Mindfulness para la reducción de síntomas de estrés, ansiedad y depresión en estudiantes universitarios de Yhú, Paraguay / Mindfulness for the reduction of stress, anxiety and depression in university students in Yhú, Paraguay

Introducción. El estrés, la ansiedad y la depresión son síntomas emergentes en estudiantes universitarios, por esto es vital para controlarlos identificar programas basados en evidencia, de bajo costo, y factibles de ser implementados y replicados en contextos naturalescomo las universidades. Objetivo.Evaluar el efecto de un taller introductorio a la práctica de mindfulness para la reducción de síntomas del estrés, ansiedad y depresión en estudiantes universitarios de la ciudad de Yhú en el periodo lectivo 2022. Materiales y métodos.Estudio cuasi-experimental en el que participaron en los talleres de mindfulness 20 estudiantes por ocho semanas. La escala estandarizada DASS21 se utilizó para la medición de estrés, la ansiedad y la depresión antes y después de la intervención; y la prueba de rangos con signo de Wilcoxon para muestras pareadas para determinar si había una diferencia en los datos previos y posteriores a la intervención en depresión, ansiedad y estrés. Resultados.Hubo diferencia significativa (p <0.001) en los puntajes pre-post de depresión, ansiedady estrés. Conclusión.Este estudio ha demostrado que las técnicas del mindfulness tienen una efectividad significativa en la reducción de síntomas de ansiedad, estrés y depresión en estudiantes universitarios. Serecomienda seguir evaluando el efecto del mindfulness con estudiantes universitarios, y la utilización de ensayos clínicos más complejos, y considerar además medir la validez social de las intervenciones a través de entrevistas o grupos focales con los participantes. Palabras Clave:ansiedad; depresión; mindfulness; estudiantes.

Introduction.Stress, anxiety and depression are emerging symptoms in university students; therefore,inorder to control them it is vital to identify programs based on evidence, at low cost, and feasible of being implemented and replicated in natural contexts such as universities. Objective.To evaluate the effect of an introductory workshop on the practiceof mindfulness for the reduction of symptoms of stress, anxiety and depression in university students from the city of Yhú in the 2022 academic year. Materials and methods.Quasi-experimental study in which 20 students participated in mindfulness workshops for eight weeks. The DASS21 standardized scale was used to measure stress, anxiety and depression before and after the intervention; and the Wilcoxon signed-rank test for paired samples to determine if there was a difference in pre-and post-interventiondata on depression, anxiety, and stress. Results.There was a significant difference (p < 0.001) in the pre-post scores of depression, anxiety and stress. Conclusion.This study has shown that mindfulness techniques are significantly effective in reducingsymptoms of anxiety, stress, and depression in university students. It is recommended to continue evaluating the effect of mindfulness with university students, and the use of more complex clinical trials, and also consider measuring the social validity of the interventions through interviews or focus groups with the participants.Key Words:anxiety; depression; mindfulness; students.

Tecnologías para la Evaluación, Diagnóstico y Tratamiento del Trastorno por Déficit de Atención e Hiperactividad: Una Revisión Preliminar e Integradora / Technologies for the Evaluation, Diagnosis and Treatment of Attention Deficit Hyperactivity Disorder: A Preliminary and Integrative Review

El trastorno por déficit de atención e hiperactividad (TDAH) es uno de los trastornos del neurodesarrollo con más alta prevalencia, estimada en 5%, en la población infantil. El objetivo de esta revisión fue sintetizar las tecnologías existentes que sirven para evaluar, diagnosticar y tratar síntomas de TDAH en población pediátrica. Esta es una revisión preliminar, de tipo integradora, que incluyó artículos publicados en 3 bases de datos especializadas, PsycINFO, Eric y Web of Science, entre los años 2005 y 2021. Se encontró que las pruebas diagnósticas clásicas se dividen en pruebas psicométricas, evaluación por biomarcadores y movimientos oculares. Por su parte, las pruebas que utilizan la tecnología son aquellas a evaluación y diagnóstico (DIDE, MOXO, AULA, AQUIARUM y BRAINGAZE) y aquellas que se utilizan en la terapéutica (SINCROLAB, PSIOUS, SISTEMA eTNS y varias basadas en neurofeedback). Las modernas tecnologías ofrecen cierto porcentaje de sensibilidad con baja inversión, tampoco requieren de equipos costosos y la preparación del profesional psicólogo o médico para su aplicación, es relativamente sencilla y accesible, ya que viene como complemento en la compra de la mayoría de los programas. Con el fin de continuar examinando su efectividad, se recomienda seguir evaluando estas herramientas con metodologías más robustas, en poblaciones clínicas grandes, debiendo ser esto una prioridad para futuras investigaciones.

Attention deficit hyperactivity disorder (ADHD) is one of the neurodevelopmental disorders with the highest prevalence, estimated at 5%, in the pediatric population. The objective of this review was to synthesize the existing technologies used to evaluate, diagnose, and treat ADHD symptoms in the pediatric population. This is a preliminary, integrative review, which included articles published in 3 specialized databases, PsycINFO, Eric and Web of Science, between 2005 and 2021. It was found that classical diagnostic tests are divided into psychometric tests, biomarker assessment and eye movements. On the other hand, the tests that use technology are those for evaluation and diagnosis (DIDE, MOXO, AULA, AQUIARUM and BRAINGAZE) and those used in therapy (SINCROLAB, PSIOUS, SISTEMA eTNS and several based-on neurofeedback). The modern technologies offer a certain percentage of sensitivity with low investment, they do not require expensive equipment and the preparation of the psychologist or medical professional for their application is relatively simple and accessible, since it comes as a complement in the purchase of most of the programs. To continue examining their effectiveness, it is recommended to continue assessing these tools with more robust methodologies, in large clinical populations, and this should be a priority for future research.

Tecnologías para la Evaluación, Diagnóstico y Tratamiento del Trastorno por Déficit de Atención e Hiperactividad: Una Revisión Preliminar e Integradora

El trastorno por déficit de atención e hiperactividad (TDAH) es uno de los trastornos del neurodesarrollo con más alta prevalencia, estimada en 5%, en la población infantil. El objetivo de esta revisión fue sintetizar las tecnologías existentes que sirven para evaluar, diagnosticar y tratar síntomas de TDAH en población pediátrica. Esta es una revisión preliminar, de tipo integradora, que incluyó artículos publicados en 3 bases de datos especializadas, PsycINFO, Eric y Web of Science, entre los años 2005 y 2021. Se encontró que las pruebas diagnósticas clásicas se dividen en pruebas psicométricas, evaluación por biomarcadores y movimientos oculares. Por su parte, las pruebas que utilizan la tecnología son aquellas a evaluación y diagnóstico (DIDE, MOXO, AULA, AQUIARUM y BRAINGAZE) y aquellas que se utilizan en la terapéutica (SINCROLAB, PSIOUS, SISTEMA eTNS y varias basadas en neurofeedback). Las modernas tecnologías ofrecen cierto porcentaje de sensibilidad con baja inversión, tampoco requieren de equipos costosos y la preparación del profesional psicólogo o médico para su aplicación, es relativamente sencilla y accesible, ya que viene como complemento en la compra de la mayoría de los programas. Con el fin de continuar examinando su efectividad, se recomienda seguir evaluando estas herramientas con metodologías más robustas, en poblaciones clínicas grandes, debiendo ser esto una prioridad para futuras investigaciones.

Attention deficit hyperactivity disorder (ADHD) is one of the neurodevelopmental disorders with the highest prevalence, estimated at 5%, in the pediatric population. The objective of this review was to synthesize the existing technologies used to evaluate, diagnose, and treat ADHD symptoms in the pediatric population. This is a preliminary, integrative review, which included articles published in 3 specialized databases, PsycINFO, Eric and Web of Science, between 2005 and 2021. It was found that classical diagnostic tests are divided into psychometric tests, biomarker assessment and eye movements. On the other hand, the tests that use technology are those for evaluation and diagnosis (DIDE, MOXO, AULA, AQUIARUM and BRAINGAZE) and those used in therapy (SINCROLAB, PSIOUS, SISTEMA eTNS and several based-on neurofeedback). The modern technologies offer a certain percentage of sensitivity with low investment, they do not require expensive equipment and the preparation of the psychologist or medical professional for their application is relatively simple and accessible, since it comes as a complement in the purchase of most of the programs. To continue examining their effectiveness, it is recommended to continue assessing these tools with more robust methodologies, in large clinical populations, and this should be a priority for future research.

Determination of distribution factors for heavy n-alkanes (nC12-nC98) in high temperature gas chromatography.

The ultimate purpose of this research work is to get an insight into the incomplete elution of heavy n-alkanes which along with thermal cracking, is one of the two main factors questioning the reliability of High Temperature Gas Chromatography (HTGC) analysis of heavy oils. For this purpose, knowledge of how the Distribution Factors vary with temperature is an essential requirement in the GC modelling. This study provides an extension of the data set of distribution factors for n-alkanes up to nC98H198 in a HT5 GC column over the temperature range 10 °C-430 °C, and introduces a method to determine the distribution coefficient of heavy n-alkanes by using two complimentary HTGC modes: i.) High-Efficiency mode, for efficient resolution with a long column operated at low flow rate with n-alkanes elution rate up to nC64, and ii.) true SimDist mode, with a short column operated at high flow rate for inefficient resolution with n-alkanes elution rate up to nC100. Furthermore, this study demonstrates the use of the in-house obtained distribution factors as the main input in the in-house GC model for the prediction of the retention times. Its validation has been carried out using distribution factors obtained at both constant flow rate and constant inlet pressure operating conditions, with an average relative error in the GC modelling at the same operating conditions of 4.4% for the former and 1.5% for the latter. This new extension of the data set of heavy n-alkanes distribution factors provides the basis for studying the partitioning and incomplete elution of heavy n-alkanes in HTGC analysis. Also, these new distribution factors can be used as input in GC modelling, to determine the optimum analytical conditions to improve the separation process and thus the HTGC practices.

Antinociceptive and anti-inflammatory activities of Geranium bellum and its isolated compounds.

BACKGROUND: Geranium bellum Rose, locally known as "Pata de león", is a perennial plant distributed in the mountains of Hidalgo, Mexico. It is widely used in Mexican traditional medicine to treat fever, pain, and gastrointestinal disorders. To date, there are not published studies regarding the in vivo antinociceptive and anti-inflammatory potential of the acetone-aqueous extract from the aerial parts of G. bellum. METHODS: Antinociceptive effects of the acetone-aqueous G. bellum (AGB) extract and the isolated compounds were assessed using experimental pain models, including thermal nociception like hot plate test, and chemical nociception induced by intraperitoneal acetic acid or subplantar formalin injection in vivo. The anti-inflammatory properties of the extract were studied using systemic administration in carrageenan-induced paw edema. RESULTS: Intra-gastric administration of AGB (75, 150, and 300 mg/kg) showed a dose-dependent antinociceptive effect in intraperitoneal acetic acid (writhing), thermal nociception in CD1 mice, and subplantar formalin models, as well as anti-inflammatory effect in carrageenan- induced paw edema in Wistar rats. Geraniin and quercetin showed the highest antinociceptive activity in writhing test, whereas ellagic acid was the most active compound in the hot plate model. CONCLUSION: These studies provide evidences that G. bellum shows antinociceptive and anti- inflammatory effects, and gives support to its use in treating pain in Mexican traditional medicine.

Nivel de depresión experimentada por una muestra de cuidadores informales de pacientes con demencia tipo Alzheimer / Level of depression experienced by a sample of informal caregivers of patients with Alzheimer-type dementia

Estudio transversal descriptivo, tipo cuantitativo, cuyo objetivo fue identificar el nivel de depresión en una muestra de cuidadores informales de pacientes con Alzheimer, compuesta por 52 sujetos. Se tuvo en cuenta los siguientes criterios de inclusión: ser cuidador informal principal, tener mínimo 3 meses cuidando al enfermo, no recibir ningún tipo de remuneración económica y cuidar pacientes no institucionalizados. Se aplicó el Inventario de Depresión Estado/ Rasgo ( IDER ). Los resultados arrojados indican en la escala total de estado 46,2% y en la subescala de eutimia estado 51,9%, lo cual evidencia una alta presencia de depresión. En la escala total de rasgo se encuentra un total de ausencia de 76,9% y en la subescala de distimia rasgo una ausencia de 88,5%, lo cual indica que no hay relevancia en cuanto el nivel de depresión como rasgo.

Descriptive cross-sectional, quantitative study, aimed to identify the level of depression in a sample of informal caregivers of Alzheimer's patients, composed of 52 subjects. Consideration was given to the following inclusion criteria: primary informal caregiving, with at least 3 months in the care of the patient, with no financial compensation and taking care of non-institutionalized patients. The Depression Inventory (state / trait) IDER , was applied on the sample; The results of the test show a 46.2% in the scale of total state, and a 51.9% in euthymic state subscale, showing also a high incidence of depression. In full scale of trait, there is a total absence of 76.9%, but in the dysthymia subscale, the trait had an absence of 88.5%, therefore, there is no relevance in terms of the level of depression as a trait.

Dipeptidyl peptidase 2 is an essential survival factor in the regulation of cell quiescence.

Most cells in the body are in a resting state and undergo cell cycle progression only upon growth factor stimulation or activation. while much research on proliferation and activation has been performed, very little about signals that maintain quiescent cells in G(0) is known, preventing cell cycle entry or apoptosis. In this study, the pathways of apoptosis induction in quiescent peripheral blood cells and fibroblasts mediated by inhibition or downregulation of Dipeptidyl Peptidase 2 (DPP2) have been explored. A decrease in DPP2 activity was found to cause resting cells to exit from G(0), accompanied by a decrease in p130, p27(Kip1) and p21(Cip1) protein levels. In addition, DPP2-inhibited or downregulated cells exhibit an increase in early G(1)/S progressors, with increases in the levels of retinoblastoma (pRb), p107 and cyclin D proteins. Furthermore, decrease of DPP2 activity leads to an increase in c-Myc and a decrease in Bcl-2, two events that have been associated with apoptosis induction. This apoptosis by DPP2 downregulation is prevented in p53(-/-) cells or by ectopic expression of proteins that suppress p53 or c-Myc activity. Thus, DPP2 is essential for maintaining lymphocytes and fibroblasts in G(0), and its inhibition results in apoptosis mediated by induction of c-Myc and p53.

Lymphocyte quiescence factor Dpp2 is transcriptionally activated by KLF2 and TOB1.

We have shown previously that dipeptidyl peptidase 2 (DPP2) activity is essential for the survival of quiescent, but not activated, lymphocytes. The specific requirement of DPP2 activity for non-dividing cells is indicative of cell cycle specific regulation of this gene product. In the present study, we tested this hypothesis by looking at contact and serum dependence of Dpp2 transcription. We found that transfected promoter-reporter activity, as well as endogenous Dpp2 transcripts, were enhanced in NIH-3T3 cells upon contact-inhibition or serum starvation. Since lung Kruppel-like factor (KLF2), a transcription factor, and TOB1, a transcriptional co-activator, have been shown to be important in maintaining T-lymphocyte quiescence and are both downregulated upon cellular activation, we also looked at the contributions of these factors to Dpp2 transcription. Using a Dpp2 promoter-reporter system, we demonstrate that KLF2 and TOB1 activate the mouse Dpp2 promoter. Finally, we show that in human PBMC, there is a decrease in levels of endogenous DPP2 transcripts upon T cell receptor activation when compared to resting cells. These results demonstrate that Dpp2 transcription is serum and contact-dependent and link two quiescence-specific transcriptional elements to the quiescence-specific requirement of DPP2 enzymatic activity.

Kidney disease in Paraguay.

Paraguay is a landlocked country located in South America with a total population of 5,884,491. Most of the population (95%) is mestizo, a mixture of Spanish and American/Indian races. The total number of indigenous people in the country has increased from 38,703 in 1981 to 85,674 in 2002. The gross domestic product per capita was US $932.00 annually per person in the year 2002. Between 1992 and 1997, there were 380 patients on chronic dialysis in Paraguay and 75 patients received renal transplants, mostly living-related. The prevalence of renal replacement therapy was 87 patients per million, and the incidence of renal disease continues to rise. Seventy percent of cases of ESRD are of unknown etiology and 15% have diabetes-related renal disease. Only citizens covered by the employee's national health insurance have complete coverage for dialysis and transplantation. The remainder of the population has to apply to public hospitals when the need for hemodialysis arises. At such hospitals, they can receive hemodialysis coverage from the National Institute of Nephrology or from other medical foundations to obtain entrance to these programs. They must otherwise use their own resources to pay for treatment. Seventy percent of patients on chronic dialysis turn to public hospitals for treatment. Hospital hemodialysis is the method most widely used. Home dialysis is rarely performed and there are very few programs for ambulatory peritoneal dialysis. Thus, a large number of patients are not able to enter chronic dialysis programs. In a recent survey of 4655 ill children registered, the distribution of main renal disease was acute glomerulonephritis in 42 cases (9 per 1000), nephrotic syndrome in 40 cases (8.5 per 1000), systemic lupus erythematosis in 28 cases (6 per 1000), and hematuria alone in 11 cases (2.3 per 1000). In ambulatory pediatric practice, urinary tract infection is the leading reason for seeking medical advice. Two thirds of such cases are associated with urinary tract anomalies. Children with ESRD are able to enter hemodialysis programs, but there are not sufficient resources to transplant them. Over 60% of the children with ESRD are hospitalized with terminal renal failure; malformations of the urinary tract are the usual cause. One study of 9880 adults aged 18 to 74 years reported that 39.1% of the women and 26.8% of the men examined were found to have hypertension. Almost half who were found to have raised blood pressure in this study were not previously known to have hypertension. In another cross-sectional study of the urban and suburban mestizo population of Asuncion among patients between 20 and 74 years of age, the overall prevalence of diabetes mellitus was 6.5%, impaired glucose tolerance 13.5%, hypertension 17%, and obesity 31.6%. Extrapolating from this data, we can assume that 178,000 patients with hypertension in Paraguay need medical treatment. To face the problem of growing numbers of patients with end-stage renal failure, it is necessary to carry out basic epidemiologic research to detect and quantify cases early in the course of disease, and thus propose treatments designed to slow the progress of the disease. Without this type of data, it would be difficult to establish an efficient action plan for improving the development of the treatment of renal disease. Thus, we are recommending the establishment of early detection and treatment campaigns for chronic renal disease, especially in individuals at risk. It is also desirable to promote renal transplantation using related live donors. We need to cooperate with government authorities to increase the insurance coverage of patients on chronic dialysis and find the most practical ways to establish long-term dialysis programs. A major question that is hard to answer in practice is whether there should be universal insurance for dialysis and transplantation for all who need it from the outset, as opposed to implementation in successive stages, which gives priority to only a minority of the population; which could be better adapted to our financial possibilities.

Differential control of G0 programme in chronic lymphocytic leukaemia: a novel prognostic factor.

Chronic lymphocytic leukaemia (CLL) is a unique malignancy where quiescent B cells accumulate in the peripheral blood. Since clinical outcomes in CLL are very heterogeneous, it is of utmost importance to correctly assess the disease prognosis in each individual case. Recently, it has been shown that high ZAP-70 [Zeta-chain (T-cell receptor) associated protein kinase (70 kDa)] expression level strongly correlates with lack of IgV(H) mutations and poor prognosis in B-CLL. As CLL malignant cells are arrested in G(0), we investigated whether Dipeptidyl Peptidase 2 (DPP2), a serine protease that plays a key role in keeping cells in the quiescent state, is involved in cell-cycle control in CLL. We have previously shown that specific inhibition of DPP2 results in apoptosis of normal lymphocytes. In this study, cell apoptosis experiments were conducted in 38 patients with B-CLL. Two distinct subsets of B-CLL were identified, susceptible and resistant to DPP2-inhibition-induced apoptosis. If resistant to apoptosis (42.1%), the CLL cells have higher expression of ZAP-70 and exhibit a worse prognosis, such as shorter treatment-free time period. Thus, resistance vs. susceptibility to DPP2-inhibiton induced apoptosis can be employed as a novel prognostic factor in CLL.