Prognostic Role of Neutrophil, Monocyte and Platelet to Lymphocyte Ratios in Advanced Ovarian Cancer According to the Time of Debulking Surgery.

Despite a multimodal radical treatment, mortality of advanced epithelial ovarian cancer (AEOC) remains high. Host-related factors, such as systemic inflammatory response and its interplay with the immune system, remain underexplored. We hypothesized that the prognostic impact of this response could vary between patients undergoing primary debulking surgery (PDS) and those undergoing interval debulking surgery (IDS). Therefore, we evaluated the outcomes of two surgical groups of newly diagnosed AEOC patients according to the neutrophil, monocyte and platelet to lymphocyte ratios (NLR, MLR, PLR), taking median ratio values as cutoffs. In the PDS group (n = 61), low NLR and PLR subgroups showed significantly better overall survival (not reached (NR) vs. 72.7 months, 95% confidence interval [CI]: 40.9-95.2, p = 0.019; and NR vs. 56.1 months, 95% CI: 40.9-95.2, p = 0.004, respectively) than those with high values. Similar results were observed in progression free survival. NLR and PLR-high values resulted in negative prognostic factors, adjusting for residual disease, BRCA1/2 status and stage (HR 2.48, 95% CI: 1.03-5.99, p = 0.043, and HR 2.91, 95% CI: 1.11-7.64, p = 0.03, respectively). In the IDS group (n = 85), ratios were not significant prognostic factors. We conclude that NLR and PLR may have prognostic value in the PDS setting, but none in IDS, suggesting that time of surgery can modulate the prognostic impact of baseline complete blood count (CBC).

The experience of social distancing for families with children and adolescents during the coronavirus (COVID-19) pandemic in Uruguay: Difficulties and opportunities.

The social distancing measures implemented to contain the coronavirus (COVID-19) pandemic worldwide have created a series of emotional and economic challenges. The aim of the present work was to explore the experiences of families with children and adolescents during the coronavirus (COVID-19) pandemic in Uruguay. An online study was conducted in March 2020 with 1725 parents with children under 18 years old. A series of closed and open-ended questions about their family life since the implementation of social distancing measures were asked, addressing the following topics: how they had felt, changes they had experienced in their daily life, children's daily routine, changes implemented in relation to child-care, changes they had perceived in children's eating patterns, changes in their relationship with their children, changes in their children's mood and behavior, and their reaction to those changes. Results showed that the coronavirus pandemic elicited negative feelings in the majority of participants, mainly related to worry, fear, anxiety and uncertainty. Social distancing measures caused a major disruption in daily habits, which were mostly attributed to changes in work-related activities and the closure of educational institutions. Changes in children's mood and behavior were perceived by the majority of the participants, who mainly referred to boredom, agitation and restlessness. Although some participants reported difficulties to cope with children's behavior during social distancing, others valued the opportunity of spending more time with their children. In terms of children's eating patterns, changes related to both an increase and a decrease in the consumption of healthy foods were observed. Results from the present work have relevant implications for public health policy and practice by highlighting the importance of providing emotional and psychological support to people during social distancing measures and providing insights for the design of communication campaigns and interventions.

Clinical and Translational Challenges in Thyroid Cancer.

Thyroid cancer is the most common endocrine malignancy and it accounts for 1% of all newly diagnosed tumors. Approximately 10% of patients with differentiated thyroid carcinomas (DTC) and 30% with medullary thyroid carcinoma (MTC) could not be cured with locoregional treatment and could develop metastatic disease. In addition, one of the most aggressive solid tumors can arise from the thyroid gland, the anaplastic thyroid carcinoma, with a median overall survival of less than 6 months. Currently, only four drugs are approved for the treatment of DTC and MTC and several unmet needs are focusing the scientific discussions, including the resistant setting, the off-target side effects that may reduce the efficacy and the molecular knowledge-based combinations. In this review, we aimed to discuss the current molecular landscape and treatment of thyroid cancers, and the ongoing clinical and translational research lines focusing on new drugs and drug combinations to improve the inhibition of driver mutations, such as BRAF and RET, and how systemic therapies that improved outcomes of other cancer types, like immunotherapy and peptide receptor radionuclide therapy, may play a role in the future management of advanced thyroid cancers.

New Horizons in the Treatment of Metastatic Pancreatic Cancer: A Review of the Key Biology Features and the Most Recent Advances to Treat Metastatic Pancreatic Cancer.

Only a limited number of therapeutic strategies are available for patients diagnosed with pancreatic adenocarcinoma, and disease recurrence and mortality are consequently high. For metastatic disease, two combinations are approved in the first line setting: a triplet with 5-fluoruracil, irinotecan, and oxaliplatin, and the combination of gemcitabine and nab-paclitaxel. In patients who have progressed on gemcitabine, a new nanoliposomal formulation of irinotecan has recently been approved. While these treatments have demonstrated some efficacy, there has been little increase in survival rates for metastatic pancreatic cancer patients. Consequently, there is an urgent need for research and development of new treatments. As there is now a deeper understanding of pancreatic cancer biology, new drugs targeting altered pathways are under research, including agents that target TGF-ß, IGF, or NOTCH. Furthermore, taking into account the role of the tumor stroma in this disease, some stroma-targeting drugs are being developed, including PEGPH20, a pegylated recombinant human hyaluronidase. In the immunotherapy field, although checkpoint inhibitors have failed to demonstrate benefit as monotherapies, combinations with other drugs are being investigated, with promising preliminary results. Other strategies under research are targeting tumor metabolism or DNA repair deficiency.

Maternal and child health services and an integrated, life-cycle approach to the prevention of non-communicable diseases.

Described as the 'invisible epidemic', non-communicable diseases (NCDs) are the world's leading cause of death. Most are caused by preventable factors, including poor diet, tobacco use, harmful use of alcohol and physical inactivity. Diabetes, cancer and cardiovascular and chronic lung diseases were responsible for 38 million (68%) of global deaths in 2012. Since 1990, proportionate NCD mortality has increased substantially as populations have aged and communicable diseases decline. The majority of NCD deaths, especially premature NCD deaths (<70 years, 82%), occur in low-income and middle-income countries, and among poor communities within them. Addressing NCDs is recognised as central to the post-2015 agenda; accordingly, NCDs have a specific objective and target in the Sustainable Development Goals. While deaths from NCDs occur mainly in adulthood, many have their origins in early life, including through epigenetic mechanisms operating before conception. Good nutrition before conception and interventions aimed at preventing NCDs during the first 1000 days (from conception to age 2 years), childhood and adolescence may be more cost-effective than managing established NCDs in later life with costly tests and drugs. Following a life-course approach, maternal and child health interventions, before delivery and during childhood and adolescence, can prevent NCDs and should influence global health and socioeconomic development. This paper describes how such an approach may be pursued, including through the engagement of non-health sectors. It also emphasises evaluating and documenting related initiatives to underwrite systematic and evidence-based cross-sectoral engagement on NCD prevention in the future.

Diferencias de personalidad entre adictos al alcohol y controles emparejados: relación con sintomatología frontal y subtipos de adictos / Personality differences between alcohol abusers and matched controls: Relation to frontal symptoms and subtypes of addicts

Los estudios epidemiológicos muestran estrecha relación entre trastornos de personalidad y adicciones. Los modelos dimensionales de la personalidad, como el de Cloninger, permiten formular diagnósticos capaces de discriminar entre estilos de conducta disfuncionales transitorios y rasgos relativamente más estables. Se han propuesto determinadas localizaciones cerebrales, como sustratos de los rasgos, basados en la activación de zonas cerebrales específicas. Este trabajo explora las diferencias en rasgos de personalidad entre una muestra de adictos al alcohol (N= 95) y un grupo de control de población no-clínica (N= 95), emparejados a partir de variables sociodemográficas, utilizando el TCI-R-67 y la FrSBe-Sp. Se hipotetiza que tales diferencias se relacionan con sintomatología frontal y se estudia la existencia de diversos subgrupos de adictos a partir de determinadas combinaciones de rasgos. Los resultados muestran diferencias significativas en dos rasgos temperamentales (Búsqueda de Novedad y Evitación del Daño) y uno caracterial (Autodirección). Se encontró una correlación con gran tamaño del efecto entre estos rasgos y sintomatología frontal. El análisis de clusters clasificó a los participantes en diversos subtipos con diferentes combinaciones de rasgos que se corresponden con sintomatología frontal variada. Se discuten las posibles explicaciones neurobiológicas de las diferencias y su importancia en la clínica (AU)

Epidemiological studies usually show a link between personality disorders and addictions. Dimensional models of personality, such as that of Cloninger, are able to diagnose and discriminate between transient dysfunctional behavior styles and relatively more stable traits. Certain brain areas have been proposed, as trait locations, based on their activation. This paper explores differences in personality traits among a sample of alcohol abusers (N= 95) and a control group of nonclinical population (N= 95), matched in sociodemographic variables, using the TCI-R-67 and the FrSBe- Sp. It is hypothesized that such differences are associated with frontal symptomatology. The existence of different subgroups of addicts based on certain combinations of traits is also analyzed. Results showed significant differences in two temperament traits (Novelty Seeking and Harm Avoidance) and a characterial trait (Self-Direction). We also found a correlation with a large effect size between these traits and frontal symptomatology. Cluster analysis classified the participants into several subtypes with different combinations of traits that matched diverse frontal symptomatology. Possible neurobiological explanations of these differences and their importance in the clinical practice are discussed (AU)

[Personality differences between alcohol abusers and matched controls: Relation to frontal symptoms and subtypes of addicts]. / Diferencias de personalidad entre adictos al alcohol y controles emparejados: relación con sintomatología frontal y subtipos de adictos.

Epidemiological studies usually show a link between personality disorders and addictions. Dimensional models of personality, such as that of Cloninger, are able to diagnose and discriminate between transient dysfunctional behavior styles and relatively more stable traits. Certain brain areas have been proposed, as trait locations, based on their activation. This paper explores differences in personality traits among a sample of alcohol abusers (N= 95) and a control group of non-clinical population (N= 95), matched in sociodemographic variables, using the TCI-R-67 and the FrSBe-Sp. It is hypothesized that such differences are associated with frontal symptomatology. The existence of different subgroups of addicts based on certain combinations of traits is also analyzed. Results showed significant differences in two temperament traits (Novelty Seeking and Harm Avoidance) and a characterial trait (Self-Direction). We also found a correlation with a large effect size between these traits and frontal symptomatology. Cluster analysis classified the participants into several subtypes with different combinations of traits that matched diverse frontal symptomatology. Possible neurobiological explanations of these differences and their importance in the clinical practice are discussed.

Estrés percibido en adictos a sustancias en tratamiento mediante la escala de Cohen: propiedades psicométricas y resultados de su aplicación / Perceived stress in addicted individuals in treatment by the Cohen scale: psychometric properties and results of its application

El estrés es una condición fuertemente vinculada a la adicción en todas sus fases. Desde la teoría de Lazarus, el estrés es el producto de la evaluación individual de las amenazas y los recursos disponibles para contrarrestarlas. La Escala de Estrés Percibido (EEP) es un instrumento ampliamente utilizado en investigación y en clínica, aunque apenas hay traba-jos que lo hayan utilizado con adictos. Se obtiene una muestra de 133 sujetos en tratamiento por adicción a al menos una sustancia, que cumplimentan el EEP y el MCMI-II. Se estudian las propiedades psicométricas del cuestionario en esta muestra, resultando satisfactorias. Los resultados apuntan a niveles de estrés elevados en las primeras fases de tratamiento, que tienden a ser menores en quienes llevan más de tres meses de abstinencia mantenida. Los niveles medios no alcanzan los observados en muestras de sujetos diagnosticados de depresión mayor, pero superan a la mayor parte de los obtenidos en poblaciones no clínicas. El EEP, en sus tres versiones de 14, 10 y 4 ítems, correlaciona significativamente con trastornos de los Ejes I y II, medidos por el MCMI-II. Se plantea la necesidad de evaluar el estrés subjetivo para interpretar adecuadamente los trastornos psicológicos coexistentes con la adicción (AU)

Stress is strongly related to addiction throughout all its stages. Since Lazarus published his theoretical framework, stress is considered a product of the individual’s evaluation of threats and the available resources to face them. Perceived Stress Scale (PSS) is a widely used test in research and clinics, although it has not been usually applied in addicted individuals. In a sample of 133 individuals in treatment of addictive behaviors, PSS and MCMI-II were used. Psychometric properties of the questionnaire were studied in this sample, resulting adequate. High levels of perceived stress were found in individuals at the beginning of treatment, being lower in individuals who were abstinent for more than three months. Average levels were also lower than those found in individuals suffering from major depression. On the other hand, they resulted to be higher than those obtained from most of the non-clinic population who answered this test in previous works. Results in PSS, in all three different versions, were highly correlated with Axis I and II disorders, as measured with the MCMI-II. The study and evaluation of subjective stress may be necessary to adequately elucidate the psychological disorders associated with addiction (AU)

Personalidad y sintomatología frontal en adictos y población no clínica: hacia una neuropsicología de la personalidad / Personality and frontal symptomatology in addicts and nonclinical population: toward a neuropsychology of personality

Objetivo. Desde hace años, la Neuropsicología y la Psicología de la Personalidad han discurrido por senderos paralelos sin que se haya prestado atención a la integración del conocimiento aportado por las diferentes disciplinas. El presente trabajo pretende analizar las relaciones entre la presencia de síntomas en la vida cotidiana relacionados con el funcionamiento de los lóbulos frontales del cerebro y el patrón de personalidad de los individuos. Sujetos y método. Se administró el Cuestionario Disejecutivo (DEX-Sp), la Escala de Comportamiento de los Sistemas Frontales (FrSBe-Sp) y el Inventario del Temperamento y el Carácter Revisado (TCIR)a 421 sujetos de población no clínica y 246 sujetos en tratamiento por abuso o dependencia de sustancias. Resultados. Aparecen importantes correlaciones entre la sintomatología relacionada con los tres síndromes frontales (mesial, orbital y dorsolateral) y algunos rasgos de la personalidad (búsqueda de novedad, evitación del daño y autodirección) llegando incluso a predecirse mutuamente más del 50% de la varianza. Discusión y conclusiones. Los resultados sugieren que el rendimiento frontal debe ser contemplado como una variable dimensional continua, que abarca desde el rendimiento óptimo hasta el desadaptativo, sin que pueda establecerse claramente un punto de corte entre ambos. Las adicciones se relacionarían con un incremento de la sintomatología frontal, tanto mesial (apatía), como orbital (desinhibición) y dorsolateral (síndrome disejecutivo), y ello se traduciría en cambios en el patrón de personalidad previo. Estos datos ponen en cuestión la pretendida base genética de los rasgos temperamentales y sugieren hipótesis de interés para la clínica (AU)

Objective. For many years now, Neuropsychology and the Psychology of Personality have developed in parallel, without any attempt to integrate the knowledge provided by the two disciplines. This paper sets out to analyze the relationship between the presence of symptoms in daily life related to the functioning of the brain’s frontal lobes and individuals’ personality patterns. Participants and Methods. The Dysexecutive Questionnaire (DEX-Sp), the Frontal System Behavior Scale (FrSBe-Sp) and the Inventory of Temperament and Character Revised (TCI-R)were administered to 421 non-clinical participants and 246 individuals in treatment for substance abuse or dependence. Results. Significant correlations were found between symptoms for all frontal syndromes(mesial, dorsolateral and orbital) and some personality traits (novelty seeking, harm avoidance and self-directedness), even more than 50% of the variance being predicted. Discussion and Conclusions. Results suggest that frontal performance should be seen as a continuous dimensional variable, ranging from optimal to non-adaptive performance, without an eat cut-off point. Addiction would be related to an increase in frontal symptoms, both mesial (apathy) and orbital (disinhibition), as well as dorsolateral (dysexecutive syndrome), and this would result in changes in the previous personality pattern. These data seriously question the supposed genetic basis of temperamental traits, and suggest hypotheses of great relevance for clinicians (AU)

[Personality and frontal symptomatology in addicts and nonclinical population: toward a neuropsychology of personality]. / Personalidad y sintomatología frontal en adictos y población no clínica: hacia una neuropsicología de la personalidad.

OBJECTIVE: For many years now, Neuropsychology and the Psychology of Personality have developed in parallel, without any attempt to integrate the knowledge provided by the two disciplines. This paper sets out to analyze the relationship between the presence of symptoms in daily life related to the functioning of the brain's frontal lobes and individuals' personality patterns. PARTICIPANTS AND METHODS: The Dysexecutive Questionnaire (DEX-Sp), the Frontal System Behavior Scale (FrSBe- Sp) and the Inventory of Temperament and Character Revised (TCI-R) were administered to 421 non-clinical participants and 246 individuals in treatment for substance abuse or dependence. RESULTS: Significant correlations were found between symptoms for all frontal syndromes (mesial, dorsolateral and orbital) and some personality traits (novelty seeking, harm avoidance and self-directedness), even more than 50% of the variance being predicted. DISCUSSION AND CONCLUSIONS: Results suggest that frontal performance should be seen as a continuous dimensional variable, ranging from optimal to non-adaptive performance, without a neat cut-off point. Addiction would be related to an increase in frontal symptoms, both mesial (apathy) and orbital (disinhibition), as well as dorsolateral (dysexecutive syndrome), and this would result in changes in the previous personality pattern. These data seriously question the supposed genetic basis of temperamental traits, and suggest hypotheses of great relevance for clinicians.

[Neuropsychological profile in cocaine addiction: issues about addict's social environment and predictive value of cognitive status in therapeutic outcomes]. / Perfil neuropsicológico en la adicción a la cocaína: consideraciones sobre el ambiente social próximo de los adictos y el valor predictivo del estado cognitivo en el éxito terapéutico.

INTRODUCTION AND OBJECTIVE: This study analyses the neuropsychological profile of a sample of cocaine addicts and compares it with a control group from the same social environment. Also, it explores the predictive power of some neuropsychological tests on treatment outcome six months after the exploration. PARTICIPANTS AND METHOD: We administered a neuropsychological battery to 30 patients with a diagnosis of cocaine abuse or cocaine dependence, and to 30 control participants with no history of drug abuse from the same social environment. RESULTS: Verbal learning (p<0.001), immediate visual memory (p<0.05), attentional resources management (p<0.05), phonologic fluency (p<0.01), abstraction (p<0.001), complex problem-solving (p<0.05) and mental flexibility (p<0.05) are the functions most affected by cocaine use. DISCUSSION AND CONCLUSIONS: The alterations found in the addict participants were small and non-pathognomonic, though the deficits can be correlated with impact on quality of life and on everyday occupational performance. The neuropsychological exploration showed a certain predictive capacity of abstinence after 6 months (the addict participants with better verbal mnesic performance and greater mental flexibility at the beginning of the treatment seem to benefit more from this). Finally, the results suggest that addicts live in a cognitively poor social environment. It is suggested that drug use increases previous deficits, probably of an educational or environmental origin, that are common to their immediate social context.

[Spanish version of the Dysexecutive Questionnaire (DEX-Sp): psychometric properties in addicts and non-clinical sample]. / Versión española del Cuestionario Disejecutivo (DEX-Sp): propiedades psicométricas en adictos y población no clínica.

OBJECTIVE: Several studies have shown evidence of executive function impairment associated with substance abuse. This suggests the potential usefulness of a baseline assessment measure to screen for dysexecutive impairments in individuals beginning treatment. The Dysexecutive Questionnaire (DEX) is a test widely used to estimate executive dysfunction. The main objective of this work is to study the psychometric properties of the Spanish version of the Dysexecutive Questionnaire (DEX-Sp). A complementary goal is to study its potential utility for initial screening in addicted individuals seeking treatment. METHOD: A sample of 131 non-clinical and 127 clinical individuals meeting the DSM-IV-TR substance abuse or dependence criteria were recruited. RESULTS: Internal consistency of the questionnaire was assessed (Cronbach's Alfa=0.91), as well as other reliability indicators. Exploratory and confirmatory factor analysis offers four- and five-factor solutions. Also tested were the dimensionality and structural model and its convergent and discriminant validity with other instruments. Differences between clinical and non-clinical individuals and total scores were also analyzed. CONCLUSIONS: The data suggest that the Spanish version of the DEX is a useful measure for assessing general symptoms of dysexecutive syndrome, and a valid, reliable and adequate screening test for estimating cognitive impairment associated with substance abuse.

Perfil neuropsicológico en la adicción a la cocaína: consideraciones sobre el ambiente social próximo de los adictos y el valor predictivo del estado cognitivo en el éxito terapéutico / Neuropsychological profile in cocaine addiction: issues about addict’s social environment and predictive value of cognitive status in therapeutic outcomes

Introducción y objetivo. El presente estudio analiza el perfil neuropsicológico de una muestra de adictos a la cocaína y lo compara con el de un grupo control extraído de su entorno social cercano. A su vez, pretende explorar la capacidad predictiva de algunas pruebas neuropsicológicas sobre los resultados del tratamiento a los seis meses de la exploración. Sujetos y método. Se administra una batería neuropsicológica a 30 pacientes con abuso o dependencia a la cocaína y otros 30 participantes de su ambiente social próximo. Resultados. Se observa cómo el aprendizaje verbal (p<0,001) y la memoria visual inmediata (p<0,05), la gestión de los recursos atencionales (p<0,05), la fluidez fonológica (p<0,01), la abstracción (p<0,001), la resolución de problemas complejos (p<0,05) y la flexibilidad cognitiva (p<0,05) son las funciones más afectadas por el consumo de cocaína. Discusión y conclusiones. Las alteraciones halladas en el rendimiento de los adictos son sutiles y no patognomónicas, si bien se pueden correlacionar los déficits con el impacto en la calidad de vida y el desempeño ocupacional cotidiano. La exploración neuropsicológica ha mostrado una cierta capacidad predictiva del estado de la abstinencia a los 6 meses (los adictos con mejor rendimiento amnésico verbal y mayor flexibilidad cognitiva en el momento de iniciar el tratamiento parecen beneficiarse mejor de éste). Por último, los resultados reflejan que los adictos se desenvuelven en un ambiente cognitivamente empobrecido. Se sugiere que el consumo de la sustancia acrecienta déficits previos, probablemente de origen educacional o ambiental, que son comunes a su entorno social próximo (AU)

Introduction and objective. This study analyses the neuropsychological profile of a sample of cocaine addicts and compares it with a control group from the same social environment. Also, it explores the predictive power of some neuropsychological tests on treatment outcome six months after the exploration. Participants and method. We administered a neuropsychological battery to 30 patients with a diagnosis of cocaine abuse or cocaine dependence, and to 30 control participants with no history of drug abuse from the same social environment. Results. Verbal learning (p<0.001), immediate visual memory (p<0.05), attentional resources management (p<0.05), phonologicfluency (p<0.01), abstraction (p<0.001), complex problem-solving (p<0.05) and mental flexibility (p<0.05) are the functions most affected by cocaine use. Discussion and conclusions. The alterations found in the addict participants were small and non-pathognomonic, though the deficits can be correlated with impact on quality of life and on everyday occupational performance. The neuropsychological exploration showed a certain predictive capacity of abstinence after 6 months (the addict participants with better verbal amnesic performance and greater mental flexibility at the beginning of the treatment seem to benefit more from this). Finally, the results suggest that addicts live in a cognitively poor social environment. It is suggested that drug use increases previous deficits, probably of an educational or environmental origin, that are common to their immediate social context (AU)

Versión española del Cuestionario Disejecutivo (DEX-Sp): propiedades psicométricas en adictos y población no clínica / Spanish version of the Dysexecutive Questionnaire (DEX-Sp): psychometric properties in addicts and non-clinical sample

Objetivo: Diversos estudios han evidenciado el deterioro de las funciones ejecutivas asociado al abuso de sustancias. Este hecho sugiere la conveniencia de contar con algún instrumento de cribado que sirva para establecer una línea base sobre los déficits que presentan los sujetos que inician tratamiento. El Cuestionario Disejecutivo (DEX) es un test ampliamente utilizado para estimar disfunción ejecutiva. El principal objetivo del presente trabajo se centra en estudiar las propiedades de la versión española del Cuestionario Disejecutivo (DEX-Sp). Complementariamente se pretende estudiar su potencial utilidad como instrumento de cribado en adictos en tratamiento. Método: 131 sujetos de población no clínica y 127 adictos (con criterios DSM-IVTR para abuso o dependencia). Resultados: Se estudia la consistencia interna (¬ de Cronbach = 0,91) entre otros indicadores de fiabilidad. El análisis factorial exploratorio y confirmatorio ofrece soluciones de 4 y 5 factores. Se estudió la dimensionalidad y el modelo estructural de base, así como la validez convergente y discriminante. Se estudiaron las diferencias apreciadas entre adictos y población no clínica. Conclusiones: Los datos sugieren que la versión española del DEX es un instrumento útil para evaluar síntomas disejecutivos generales, con la suficiente fiabilidad y validez para explorar deterioro cognitivo asociado al abuso desustancias (AU)

Objective: Several studies have shown evidence of executive function impairment associated with substance abuse. This suggests the potential usefulness of a baseline assessment measure to screen for dysexecutive impairments in individuals beginning treatment. The Dysexecutive Questionnaire (DEX) is a test widely used to estimate executive dysfunction. The main objective of this work is to study the psychometric properties of the Spanish version of the Dysexecutive Questionnaire (DEX-Sp). A complementary goal is to study its potential utility for initial screening in addicted individuals seeking treatment. Method: A sample of 131 non-clinical and 127 clinical individuals meeting the DSM-IV-TR substance abuse or dependence criteria were recruited. Results: Internal consistency of the questionnaire was assessed (Cronbach’s ¬ =0.91), as well as other reliability indicators. Exploratory and confirmatory factor analysis offers four- and five-factor solutions. Also tested were the dimensionality and structural model and its convergent and discriminant validity with other instruments. Differences between clinical and non-clinical individuals and total scores were also analyzed. Conclusions: The data suggest that the Spanish version of the DEX is a useful measure for assessing general symptoms of dysexecutive syndrome, and a valid, reliable and adequate screening test for estimating cognitive impairment associated with substance abuse (AU)

[Social values and addiction: applicability and psychometric properties of VAL-89 questionnaire]. / Valores sociales y adiccion: aplicabilidad y propiedades psicometricas del cuestionario VAL-89.

OBJECTIVE: To study the psychometric properties of the VAL-89 questionnaire and its possible use in addict individuals who ask for treatment. METHOD: Analysis of the psychometric properties of the questionnaire and its factorial structure, applying it to 792 individuals. 365 of them were substance users seeking treatment and 427 were general population. RESULTS: Reliability of the questionnaire is confirmed, although its factorial structure appears to be different from the original. In our study appear 12 factors, instead of the original 10. These factors are named: Power, Stimulation, Submission, Tradition, Spirituality, Self-Sufficience, Hedonism, Sociability, Universality, Convencionalism, Idealism and Self-Realization. These factors are distributed through several dimensions represented by four axis: individual-social, dominance-equality, tradition-pleasure and great values-anomie. CONCLUSIONS: The VAL-89 questionnaire seems to be a useful tool to explore which are the more appreciated social values, being of special interest to know which are specially selected by addict individuals.

Valores sociales y adicción: aplicabilidad y propiedades psicométricas del cuestionario val-89 / No disponible

Objetivo: Estudiar las propiedades psicométricas y la aplicabilidad del cuestionario VAL-89 en población adicta que solicita tratamiento. Método: Análisis de las propiedades psicométricas del cuestionario y su estructura factorial, mediante su aplicación a 792 sujetos de los que 365 son consumidores de sustancias que demandan tratamiento por problemas asociados al consumo y 427 eran población general. Resultados: Se confirma la fiabilidad del cuestionario, aunque la estructura factorial no se corresponde con la original. Frente a los 10 factores originales, en nuestro estudio aparecen 12 factores: Poder, Estimulación, Sumisión, Tradición, Espiritualidad, Autosuficiencia, Hedonismo, Sociabilidad, Universalidad, Convencionalismo, Idealismo y Autorrealización. Estos factores se agrupan en función de dimensiones en forma de ejes tales como lo individual frente a lo social, la dominación sobre los otros frente a la justicia y la igualdad, las tradiciones y convenciones sociales frente a la búsqueda del placer y el disfrute y, por último, los grandes valores frente a la anomia. Conclusiones: El VAL-89 aparece como un cuestionario útil para explorar los valores sociales que más se aprecian, resultando de especial interés cuáles son los más destacables para los individuos adictos

Objective: To study the psychometric properties of theVAL-89 questionnaire and its possible use in addict individuals who ask for treatment. Method: Analysis of the psychometric properties of the questionnaire and its factorial structure, applying it to 792 individuals. 365 of them were substance users seeking treatment and 427 were general population. Results: Reliability of the questionnaire is confirmed, althoughits factorial structure appears to be different from the original. In our study appear 12 factors, instead of the original 10. These factors are named: Power, Stimulation, Submission, Tradition, Spirituality, Self-Sufficience, Hedonism, Sociability, Universality, Convencionalism, Idealism and Self-Realization. These factors are distributed through several dimensions represented by four axis: individual-social, dominance-equality, tradition-pleasure and great values-anomie. Conclussions: The VAL-89 questionnaire seems to be auseful tool to explore which are the more appreciated social values, being of special interest to know which are specially selected by addict individuals

Esquemas de tratamiento para la enfermedad de Carrión no complicada en la ciudad de Caraz, Perú / Treatment outlines for non-complicated Carrion's Disease, in Caraz, Peru

Objetivos: Describir el tratamiento para infección por Bartonella bacilliformis, en Caraz, Ancash. Diseño: Estudio observacional, transversal y retrospectivo. Lugar: Caraz, Ancash, Perú. Pacientes: Quinientos dieciocho pacientes. Intervenciones: Recolección de datos, entre enero 2004 y marzo 2005, por medio de historias clínicas realizadas en el Hospital de Caraz. Principales medidas de resultados: Esquemas de tratamiento para infección por Bartonella bacilliformis. Resultados: Se registró 248 pacientes en fase aguda. En 215 (86,7 por ciento), se indicó cloramfenicol para su tratamiento y en todos ellos no se registró la dosis de carga de 50 mg/kg, por 3 días; 164 (66,1 por ciento) pacientes necesitaron una dosis de cloramfenicol superior a 25 mg/kg. En fase eruptiva, se registró 270 pacientes; en 260 (96,3 por ciento) se indicó rifampicina y 222 (82,2 por ciento) sobrepasaron los 21 días de duración de tratamiento con dicho antibiótico. Cloramfenicol obtuvoun 89 por ciento de eficacia en curación clínica y rifampicina, 93,1 por ciento. Conclusiones: En la población estudiada, existió una marcada tendencia a aumentar la dosis de cloramfenicol e incrementar el número de días de tratamiento con rifampicina, en fase aguda y eruptiva, respectivamente, de la Enfermedad de Carrión.

Objectives: To describe Bartonella bacilliformis' infection treatment, in Caraz, Ancash. Design: Observational, transverse and retrospective study. Setting: Caraz, Ancash, Peru. Patients: Five hundred and eighteen patients. Interventions: Study of clinical histories data from January 2004 through March 2005 at Caraz Hospital. Main outcome measures: Treatment outlines for Bartonella bacilliformis infection. Results: In the acute phase, 248 patients were registered; in 215 (86,7 per cent) chloramphenicol treatment was indicated but the 50 mg/kg loading dose by 3 days was not prescribed; 164 (66,1 per cent) patients needed a higher chloramphenicol dose of 25 mg/kg. In the eruptive phase, 270 patients were registered; in 260 (96,3 per cent) rifampicin was indicated and 222 (82,2 per cent) for more than the 21 treatment days suggested for this antibiotic. Clinical cure was obtained with chloramphenicol in 89 per cent and 93,1 per cent with rifampicin. Conclusions: In the population studied there was a tendency to increase both chloramphenicol dose and rifampicin number of treatment days respectively in the acute and eruptive phases of Carrion's disease.