Neovasculopatía paquicoroidea / Pachychoroid neovasculopathy

No disponible

Estructutura de personalidad límite en adolescentes. A propósito de un caso / Border line personality structure in adolescents. A case study

A pesar de su inicio en la infancia y adolescencia, el diagnóstico de trastornos de personalidad en estas etapas de la vida es muy controvertido. La estructura límite de la personalidad es especialmente compleja por la variabilidad de la sintomatología y por la dificultad que plantea en el diagnóstico diferencial con rasgos propios de la etapa adolescente. Un modelo que puede resultar de utilidad es el propuesto por Paulina Kernberg, desde la perspectiva del desarrollo de la personalidad. Describimos, a través de este modelo, el caso de una paciente de 15 años con una larga historia de autolesiones, comportamiento suicida, alteración de la conducta y deterioro progresivo del funcionamiento; en la que se identificaron una compleja historia familiar, dificultades en la relaciones sociales desde la infancia y la utilización de defensas primarias como la escisión y la identificación proyectiva

Despite commencing through childhood and adolescence, the diagnosis of personality disorders during these life stages is controversial. Borderline personality structure is especially complex due to symptomatology variability and the challenges presented in the differential diagnosis from adolescent stage characteristic features. A useful model could be the one posed by Paulina Kernberg, based on a personality development perspective. We describe, through this model, the case of a 15 year old patient with a long history of recurrent selfinjury, suicidal behaviour, behavioural disturbances and progressive functioning impairment; in which complex family history, difficulties in social relationships and utilization of primary defence mechanisms such as scission and projective identification, were detected

An ecosystem-scale perspective of the net land methanol flux: synthesis of micrometeorological flux measurements.

Methanol is the second most abundant volatile organic compound in the troposphere and plays a significant role in atmospheric chemistry. While there is consensus about the dominant role of living plants as the major source and the reaction with OH as the major sink of methanol, global methanol budgets diverge considerably in terms of source/sink estimates reflecting uncertainties in the approaches used to model, and the empirical data used to separately constrain these terms. Here we compiled micrometeorological methanol flux data from eight different study sites and reviewed the corresponding literature in order to provide a first cross-site synthesis of the terrestrial ecosystem-scale methanol exchange and present an independent data-driven view of the land-atmosphere methanol exchange. Our study shows that the controls of plant growth on the production, and thus the methanol emission magnitude, and stomatal conductance on the hourly methanol emission variability, established at the leaf level, hold across sites at the ecosystem-level. Unequivocal evidence for bi-directional methanol exchange at the ecosystem scale is presented. Deposition, which at some sites even exceeds methanol emissions, represents an emerging feature of ecosystem-scale measurements and is likely related to environmental factors favouring the formation of surface wetness. Methanol may adsorb to or dissolve in this surface water and eventually be chemically or biologically removed from it. Management activities in agriculture and forestry are shown to increase local methanol emission by orders of magnitude; they are however neglected at present in global budgets. While contemporary net land methanol budgets are overall consistent with the grand mean of the micrometeorological methanol flux measurements, we caution that the present approach of simulating methanol emission and deposition separately is prone to opposing systematic errors and does not allow taking full advantage of the rich information content of micrometeorological flux measurements.

Metabolic responses of Quercus ilex seedlings to wounding analysed with nuclear magnetic resonance profiling.

Plants defend themselves against herbivory at several levels. One of these is the synthesis of inducible chemical defences. Using NMR metabolomic techniques, we studied the metabolic changes of plant leaves after a wounding treatment simulating herbivore attack in the Mediterranean sclerophyllous tree Quercus ilex. First, an increase in glucose content was observed in wounded plants. There was also an increase in the content of C-rich secondary metabolites such as quinic acid and quercitol, both related to the shikimic acid pathway and linked to defence against biotic stress. There was also a shift in N-storing amino acids, from leucine and isoleucine to asparagine and choline. The observed higher content of asparagine is related to the higher content of choline through serine that was proved to be the precursor of choline. Choline is a general anti-herbivore and pathogen deterrent. The study shows the rapid metabolic response of Q. ilex in defending its leaves, based on a rapid increase in the production of quinic acid, quercitol and choline. The results also confirm the suitability of (1)H NMR-based metabolomic profiling studies to detect global metabolome shifts after wounding stress in tree leaves, and therefore its suitability in ecometabolomic studies.

Evaluación de resultados tras un año de intervención en un CRPS / No disponible

Introducción. La evaluación de resultados en rehabilitación psicosocial (RPS) se hace difícil por diversos motivos: la intervención se realiza mediante diferentes estrategias y programas; se trabaja sobre numerosas áreas al mismo tiempo; los objetivos se individualizan; las manifestaciones y evolución de la enfermedad varían; y numerosas variables repercuten en la generalización y mantenimiento de resultados. No obstante existe evidencia de que la RPS mejora el nivel de funcionamiento, la integración en recursos comunitarios, el rendimiento cognitivo, la autoestima y la calidad de vida de las personas con enfermedad mental, además de aumentar la adherencia a los servicios de salud mental y reducir el número de hospitalizaciones y coste de cuidado. Objetivo. Valorar si hay cambios significativos tras un año de intervención en RPS con 74 personas que acuden a un Centro de Rehabilitación Psicosocial, en variables como la sintomatología, el rendimiento cognitivo, las habilidades sociales y las actitudes hacia la enfermedad. Método. Se realiza una evaluación al inicio de la intervención y pasado un año, comparando resultados. Se señalan los programas de intervención utilizados. Resultados. Se observan diferencias significativas en las pruebas que valoran ansiedad, depresión, autoestima, psicopatología general, habilidades conversacionales y expresivas, capacidad de resolución de problemas y algunas medidas cognitivas. No se observan cambios en actitudes hacia la enfermedad, habilidades asertivas, y sintomatología positiva y negativa. Conclusiones. E l hecho de que la RPS produzca ganancias sobre el bienestar y funcionamiento del paciente justifica las intervenciones realizadas. Se evidencia la necesidad de identificar qué pacientes son los que más se benefician del tratamiento, hacer una valoración a más largo plazo, y estudiar cada una de las intervenciones por separado para ver qué componentes son los más efectivos (AU)

Introduction. Evaluation of results in psychosocial rehabilitation is difficult for several reasons: the procedure is done through different strategies and programs, working on many areas at the same time, the objectives are individualized, the course of the disease varies; and many variables affect the generalization and maintenance of results. However there is evidence that the psychosocial rehabilitation improves the psychosocial funcioning, integration into community resources, cognitive performance, selfesteem and quality of life of people with mental illness, as well as increasing adherence to mental health services and reduce the number of admissions in hospital and cost of care. Objective. T he aim is to assess if there are significant changes after a year of intervention in psychosocial rehabilitation with 74 people attending a Center for Psychosocial Rehabilitation, in variables such as symptoms, cognitive performance, social skills and attitudes toward the disease. Method. We compared the results after one year of intervention, through an assessment made at the beginning and repeated one year later. We focus on the intervention programs used. Results. Significant differences were observed in areas related to anxiety, depression, self esteem, general psychopathology, and expressive and conversational skills, problem-solving ability and some cognitive measures. No significant changes in attitudes towards illness, assertiveness skills, and psychotic symptoms. Conclusions. T he psychosocial rehabilitation produces benefits, which suggest the importance of implementing these interventions in the community. Research needs to identify which patients benefit from treatment and which components of the psychosocial rehabilitation are most effectives (AU)

Influencia de la sintomatología y del nivel de funcionamiento en esquizofrenia sobre la carga del cuidador / No disponible

Introducción. Las consecuencias de convivir con alguien que padece una enfermedad mental es lo que habitualmente se denomina «carga del cuidador», y esta se relaciona con diversas variables tanto sociodemográficas como clínicas. Objetivo. Se analizan las relaciones existentes entre la carga del cuidador y variables tanto del paciente como del cuidador. Asimismo, se evalúan qué variables podrían estar relacionadas con la adherencia de los cuidadores a grupos de intervención familiar. Metodología. La muestra consta de 75 familiares de personas con diagnóstico de esquizofrenia que acuden a un Centro de Rehabilitación Psicosocial. Se evalúa la percepción familiar de las conductas y funcionamiento del paciente así como la carga del cuidador. Por otro lado se valora clínicamente la sintomatología del paciente y del cuidador. Resultados. Los análisis muestran correlaciones positivas ente los síntomas positivos y la psicopatología general del paciente y la carga del cuidador, y una correlación negativa entre carga y funcionamiento del paciente. La carga del cuidador se relaciona con su sintomatología afectiva. La adherencia a grupos de intervención familiar no se relaciona con la carga del cuidador, y sí con su sintomatología afectiva. Conclusiones. De los resultados se valora la importancia de tener en cuenta las necesidades concretas de afrontamiento familiar antes de diseñar e implementar las intervenciones grupales, así como la necesidad de un estudio más exhaustivo de los elementos concretos que conforman lo que llamamos "carga del cuidador" (AU)

Introduction. The consequences of living with someone with mental illness is referred as «caregiver burden» and is related to demographic and clinical variables. Objective. T o analyze the relationship between caregiver burden and patient and caregiver variables. It is to assess other variables that could be related to adherence of caregivers to family intervention groups. Methodology. T he sample consisted of 75 relatives of people with schizophrenia who attended a Psychosocial Rehabilitation Center. The study assesses family perception about the behavior and adjustment of patients, and patients’ symptoms. Results. T he results shows a positive correlation between caregiver burden and positive symptoms and general psychopathology; and a negative correlation between caregivers burden and psychosocial adjustment. The burden is associated with affective symptoms of the caregiver. Adherence to the intervention groups were not related to burden, but it is related with affective symptoms of caregiver. Conclusions. T he results shows the importance of taking into account the specific needs of the family to design and implement family interventions, and the importance of further study of specific elements of the "caregiver burden" (AU)

Teoría de la mente en esquizofrenia: su relación con síntomas positivos y negativos / No disponible

Introducción. Los pacientes con esquizofrenia tienen un mal manejo de la teoría de la mente (ToM). Sin embargo, no hay acuerdo en si se trata de una variable relacionada con la presencia de sintomatología positiva o si se trata de un déficit estable que se mantiene incluso cuando los síntomas remiten. Objetivo. C omparar el rendimiento en ToM entre personas con esquizofrenia y sujetos control, y valorar en la población con esquizofrenia la relación entre ToM y la presencia de sintomatología, tanto positiva como negativa. Metodología. La muestra consta de 40 pacientes con esquizofrenia y 39 sujetos control. ToM se evaluó mediante la adaptación al español del Hinting Task, y la sintomatología mediante la PANSS. Se compararon resultados utilizando la t de Student. Resultado. E n su conjunto, los pacientes con esquizofrenia lograron una puntuación significativamente más baja que los sujetos control, si bien un 25 % de la muestra obtuvo puntuaciones equiparables a la media normalizada. Respecto a la relación entre la sintomatología y el Hinting Task, solo se encontraron diferencias significativas en función del factor cognitivo de la PANSS. Conclusión. Los pacientes con esquizofrenia en fase de remisión presentan dificultades en el manejo de ToM, aunque uno de cada cuatro pacientes mantienen un funcionamiento preservado. La sintomatología no explica las diferencias observadas entre los pacientes (AU)

Introduction. T here is evidence that people with schizophrenia show deficits in theory of mind (ToM). However, there is no agreement on whether it is a variable related to the presence of positive symptoms, or if it is a deficit that remains when symptoms disappear. Objective. T o compare the scores in ToM in people with schizophrenia and control subjects, and analyze in schizophrenia the relationship between ToM and positive and negative symptoms. Methodology. T he sample consisted of 40 patients with schizophrenia and 39 healthy controls. ToM was assessed using the Spanish adaptation of Hinting Task, and symptoms with the PANSS. The results were compared with Student t test. Results. Schizophrenia patients were impaired relative to controls, although a 25 % of the sample achieved normal scores. About the relationship between symptoms and Hinting Task, only significant differences on PANSS cognitive factor and stereotyped thinking were found. Conclusion. Patients with schizophrenia in remission have difficulties in ToM, although there is a subgroup of patients that don’t show this deficit. Symptoms do not explain the differences observed among patients (AU)

Biomass burning contributions to urban aerosols in a coastal Mediterranean city.

Mean annual biomass burning contributions to the bulk particulate matter (PM(X)) load were quantified in a southern-European urban environment (Barcelona, Spain) with special attention to typical Mediterranean winter and summer conditions. In spite of the complexity of the local air pollution cocktail and the expected low contribution of biomass burning emissions to PM levels in Southern Europe, the impact of these emissions was detected at an urban background site by means of tracers such as levoglucosan, K(+) and organic carbon (OC). The significant correlation between levoglucosan and OC (r(2)=0.77) and K(+) (r(2)=0.65), as well as a marked day/night variability of the levoglucosan levels and levoglucosan/OC ratios was indicative of the contribution from regional scale biomass burning emissions during night-time transported by land breezes. In addition, on specific days (21-22 March), the contribution from long-range transported biomass burning aerosols was detected. Quantification of the contribution of biomass burning aerosols to PM levels on an annual basis was possible by means of the Multilinear Engine (ME). Biomass burning emissions accounted for 3% of PM(10) and PM(2.5) (annual mean), while this percentage increased up to 5% of PM(1). During the winter period, regional-scale biomass burning emissions (agricultural waste burning) were estimated to contribute with 7±4% of PM(2.5) aerosols during night-time (period when emissions were clearly detected). Long-range transported biomass burning aerosols (possibly from forest fires and/or agricultural waste burning) accounted for 5±2% of PM(2.5) during specific episodes. Annually, biomass burning emissions accounted for 19%-21% of OC levels in PM(10), PM(2.5) and PM(1). The contribution of this source to K(+) ranged between 48% for PM(10) and 97% for PM(1) (annual mean). Results for K(+) from biomass burning evidenced that this tracer is mostly emitted in the fine fraction, and thus coarse K(+) could not be taken as an appropriate tracer of biomass burning.

Incidencia de los trastornos de personalidad en esquizofrenia: relación con variables clínicas y sociodemográficas / No disponible

Se da una alta incidencia de los trastornos de personalidaden esquizofrenia, aunque los estudios realizadosno han encontrado una prevalencia clara de ningún trastornoen concreto. Tampoco se han llegado a conclusionesclaras sobre la relación entre los trastornos de personalidady los síntomas positivos y negativos. Estetrabajo valora la presencia de trastornos de personalidaden una muestra de 107 pacientes, y su relación convariables clínicas y sociodemográficas. Los resultadosobtenidos indican que un alto porcentaje de pacientestiene asociado algún trastorno de personalidad. Los trastornosmás frecuentes fueron los trastornos esquizoide,fóbico, dependiente, compulsivo y esquizotípico. Estostrastornos se relacionaron con síntomas positivos ynegativos. No se halló ninguna relación significativacon las variables sociodemográficas. Estos datos sonconsistentes con resultados previos, y plantean la necesidadde desarrollar programas de intervención específicospara pacientes con esquizofrenia con comorbilidadde trastornos de personalidad

There is a high incidence of personality disorders inschizophrenia, although studies don’t find a clear prevalenceof any specific diagnosis. Relationship betweenthese disorders and positive and negative symptoms isnot conclusive. The aim of this paper is to evaluate theprevalence of personality disorders in a sample of 107schizophrenic outpatients, and its relationship with clinicaland demographic variables. Results showed a highprevalence of personality disorders in schizophrenia.The most frequent personality disorders were schizoid,avoidant, dependent, compulsive and schizotypal.These disorders showed relationship with positive andnegative symptoms. No relationship with demographicvariables were found. These results are consistent withprevious findings, and indicate the desirability of developingspecific programs of rehabilitation for patients with schizophrenia and co-morbid personality disorders (AU)

[Conventional electroencephalography and delirium]. / Electroencefalograma convencional y delirio.

OBJECTIVE: To review the electroencephalographic changes in conventional tracings made in patients with an acute attack of delirium described in the literature. PATIENTS AND METHODS: These alterations are considered in a sub-sample of 60 patients randomly selected from a sample of 223 persons admitted to hospital for different medical and surgical conditions and seen in psychiatric consultation for delirium during the years 1996 and 1997 in the Hospital General Yagüe in Burgos, Spain. The methods used included a conventional EEG tracing, following the usual clinical technique, in the context of a prospective, observational study. The changes were classified according to the trace seen and overall criterion of the neurophysiologist. The results were compared with simple statistical tests (frequency and percentage counts, chi squared and residual contingency tables, average comparisons and unidirectional Anova variance analysis and Bonferroni post hoc test). RESULTS: Marked alterations of tracings were seen in 83.3% of cases (78.7% 'slight', 'moderate' and 'excessive' slowing and 6.6% 'rapid' anomalies. Statistically, 'multi-factorial' and 'on dementia' types of delirium (characterized on the electroencephalogram by different degrees of slowing of the recording) could be clearly differentiated from delirium due to abstinence from alcohol which was mainly seen with 'fast' recordings. CONCLUSION: It was confirmed that there are two distinct types of delirium which are very different from the electroencephalographic point of view.

Electroencefalograma convencional y delirio / Conventional electroencephalogram and delirium

Objetivo: Revisar las alteraciones electroenfalográficas de los trazados convencionales practicados a pacientes con un cuadro agudo de delirio descritas en la literatura. Pacientes y métodos. Se contrastan dichas alteraciones en una submuestra de 60 pacientes seleccionados aleatoriamente de una muestra de 223 individuos hospitalizados por diversas enfermedades médico quirúrgicas y atendidos en interconsulta psiquiátrica por cuadro de delirio durante los años 1996 y 1997 en el Hospital General Yagüe de Burgos, España. Los métodos empleados fueron la realización del trazado EEG convencional, tal como se procede de forma habitual en la clínica, en el contexto de un estudio observacional prospectivo. Se tipifican las alteraciones según los grafismos presentes y el criterio global del neurofisiólogo, y se contrastan los resultados con pruebas estadísticas sencillas (recuento de frecuencias y porcentajes, tablas de contingencia con ji al cuadrado y residuales tipificados, comparación de medias y análisis de la varianza con Anova de una dirección y prueba post hoc de Bonferroni). Resultados. Se objetivaron alteraciones claras del trazado en el 83,3 por ciento de los casos (76,7 por ciento lentificaciones "discretas", "moderadas" y "excesivas", y 6,6 por ciento anomalías "rápidas"). Estadísticamente, se diferencian claramente los tipos de elirio "multifactorial" y "sobre demencia" (caracterizado electroencefalográficamente por diversos grados de lentificación del trazado) y el delirio por abstinencia alcohólica expresado sobre todo por alteraciones de tipo "rápido". Conclusión. Se comprueba la existencia de dos tipos distintos de delirio muy distantes entre sí desde el punto de vista electroencefalográfico (AU)