Mindfulness-Based Cognitive Therapy for Spanish Oncology PATIENTS: The Bartley Protocol / Terapia Cognitiva Basada en Mindfullness en Pacientes Oncológicos Españoles: el Protocolo Bartley

OBJECTIVES: The aim of this study is to analyse whether MBCT will reduce the general level of psychopathology, increase the quality of life, and increase meta-knowledge about their emotional state in Spanish participants with cancer. METHOD: The sample consisted of n = 88 Spanish oncology patients. This was a non-randomized, two-group (experimental vs waiting list) trial conducted in a naturalistic setting. We evaluated psychological distress (BSI-18), quality of life (FACT-G), and meta-knowledge of emotions (TMMS-24). RESULTS: The participants who received the MBCT treatment improved more than the control group in distress (F= 6.79; p = .01, BSI-18), depression (F= 8.38; p = .005 ), quality of life -physical health (F = 5.56; p = .02), emotional state (F = 7.06; p= .01), and functional capacity (F = 7.98; p = .006), as well as meta-knowledge about their emotional state (F = 35.4; p = .01), and its subscales of perception, (F = 8.95; p = .004), comprehension, (F= 16.06; p = .01), and repair (F = 15.67; p = .01). CONCLUSIONS: The Bartley MBCT program was feasible and showed promise in improving general psychopathology (depression), improving patients' quality of life, and increasing meta-knowledge about their emotional state

OBJETIVOS: el objetivo de este estudio es analizar el papel de la MBCT en la reducción de la psicopatología, la mejora de la calidad de vida y del metaconocimiento del estado emocional en participantes españoles oncológicos. MÉTODO: la muestra consta de n = 88 pacientes oncológicos españoles. Este es un ensayo no aleatorio de dos grupos (experimental versus lista de espera) realizado en un entorno hospitalario. Se evaluaron distrés psicológico (BSI-18), calidad de vida (FACTG) y metaconocimiento de las emociones (TMMS). RESULTADOS: los participantes con tratamiento MBCT mejoraron más que el grupo control en distrés (F= 6.79; p = .01), depresión (F= 8.38; p = .005), en la calidad de vida asociada a salud física (F = 5.56; p = .02), al estado emocional (F = 7.06; p= .01) y a la capacidad funcional personal (F = 7.98; p = .006), y en metaconocimiento de las emociones (F = 35.4; p = .01), y sus subescalas percepción (F = 8.95; p = .004), comprensión, (F= 16.06; p = .01) y reparación (F = 15.67; p = .01). CONCLUSIONES: la MBCT mostró resultados prometedores para mejorar la psicopatología general, la calidad de vida y el metaconocimiento sobre el estado emocional

Mindfulness-Based Cognitive Therapy for Spanish Oncology Patients: The Bartley Protocol.

OBJECTIVES: The aim of this study is to analyse whether MBCT will reduce the general level of psychopathology, increase the quality of life, and increase meta-knowledge about their emotional state in Spanish participants with cancer. METHOD: The sample consisted of n = 88 Spanish oncology patients. This was a non-randomized, two-group (experimental vs waiting list) trial conducted in a naturalistic setting. We evaluated psychological distress (BSI-18), quality of life (FACT-G), and meta-knowledge of emotions (TMMS-24). RESULTS: The participants who received the MBCT treatment improved more than the control group in distress (F= 6.79; p = .01, BSI-18), depression (F= 8.38; p = .005 ), quality of life -physical health (F = 5.56; p = .02), emotional state (F = 7.06; p= .01), and functional capacity (F = 7.98; p = .006), as well as meta-knowledge about their emotional state (F = 35.4; p = .01), and its subscales of perception, (F = 8.95; p = .004), comprehension, (F= 16.06; p = .01), and repair (F = 15.67; p = .01). CONCLUSIONS: The Bartley MBCT program was feasible and showed promise in improving general psychopathology (depression), improving patients' quality of life, and increasing meta-knowledge about their emotional state.

Baja penetrancia clínica en sujetos portadores de mutación patogénica para las canalopatías cardiacas / Low clinical penetrance in causal mutation carriers for cardiac channelopathies

Introducción y objetivos. Las canalopatías cardiacas son trastornos genéticos que pueden causar muerte súbita. Entre ellas se encuentran el síndrome de QT largo y el síndrome de Brugada. Ambos se diagnostican según unos criterios previamente publicados. Nuestro objetivo es evaluar la sensibilidad de esos criterios en una serie consecutiva de sujetos portadores de mutación patogénica para síndrome de QT largo y síndrome de Brugada. Métodos. Se incluyó a 15 familias y 31 sujetos portadores de mutaciones con alta probabilidad patogénica de síndrome de QT largo o síndrome de Brugada. Realizamos estudio clínico y electrocardiográfico para analizar el cumplimiento de los criterios diagnósticos. El estudio estadístico se realizó con el programa estadístico SPSS 17.0. Resultados. El 48,3% de los sujetos cumplían criterios de alta probabilidad de síndrome de QT largo o síndrome de Brugada. Entre la población con mutación para síndrome de QT largo, sólo 10 de 21 sujetos mostraron un índice de Schwartz >= 4. Tanto la mediana de la puntuación de Schwartz como el intervalo QTc fueron menores en familiares que en probandos. En la población con mutación para síndrome de Brugada, el 60% no cumplía los criterios diagnósticos vigentes, algo que fue más frecuente en familiares. El test farmacológico con epinefrina y flecainida ayudó a establecer el diagnóstico en dos familias portadoras de mutación con fenotipo negativo. Conclusiones. Los criterios diagnósticos actuales para síndrome de QT largo y síndrome de Brugada tuvieron baja sensibilidad en nuestra muestra de portadores genéticos. El test genético apoyado por tests farmacológicos puede incrementar la sensibilidad diagnóstica, especialmente en familiares asintomáticos (AU)

Introduction and objectives. Cardiac channelopathies are genetic alterations that can cause sudden death. Long QT syndrome and Brugada syndrome are 2 such conditions. Both are diagnosed according to previously published criteria. Our objective was to determine the sensitivity of these criteria in a consecutive series of patients carrying the mutations that cause them. Methods. We enrolled 15 families and 31 causal mutation carriers with a high pathogenic probability of having long QT syndrome and Brugada syndrome. We conducted clinical and electrocardiographic studies to analyze the extent to which these patients fulfilled the diagnostic criteria. Statistical analysis was with SPSS 17.0. Results. Some 48.3% of the subjects met the criteria indicating a high probability of long QT syndrome or Brugada syndrome. Among those with the mutation for long QT syndrome, only 10 out of 21 had a Schwartz index score >=4. Both the median Schwartz score and the cQT interval were lower in relatives than in probands. Of those with the mutation for Brugada syndrome, 60% failed to meet current diagnostic criteria, which were more frequently fulfilled in relatives. Pharmacological tests with epinephrine and flecainide helped establish the diagnosis in 2 mutation carriers with negative phenotype. Conclusions. Current diagnostic criteria for long QT syndrome and Brugada syndrome had low sensitivity in our sample of genetic carriers. Genetic tests supported by pharmacological tests can increase diagnostic sensitivity, especially in asymptomatic relatives (AU)

Low clinical penetrance in causal mutation carriers for cardiac channelopathies.

INTRODUCTION AND OBJECTIVES: Cardiac channelopathies are genetic alterations that can cause sudden death. Long QT syndrome and Brugada syndrome are 2 such conditions. Both are diagnosed according to previously published criteria. Our objective was to determine the sensitivity of these criteria in a consecutive series of patients carrying the mutations that cause them. METHODS: We enrolled 15 families and 31 causal mutation carriers with a high pathogenic probability of having long QT syndrome and Brugada syndrome. We conducted clinical and electrocardiographic studies to analyze the extent to which these patients fulfilled the diagnostic criteria. Statistical analysis was with SPSS 17.0. RESULTS: Some 48.3% of the subjects met the criteria indicating a high probability of long QT syndrome or Brugada syndrome. Among those with the mutation for long QT syndrome, only 10 out of 21 had a Schwartz index score ≥ 4. Both the median Schwartz score and the cQT interval were lower in relatives than in probands. Of those with the mutation for Brugada syndrome, 60% failed to meet current diagnostic criteria, which were more frequently fulfilled in relatives. Pharmacological tests with epinephrine and flecainide helped establish the diagnosis in 2 mutation carriers with negative phenotype. CONCLUSIONS: Current diagnostic criteria for long QT syndrome and Brugada syndrome had low sensitivity in our sample of genetic carriers. Genetic tests supported by pharmacological tests can increase diagnostic sensitivity, especially in asymptomatic relatives.

Cavotricuspid isthmus catheter ablation without the use of fluoroscopy as a first-line treatment.

INTRODUCTION AND OBJECTIVES: The use of intracardiac navigation systems has enabled a significant reduction of the radiation dose in the majority of ablation procedures. The purpose of this study is to evaluate the feasibility and safety of cavotricuspid isthmus ablation without the use of fluoroscopy as a first-line treatment. METHODS AND RESULTS: An observational study without a control group in patients referred for treatment of common atrial flutter. In all of the procedures, Ensite-NavX™ was the only guidance system used to visualize the catheters. One or two diagnostic catheters and a cooled-tip ablation catheter were used in each procedure. Bidirectional cavotricuspid isthmus block was considered to indicate a successful procedure. Eighty-three ablation procedures were performed in 80 patients (82.5% men, 61 ± 10 years of age). The procedure was repeated in 3 patients (3.75%) due to flutter recurrence. Success was obtained in 98.8% of the procedures; in 1 patient it was necessary to implant a pacemaker for sinus node dysfunction and 4 patients experienced minor complications. In 75 procedures (90.4%), fluoroscopy was not required. Visualization of the diagnostic catheters was the most common reason for using fluoroscopy. The time required to perform the ablation procedure was similar to that published in other series. CONCLUSIONS: Cavotricuspid isthmus ablation using a nonfluoroscopic three-dimensional (3D) navigation system is effective and safe.

Safety and feasibility of catheter ablation for atrioventricular nodal re-entrant tachycardia without fluoroscopic guidance.

BACKGROUND: Nonfluoroscopic intracardiac navigation systems reduce the dose of radiation in most ablation procedures. However, they have not been sufficiently studied as a sole guidance tool for electrode catheter handling. OBJECTIVE: The purpose of our study was to assess the feasibility and safety of catheter ablation for atrioventricular nodal re-entrant tachycardia (AVNRT) without the use of fluoroscopy. METHODS: We prospectively enrolled all of the patients with AVNRT (Group A) treated by catheter ablation guided only by a nonfluoroscopic intracardiac navigation system. These patients were compared with a matched control group of patients (Group B) who had undergone an ablation procedure for AVNRT guided only by fluoroscopy in the preceding months. We compared the success rate and the rate of complications and recurrences. We also compared the procedure and radiofrequency times. RESULTS: Fifty patients were enrolled in each group. The procedure was successful in 100% in Group A versus 96% in Group B (P = .15). One patient in Group A and 4 patients in Group B suffered nonserious complications (P = NS). The mean fluoroscopy time in Group B was 18 +/- 16 min (range 3.5 to 77, total 924). In 1 case in Group A (2%), the use of fluoroscopy was required. Procedure and radiofrequency times did not differ between the 2 groups. A recurrence developed in 2 patients in each group (P = NS). CONCLUSIONS: Catheter ablation for AVNRT without fluoroscopic guidance is feasible and safe, and does not prolong procedure time. The reduction in radiation dose is considerable for patients and professionals.