


Asunto(s)
Persona de Mediana Edad , Niño , Adulto , Adolescente , Anciano , Masculino , Femenino , Humanos , Procedimientos Quirúrgicos Ambulatorios , España , Enfermedades de la Boca , Rinitis Alérgica Perenne , Estudios Retrospectivos , Atención Primaria de Salud , Estudios Prospectivos , Instituciones de Atención Ambulatoria , Algoritmos , Rinitis Alérgica Estacional
14.
J Pharmacol Exp Ther ; 289(3): 1391-7, 1999 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-10336531

RESUMEN

Trimebutine [2-dimethylamino-2-phenylbutyl-3,4,5-trimethoxybenzoate hydrogen maleate (TMB)] has been demonstrated to be active for relieving abdominal pain in humans. To better understand its mechanism of action, we have tested TMB; nor-TMB, its main metabolite in humans; and their respective stereoisomers for their affinity toward sodium channels labeled by [3H]batrachotoxin, their effect on sodium, potassium, and calcium currents in rat dorsal root ganglia neurons, and their effect on veratridine-induced glutamate release from rat spinal cord slices. TMB has also been tested in an animal model of local anesthesia. TMB (Ki = 2.66 +/- 0.15 microM) and nor-TMB (Ki = 0.73 +/- 0.02 microM) displaced [3H]batrachotoxin from its binding site with affinities similar to that of bupivacaine (Ki = 7.1 +/- 0.9 microM). nor-TMB was found to block veratridine-induced glutamate release with an IC50 value of 8.5 microM, which is very similar to that of bupivacaine (IC50 = 8.2 microM); the effect of TMB was limited to 50% inhibition at 100 microM. TMB and nor-TMB blocked sodium currents in sensory neurons from rat dorsal root ganglia (IC50 = 0.83 +/- 0.09 and 1.23 +/- 0.19 microM, respectively), whereas no effect was observed on calcium currents at the same concentrations. A limited effect was observed on potassium currents (IC50 = 23 +/- 6 at 10 microM) for TMB. In vivo, when tested in the rabbit corneal reflex, TMB displayed a local anesthetic activity 17-fold more potent than that of lidocaine.


Asunto(s)
Corteza Cerebral/metabolismo , Ganglios Espinales/fisiología , Neuronas/fisiología , Canales de Potasio con Entrada de Voltaje , Médula Espinal/fisiología , Sinaptosomas/metabolismo , Trimebutino/análogos & derivados , Trimebutino/farmacología , Animales , Batracotoxinas/metabolismo , Unión Competitiva , Línea Celular , Células Cultivadas , Córnea/fisiología , Embrión de Mamíferos , Embrión no Mamífero , Femenino , Ganglios Espinales/citología , Ácido Glutámico/metabolismo , Humanos , Técnicas In Vitro , Membranas Intracelulares/metabolismo , Canal de Potasio Kv.1.1 , Canal de Potasio Kv.1.2 , Lidocaína/farmacología , Masculino , Potenciales de la Membrana/efectos de los fármacos , Neuronas/citología , Neuronas/efectos de los fármacos , Oocitos/efectos de los fármacos , Oocitos/fisiología , Canales de Potasio/efectos de los fármacos , Canales de Potasio/fisiología , Conejos , Ratas , Ratas Sprague-Dawley , Médula Espinal/efectos de los fármacos , Estereoisomerismo , Xenopus laevis
15.
Neuroreport ; 10(5): 1137-41, 1999 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-10321498

RESUMEN

A new rat model was established up to evaluate the antinociceptive effect of compounds in visceral pain. The test consisted in measuring the performance of rats in an aversive light stimulus avoidance experimental device. Rats with TNBS-induced colitis had a lower number of total active lever pressings and did not discriminate the active lever from the inactive one. Morphine (1 mg/kg, s.c.) and CI-977 (0.001 mg/kg, s.c.) treatment restored the level of pressing activity of animals and their ability to discriminate the active lever from the inactive one. Naloxone treatment antagonized the improvement of performance produced by morphine. The results obtained indicate that this behavioral paradigm may be used to evaluate the antinociceptive potential of compounds.


Asunto(s)
Conducta Animal/fisiología , Colitis/fisiopatología , Colitis/psicología , Dolor/psicología , Vísceras/fisiopatología , Analgésicos Opioides/farmacología , Animales , Conducta Animal/efectos de los fármacos , Benzofuranos/farmacología , Cognición/efectos de los fármacos , Cognición/fisiología , Colitis/inducido químicamente , Colitis/patología , Colon/efectos de los fármacos , Colon/patología , Discriminación en Psicología/efectos de los fármacos , Discriminación en Psicología/fisiología , Masculino , Morfina/farmacología , Pirrolidinas/farmacología , Ratas , Ratas Sprague-Dawley , Ácido Trinitrobencenosulfónico/farmacología
16.
Rev Esp Enferm Dig ; 90(7): 480-6, 1998 Jul.
Artículo en Inglés, Español | MEDLINE | ID: mdl-9741205

RESUMEN

OBJECTIVE: To know the prevalence of serological markers of hepatitis A, B and C virus in first year student nurses. SETTING: A transversal study of prevalence. SUBJECTS AND METHODS: 81 first year student nurses, mean age 20.6 years (18-37, S.D. 3.8), with demographic, epidemiologic and clinical variables, performing liver enzymes, anti-HAV IgG, anti-HBcore and anti-HCV. RESULTS: The anti-HAV IgG was positive in 9 students (11.1%), with a prevalence of 6.7% between 17 and 19 years (C.I.95% 1.7 to 19.3%), 8.7% between 20 and 22 years (C.I.95% 1.5 to 29.5%), 20% between 23 and 25 years (C.I.95% 10.5 to 70.1%), and 37.5% (C.I.95% 10.2 to 74.1) in those over 25 years (p < 0.001). No other significative variables existed according to age-group. Regarding hepatitis B virus, of the 65 not previously vaccinated, only 1 (1.5%, C.I.95% 0.08 to 9.4%) was immunized, and there were no cases of HBsAg positive. The anti-VHC was positive in one case (1.2%, C.I.95% 0.06 to 7.6%), RIBA indeterminate and with normal ALT. Only one student (1.2%) showed increased transaminase values, attributed to liver steatosis. None of the students had suffered any episode of acute clinic hepatitis. CONCLUSIONS: The anti-HAV IgG prevalence in first year student nurses in our area is very low, and it is not necessary to carry out prevacunal screening. The low prevalence of anti-Hbcore also rejects a similar screening with respect to HBV. There were no HBsAg or anti-HCV positive cases, but it should not be the cause of forgetting to take the universal precautions or giving a false sensation of security.


Asunto(s)
Biomarcadores/sangre , Virus de Hepatitis , Hepatitis Viral Humana/transmisión , Transmisión de Enfermedad Infecciosa de Paciente a Profesional , Estudiantes de Enfermería , Femenino , Hepatitis Viral Humana/virología , Humanos , Prevalencia , España/epidemiología
17.
Gastroenterol Hepatol ; 20(7): 347-52, 1997.
Artículo en Español | MEDLINE | ID: mdl-9377232

RESUMEN

The aim of this study was to know the prevalence of hepatitis A, B and C markers in an adult population in Gijón, Spain. A randomized, transversal sample according to the census was made in a population between 26 and 65 years of age in Gijón, analyzing demographic, epidemiologic and clinical variables, liver function tests, anti-HAV IgG, anti-HBcore and anti-HCV. Of the 476 individuals included a census error was detected in 26 (5.5%) and 340 (71.4%) were studied. Of these anti-HAV IgG was positive in 210 (61.8%) with prevalences of 17.9% from 26 to 30 years (CI: 95%, 11.1%-27.4%), 54.7% from 31 to 35 years (CI: 95%, 41.8%-67%), 73.6% from 36 to 40 years (CI: 95%, 59.4%-84.3%) and 93% (CI: 95%, 86.7%-96.5%) above 40 years of age (p < 0.001). No other significant variables were found adjusted by age groups. With regard to HBV, of the 331 unvaccinated cases, 35 (10.6, CI 95%, 7.6%-14.5%) presented immune markers and 4 (1.2% CI: 95%, 0.4%-3.3%) HBsAg positivity, with all having normal ALT and no viral replication. Anti-HCV was positive in 1.7% (CI: 95%, 0.7-3.9%), being significantly related to IVDA or tattoos. Hypertransaminasemias were detected in 18 (5.3%) being attributed to virus C (27.8%), alcoholism (27.8%) or obesity (44.4%). History of clinical manifestations of acute hepatitis was collected in 9.7% of the cases with no memory of the episode in 84.3% of the anti-HAV IgG positive cases, 79.5% of the anti-HBcore positive cases and 83.3% of the anti-HCV positive cases. The current curve of prevalence of anti-HAV IgG in the Gijón population varies in the decade from 30 to 40 years in age ranging from values discarding prevaccination screening under the age of 30 to levels of minimum susceptibility to infection above the age of 40. The low prevalence of anti-HBcore underestimates its use as prevaccination screening versus HBV in the population of Gijón. The prevalences of HBsAg or anti-HCV thereby make this area a zone of intermediate endemicity, with around 3% of the population being chronically infected by one of these viruses.


Asunto(s)
Virus de la Hepatitis A Humana/inmunología , Anticuerpos Antihepatitis/sangre , Anticuerpos contra la Hepatitis B/sangre , Anticuerpos contra la Hepatitis C/sangre , Población Urbana , Adulto , Distribución por Edad , Anciano , Biomarcadores/sangre , Estudios Transversales , Femenino , Humanos , Inmunoglobulina G/sangre , Masculino , Persona de Mediana Edad , Prevalencia , Distribución Aleatoria , España/epidemiología , Población Urbana/estadística & datos numéricos
18.
J Neurosci Res ; 46(6): 734-43, 1996 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-8978508

RESUMEN

Recent reports suggest an interaction between neuro-(active)steroids and sigma1 (sigma 1) receptors, affecting biochemical parameters as well as physiological responses mediated by sigma 1 ligands in the rodent brain. In this study, we examined the modulation by neurosteroids of the haloperidol-sensitive in vivo (+)-[3H]SKF-10,047 binding to sigma 1 sites in the mouse hippocampus and cortex. Progesterone (PROG; 2-40 mg/kg), pregnenolone sulfate (PREGS; 10-40 mg/kg), and dehydroepiandrosterone sulfate (DHEAS; 10-40 mg/kg) were administered systemically 10 min before the radioactive tracer. The total amount of (+)-[3H]SKF-10,047 bound in each structure was significantly affected by PROG and PREGS only at the highest dose tested and was unaffected by DHEAS. However, bound to free (B/F) radioactivity ratios were highly significantly decreased by 30-40% in each structure by PROG and PREGS. DHEAS, at 40 mg/kg, induced a significant 20% decrease in the hippocampus. Furthermore, the in vivo (+)-[3H]SKF-10,047 binding parameters were diminished in pregnant female mice compared to non-pregnant or male mice. These results confirm the in vitro binding results, bring a direct in vivo demonstration of the interaction between neurosteroids and sigma 1 receptors, and show that physiologic modulations of the steroidal concentrations affect the sigma 1 systems.


Asunto(s)
Antipsicóticos/farmacología , Hormonas Esteroides Gonadales/farmacología , Fenazocina/análogos & derivados , Prosencéfalo/química , Receptores sigma/metabolismo , Animales , Unión Competitiva/fisiología , Corteza Cerebral/química , Corteza Cerebral/metabolismo , Sulfato de Deshidroepiandrosterona/metabolismo , Sulfato de Deshidroepiandrosterona/farmacología , Relación Dosis-Respuesta a Droga , Femenino , Hormonas Esteroides Gonadales/metabolismo , Hipocampo/química , Hipocampo/metabolismo , Masculino , Ratones , Fenazocina/farmacología , Embarazo , Pregnenolona/metabolismo , Pregnenolona/farmacología , Progesterona/metabolismo , Progesterona/farmacología , Prosencéfalo/metabolismo , Ratas , Ratas Sprague-Dawley , Tritio
19.
Brain Res ; 733(2): 219-30, 1996 Sep 16.
Artículo en Inglés | MEDLINE | ID: mdl-8891305

RESUMEN

A beneficial effect of sigma (sigma) agonists was previously described on several pharmacological models of learning impairments. We examined this effect in senescence-accelerated mice (SAM), which has been developed as a murine model of aging and cognitive dysfunction. SAMP8/Ta (P8, senescence-prone substrain), 10-12 months of age, showed significant impairments in mnemonic capacities, as compared to age-matched SAMR1/Ta controls (R1, senescence-resistant substrain). Tests included open-field behavior, spontaneous alternation performances in the Y-maze, step-down passive avoidance and place learning after repetitive training in a water-maze. Pretreatment with the sigma agonists JO-1784 (igmesine) or PRE-084, at 0.1-3 mg/kg, s.c., significantly improved spontaneous alternation and passive avoidance performances in P8. JO-1784 or PRE-084, at 1 mg/kg, also improved place learning in the water-maze, and retention, in term of escape latency. The implication of sigma sites was indicated by the lack of significant effect of JO-1783, the inactive enantiomer of JO-1784, and by the ability of BMY-14802 (5 mg/kg, i.p.) to antagonize the effects on passive avoidance of JO-1784 (0.5 mg/kg) or PRE-084 (1 mg/kg). Subchronic treatments with JO-1784 (0.5 mg/kg/day) or PRE-084 (1 mg/kg/day) during 10 days, allowed a significant improvement of learning during training in the water-maze, but retention was not significantly ameliorated. These results confirmed the interest of the SAM substrains as an experimental model for senile memory impairment and showed that sigma agonists could improve the quality of learning, although they seem less effective on long-term memory retrieval upon chronic administration.


Asunto(s)
Envejecimiento/psicología , Cinamatos/farmacología , Ciclopropanos/farmacología , Aprendizaje/efectos de los fármacos , Memoria/efectos de los fármacos , Morfolinas/farmacología , Actividad Motora/efectos de los fármacos , Receptores sigma/agonistas , Animales , Ansiolíticos/farmacología , Antipsicóticos/metabolismo , Reacción de Prevención/efectos de los fármacos , Aprendizaje por Laberinto/efectos de los fármacos , Ratones , Ratones Mutantes Neurológicos , Fenazocina/análogos & derivados , Fenazocina/metabolismo , Pirimidinas/farmacología
20.
Rev Esp Enferm Dig ; 86(5): 845-7, 1994 Nov.
Artículo en Español | MEDLINE | ID: mdl-7848698

RESUMEN

Campylobacter fetus has been implicated in the etiology of sepsis and bacteriemias in immunosupressed subjects. In a few cases, it has also been reported to be responsible for spontaneous bacterial peritonitis in cirrhotic patients. We describe the clinical picture of a woman with terminal liver cirrhosis who had bacteriemia and spontaneous bacterial peritonitis caused by this agent. We argue about the history of cleansing enemas and their probable role in the development of the infection. We stress the excellent response to the antibiotic treatment.


Asunto(s)
Infecciones por Campylobacter/complicaciones , Campylobacter fetus , Cirrosis Hepática/complicaciones , Peritonitis/microbiología , Adulto , Femenino , Humanos
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