Thromboinflammatory challenges in stroke pathophysiology.

Despite years of encouraging translational research, ischemic stroke still remains as one of the highest unmet medical needs nowadays, causing a tremendous burden to health care systems worldwide. Following an ischemic insult, a complex signaling pathway emerges leading to highly interconnected thrombotic as well as neuroinflammatory signatures, the so-called thromboinflammatory cascade. Here, we thoroughly review the cell-specific and time-dependent role of different immune cell types, i.e., neutrophils, macrophages, T and B cells, as key thromboinflammatory mediators modulating the neuroinflammatory response upon stroke. Similarly, the relevance of platelets and their tight crosstalk with a variety of immune cells highlights the relevance of this cell-cell interaction during microvascular dysfunction, neovascularization, and cellular adhesion. Ultimately, we provide an up-to-date overview of therapeutic approaches mechanistically targeting thromboinflammation currently under clinical translation, especially focusing on phase I to III clinical trials.

Binding by calmodulin is coupled to transient unfolding of the third FF domain of Prp40A.

Human pre-mRNA processing protein 40 homolog A (hPrp40A) is a splicing factor that interacts with the Huntington's disease protein huntingtin (Htt). Evidence has accumulated that both Htt and hPrp40A are modulated by the intracellular Ca2+ sensor calmodulin (CaM). Here we report characterization of the interaction of human CM with the third FF domain (FF3 ) of hPrp40A using calorimetric, fluorescence and structural approaches. Homology modeling, differential scanning calorimetry and small angle X-ray scattering (SAXS) data show FF3 forms a folded globular domain. CaM was found to bind FF3 in a Ca2+ -dependent manner with a 1:1 stoichiometry and a dissociation constant (Kd ) of 25 ± 3 µM at 25°C. NMR studies showed that both domains of CaM are engaged in binding and SAXS analysis of the FF3 -CaM complex revealed CaM occupies an extended configuration. Analysis of the FF3 sequence showed that the anchors for CaM binding must be buried in its hydrophobic core, suggesting that binding to CaM requires unfolding of FF3 . Trp anchors were proposed based on sequence analysis and confirmed by intrinsic Trp fluorescence of FF3 upon binding of CaM and substantial reductions in affinity for Trp-Ala FF3 mutants. The consensus model of the complex showed that binding to CaM binding occurs to an extended, non-globular state of the FF3 , consistent with coupling to transient unfolding of the domain. The implications of these results are discussed in the context of the complex interplay of Ca2+ signaling and Ca2+ sensor proteins in modulating Prp40A-Htt function.

Prevalence of pulmonary hypertension in COPD patients living at high altitude.

BACKGROUND: Pulmonary hypertension (PH) is associated with poor prognosis for patients with chronic obstructive pulmonary disease (COPD). Most of the knowledge about PH in COPD has been generated at sea level, with limited information associated with high altitude (HA). OBJECTIVES: To assess the prevalence and severity of PH in COPD patients living in a HA city (2,640 m). METHODS: Cross-sectional study in COPD patients with forced expiratory volume in the first second / forced vital capacity ratio (FEV1/FVC) post-bronchodilator <0,7. Transthoracic echocardiography (TTE), spirometry, carbon monoxide diffusing capacity, and arterial blood gasses tests were performed. Patients were classified according to the severity of airflow limitation. PH was defined by TTE as an estimated systolic pulmonary artery pressure (sPAP) > 36 mmHg or indirect PH signs; severe PH as sPAP > 60 mmHg; and disproportionate PH as an sPAP > 60 mmHg with non-severe airflow limitation (FEV1 > 50% predicted). RESULTS: We included 176 COPD patients. The overall estimated prevalence of PH was 56.3% and the likelihood of having PH increased according to airflow-limitation severity: mild (31.6%), moderate (54.9%), severe (59.6%) and very severe (77.8%) (p = 0.038). The PH was severe in 7.3% and disproportionate in 3.4% of patients. CONCLUSIONS: The estimated prevalence of PH in patients with COPD at HA is high, particularly in patients with mild to moderate airflow limitation, and greater than that described for COPD patients at low altitude. These results suggest a higher risk of developing PH for COPD patients living at HA compared to COPD patients with similar airflow limitation living at low altitude.

Perspectiva de la práctica clínica de fisioterapeutas colombianos en el manejo de la disfunción de la articulación sacroilíaca. Estudio descriptivo / Perspective in clinical practice of colombian physical therapists in the management of sacroiliac joint dysfunction. A descriptive study

Antecedentes y objetivo La disfunción de la articulación sacroilíaca (DASI) caracterizada por hipermovilidad o hipomovilidad de la articulación puede estar presente en un 13-30% de las personas con dolor lumbar de origen idiopático, por ello se consideró relevante analizar el abordaje fisioterapéutico realizado a pacientes con diagnóstico de DASI, en Bucaramanga (Colombia). Métodos Estudio observacional descriptivo transversal. Para la recolección de la información se elaboró un cuestionario de 31 preguntas, para ser respondido vía web, al que se evaluó la validez facial y de contenido. Se incluyeron datos sociodemográficos, de formación de los fisioterapeutas participantes y procedimientos de evaluación e intervención utilizados en la consulta. Resultados Participaron 147 fisioterapeutas, 86,4% mujeres, 22,5% con formación de posgrado. El 70,4% reconocieron la DASI como causa de dolor lumbar y el 43,5% declaró no utilizar pruebas específicas para el diagnóstico de la DASI. Las modalidades de tratamiento más informadas fueron ejercicio terapéutico, electroterapia, calor húmedo y masaje. Conclusiones La mayoría de los participantes reconocen la DASI como causa de dolor lumbar. Las pruebas de provocación de dolor para establecer el diagnóstico de la DASI no fueron utilizadas por la mayoría de los participantes. Tampoco se reportó el uso de ejercicios de estabilización lumbopélvica, útiles en la rehabilitación de personas con DASI. Estos hallazgos indican la necesidad de capacitar a los fisioterapeutas participantes en el estudio sobre el diagnóstico y el tratamiento de personas con DASI, para favorecer la recuperación y la calidad de vida de esta población (AU)

Background and aim Sacroiliac joint dysfunction (SIJD) is characterized by hypermobility or hypomobility of the joint and could be present in 13%–30% of people with low back pain of idiopathic origin. Therefore, it was important to analyse the physiotherapeutic clinical approach for patients diagnosed with SIJD in Bucaramanga (Colombia). Methods An observational descriptive cross-sectional study was conducted. The information was collected through a 31-question web survey, with face and content validation. Sociodemographic data, data on the training of the therapists and evaluation and intervention procedures used in the consultation were included. Results 147 physiotherapists participated, 86.4% were women, 22.5% with postgraduate training. Seventy point four percent recognized SIJD as cause of low back pain and 43.5% stated that they did not use a specific test to diagnose SIJD. The most reported treatment modalities were therapeutic exercise, electrotherapy, humid heat, and massage. Conclusions Most of the participants recognize SIJD as a cause of low back pain. Pain provocation tests were not used by most of the participants. Neither was the use of lumbopelvic stabilization exercises reported, required in SIJD rehabilitation. These findings show there is a need for training for the physiotherapists who participated in the study in the diagnosis and treatment of people with SIJD, to improve the recovery and quality of life of this population (AU)

Point-of-care ultrasound after attempted suicidal hanging.

Focused cardiac ultrasound (FoCUS) can provide critical information quickly to determine the etiology after cardiac arrest and may expedite a diagnosis in order to identify underlying treatable causes. We present a case of reversible acute left ventricular dysfunction after cardiopulmonary resuscitation following attempted suicide by hanging presenting with severe hypoxemia. FoCUS revealed findings consistent with severe left ventricular dysfunction, and point-of-care ultrasound (PoCUS) ruled out pneumothorax. These findings, in conjunction with the clinical presentation, facilitated an early identification and rapid evaluation of cardiogenic shock; furthermore, they led to the use of FoCUS, which can provide critical information quickly on site for a patient who is suddenly symptomatic after severe mechanical asphyxia in the pediatric emergency department, pediatric intensive care unit, or the prehospital setting.

Pitiriasis rubra pilaris: a propósito de un caso / Pityriasis rubra pilaris: case report

RESUMEN Se presenta caso de paciente masculino de 9 años de edad, fototipo VI acude a consulta especializada de Dermatología en el Hospital pediátrico William Soler por lesiones eritematoescamosas dispuestas en placas localizadas en ambas rodillas, acompañadas de queratodermia palmo plantar. Se realizan exámenes complementarios y biopsia de piel concluyéndose caso como pitiriasis rubra pilaris circunscrita juvenil. Esta dermatosis es de infrecuente presentación, desafío terapéutico por ausencia de estandarización internacional y cursa con una evolución impredecible.

ABSTRACT We present the case of a 9-year-ol, phototype 3, who attended a specialized dermatology consultation at the William Soler pediatric hospital due to erythematosquamous lesions arranged in plaques located on both knees accompanied by palmoplantar keratoderma. Laboratory tests and skin biopsies were carried out, concluding case as a juvenile and circumscribed pityriasisrubra pilaris. This is an infrequent dermatosis, a therapeutic challenge because of the absence of international standardized treatments and it has an unpredictable evolution.

Carcinoma basocelular cutáneo: diagnóstico y tratamiento en atención especializada dermatológica. Guía de Práctica Clínica de la AEDV / Diagnosis and Treatment of Basal Cell Carcinoma in Specialized Dermatology Units: A Clinical Practice Guideline

ANTECEDENTES Y OBJETIVO: El carcinoma basocelular supone el cáncer de piel más frecuente en la población. Hay una gran variabilidad en su manejo y las diferentes guías extranjeras que existen son difícilmente aplicables en nuestro medio. El objetivo de la presente guía es servir de referencia a los dermatólogos españoles para mejorar el manejo de este tumor basándose en la evidencia actual. MATERIALES Y MÉTODOS: Se escogió a miembros del Grupo Español de Dermato-Oncología y Cirugía (GEDOC) con experiencia en el tratamiento de estos tumores y con interés en participar en la elaboración de la guía. Se hizo una adaptación de las guías de práctica clínica existentes mediante el método ADAPTE, se resumió el proceso de atención, y se elaboraron las preguntas clínicas relevantes. Se seleccionaron las guías mejor puntuadas mediante el instrumento AGREE II, realizando la búsqueda de las respuestas en dichas guías y elaborando posteriormente las recomendaciones. Finalmente se sometió la guía a revisión externa. RESULTADOS: Las guías con mejor puntuación fueron las de la British Association of Dermatologits (BAD), del National Comprehensive Cancer Network (NCCN), del European Dermatology Forum (EDF) y de la European Academy of Dermatology and Venereology (EADV). Se obtuvieron en total 11 preguntas clínicas, contestadas a partir de estas guías. CONCLUSIONES: Esta guía responde a preguntas habituales sobre el manejo del carcinoma basocelular en la práctica clínica diaria y sirve a los dermatólogos como referencia en la toma de decisiones, siempre teniendo en cuenta los recursos y las preferencias del paciente

BACKGROUND AND OBJECTIVE: Basal cell carcinoma (BCC) is the most common skin cancer in the general population. BCC is managed in a variety of ways, and available international guidelines are difficult to put into practice in Spain. This guideline aims to improve the management of BCC based on current evidence and provide a point of reference for Spanish dermatologists. MATERIAL AND METHODS: Members of the Spanish Oncologic Dermatology and Surgery Group (GEDOC) with experience treating BCC were invited to participate in drafting this guideline. The drafters used the ADAPTE collaboration process to develop the new guideline based on existing ones, first summarizing the care pathway and posing relevant clinical questions. They then searched for guidelines, assessed them with the AGREEII (Appraisal of Guidelines for Research and Evaluation) tool, and searched the selected guidelines for answers to the clinical questions. Finally, the recommendations were drafted and submitted for external review. RESULTS: The highest-scoring guidelines were from the Association of Dermatologists, the National Comprehensive Cancer Network, the European Dermatology Forum, and the European Academy of Dermatology and Venereology. A total of 11 clinical questions were answered. CONCLUSIONS: This new guideline answers the working group's clinical questions about the routine management of BCC in Spain. It provides dermatologists with a tool they can use for decision-making while taking into consideration the resources available and patient preferences

Diagnosis and Treatment of Basal Cell Carcinoma in Specialized Dermatology Units: A Clinical Practice Guideline. / Carcinoma basocelular cutáneo: diagnóstico y tratamiento en atención especializada dermatológica. Guía de Práctica Clínica de la AEDV.

BACKGROUND AND OBJECTIVE: Basal cell carcinoma (BCC) is the most common skin cancer in the general population. BCC is managed in a variety of ways, and available international guidelines are difficult to put into practice in Spain. This guideline aims to improve the management of BCC based on current evidence and provide a point of reference for Spanish dermatologists. MATERIAL AND METHODS: Members of the Spanish Oncologic Dermatology and Surgery Group (GEDOC) with experience treating BCC were invited to participate in drafting this guideline. The drafters used the ADAPTE collaboration process to develop the new guideline based on existing ones, first summarizing the care pathway and posing relevant clinical questions. They then searched for guidelines, assessed them with the AGREEII (Appraisal of Guidelines for Research and Evaluation) tool, and searched the selected guidelines for answers to the clinical questions. Finally, the recommendations were drafted and submitted for external review. RESULTS: The highest-scoring guidelines were from the Association of Dermatologists, the National Comprehensive Cancer Network, the European Dermatology Forum, and the European Academy of Dermatology and Venereology. A total of 11 clinical questions were answered. CONCLUSIONS: This new guideline answers the working group's clinical questions about the routine management of BCC in Spain. It provides dermatologists with a tool they can use for decision-making while taking into consideration the resources available and patient preferences.

Time-domain induced polarization as a tool to image clogging in treatment wetlands.

During the last decade, treatment (artificial) wetlands have flourished all over Europe for the treatment of sewages from small communities thanks to their low cost of operation. The clogging of the filter of these wetlands is an issue affecting their efficiency and considered as their main operational problem. The present work shows the results of the application of a geophysical method called time-domain induced polarization. It is used to non-intrusively image, in 3D, the clogging of the gravel filters in a quick and efficient way. Induced polarization characterizes the ability of a porous material to reversibly store electrical charges when submitted to an electrical field. The material property characterizing this ability is called normalized chargeability. A set of laboratory experiments allows to determine an empirical relationship between the normalized chargeability and the weight amount of clogging. Induced polarization measurements have been performed in the field over a treatment wetland to get a 3D reconstructed image (tomography) of the normalized chargeability. From this tomography and the previously defined relationship, we are able to image in 3D the distribution of clogging and where it is concentrated in the filter. We can therefore identify the areas requiring preventive measures to minimize this clogging issue.

Calidad de las espirometrías en Atención Primaria en Cantabria 10 años después. Estudio EspiroCan / Quality of spirometry in Primary Care in Cantabria 10 years later. EspiroCan Study

INTRODUCCIÓN: Estudiar la calidad de las espirometrías realizadas en el ámbito de Atención Primaria de la Comunidad de Cantabria y el grado de cumplimiento de la normativa de dicha técnica de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR). MATERIAL Y MÉTODOS: Estudio descriptivo transversal en la Comunidad de Cantabria mediante cuestionario original basado en la última normativa SEPAR. El cuestionario se distribuyó en 2018 por correo interno a los 42 Centros de Salud del Servicio Cántabro de Salud que disponen de espirómetro tras contacto personal o vía telefónica de los investigadores con los coordinadores de los Centros de Salud y responsables de enfermería. Se trata de una encuesta original, basada en las normativas de la SEPAR, con la que se evalúa la calidad del material empleado (modelo, años de funcionamiento, calibración, limpieza), así como la formación del personal que realiza las espirometrías. RESULTADOS: Se ha encuestado al personal sanitario responsable de realizar las espirometrías en los 42 Centros de Salud del Servicio Cántabro de Salud de todo el territorio cántabro, en el que se realiza una media de 564 espirometrías al mes. Un 13% de los espirómetros no se calibran nunca. Tan solo el 10,5% de los espirómetros son calibrados por el personal que realiza la prueba en el propio centro. El 53,7% de estos profesionales (N54) nunca han recibido formación específica para realizar espirometrías, y solo el 3,8% de ellos tienen experiencia en realizar la prueba, como recomienda la SEPAR. En cuanto a la limpieza de los aparatos un 30% de los técnicos no limpia el espirómetro ni el adaptador que lo une a la boquilla. CONCLUSIONES: Diez años después de nuestro estudio inicial seguimos observando un déficit de formación de nuestros profesionales de Atención Primaria, lo que podría poner en duda la validez de las espirometrías

INTRODUCTION: To study the quality of spirometry performed in Primary Care in Cantabria (Spain) and the level of compliance with the regulations of this technique of the Spanish Society of Chest Diseases and Thoracic Surgery (SEPAR). MATERIAL AND METHODS: Cross-sectional descriptive study in the Community of Cantabria using an original questionnaire based on the latest SEPAR regulations. The questionnaire was distributed in 2018 by internal mail to the 42 Primary Care Centres of the Cantabrian Health Service, with the coordinators of the PCC and the nurses responsible having been personally contacted by the researchers or by telephone. This is an original survey, based on the regulations of the SEPAR, which evaluates the quality of the material used (model, years of operation, calibration, cleanliness), as well as the training of personnel who perform spirometry. RESULTS: The health personnel responsible for performing spirometry were surveyed in the 42 Primary Care Centres of the Cantabrian Health Service throughout the Cantabrian area. A mean of 564 spirometries are performed per month. A significant number (13%) of spirometers are never calibrated, and only 10.5% of the spirometers are calibrated by the personnel who perform the test in the centre itself. More than half (54, 53.7%) of these professionals have never received specific training to perform spirometry, and only 3.8% of them have experience in performing the test as recommended by SEPAR. As for the cleaning of the devices, 30% of the technicians do not clean the spirometer or the adapter. CONCLUSIONS: 10 years after our initial study lack of training is still being observed in the professionals, and probably translates into invalid spirometry

[Quality of spirometry in Primary Care in Cantabria 10 years later. EspiroCan Study]. / Calidad de las espirometrías en Atención Primaria en Cantabria 10 años después. Estudio EspiroCan.

INTRODUCTION: To study the quality of spirometry performed in Primary Care in Cantabria (Spain) and the level of compliance with the regulations of this technique of the Spanish Society of Chest Diseases and Thoracic Surgery (SEPAR). MATERIAL AND METHODS: Cross-sectional descriptive study in the Community of Cantabria using an original questionnaire based on the latest SEPAR regulations. The questionnaire was distributed in 2018 by internal mail to the 42 Primary Care Centres of the Cantabrian Health Service, with the coordinators of the PCC and the nurses responsible having been personally contacted by the researchers or by telephone. This is an original survey, based on the regulations of the SEPAR, which evaluates the quality of the material used (model, years of operation, calibration, cleanliness), as well as the training of personnel who perform spirometry. RESULTS: The health personnel responsible for performing spirometry were surveyed in the 42 Primary Care Centres of the Cantabrian Health Service throughout the Cantabrian area. A mean of 564 spirometries are performed per month. A significant number (13%) of spirometers are never calibrated, and only 10.5% of the spirometers are calibrated by the personnel who perform the test in the centre itself. More than half (54, 53.7%) of these professionals have never received specific training to perform spirometry, and only 3.8% of them have experience in performing the test as recommended by SEPAR. As for the cleaning of the devices, 30% of the technicians do not clean the spirometer or the adapter. CONCLUSIONS: 10 years after our initial study lack of training is still being observed in the professionals, and probably translates into invalid spirometry.

Functionalization of sol-gel coatings with organophosphorus compounds for prosthetic devices.

Sol-gel coatings are proposed as surface treatments for titanium-based materials to promote the osseointegration of prosthetic devices with the host. As precursors of sol-gel synthesis, two silanes were selected: 3-methacryloxypropyltrimethoxy silane and 2 tetramethyl orthosilane. Sol-gel synthesis was functionalized with the addition of two different organophosphorus compounds, namely, tris(trimethylsilyl) phosphite and tris(trimethylsilyl) phosphate. Depending on the organophosphorus compound, phosphorus was incorporated into the sol-gel network by different mechanisms: organophosphate was incorporated following a hydrolysis/polycondensation reaction with the precursors of synthesis (two organopolysiloxanes), whereas organophosphite was introduced into the network through transformation of trivalent phosphorus to pentavalent phosphorus following a Michaelis-Arbuzov reaction and subsequent reaction of hydrolysis/polycondensation. When compared to the control coating, which has good adhesion coating-substrate, only the addition of the organophosphite ensured good adhesion without altering synthesis. The resulting coating modified with organophosphite was subjected to cellular study and the concentration of this compound was varied to reach the highest enhancement of proliferation. It was demonstrated that by increasing the amount of organophosphite cell proliferation increased. Inspection of the surfaces of the coatings revealed that by increasing the quantity of organophosphite, adhesion to the substrate was compromised. Thus, an intermediate quantity of organophosphite was considered the most suitable for application on metallic prosthetic devices.

Desarrollo moral de los estudiantes de un programa de enfermería / Moral development of the students of a nursing program

Resumen Objetivo: Determinar el nivel de desarrollo moral de los estudiantes del programa de Enfermería de la Universidad Industrial de Santander. Materiales y métodos: Estudio de corte transversal que utilizó el Cuestionario de Opinión sobre Problemas Sociales (COPS) fundamentado en la clasificación propuesta por Kohlberg y reestructurado por Rest. La población blanco correspondió a 187 estudiantes de enfermería de la Universidad Industrial de Santander, matriculados en los núcleos temáticos de cuidado. Resultados: Se pudo establecer el desarrollo de la competencia moral en cada uno de sus niveles: pre convencional, convencional y pos convencional, evidenciándose una correspondencia del 42.9% para el desarrollo moral convencional, seguida del 39.4% para el post convencional, y del 9.5% para el pre convencional. Conclusiones: La mayoría de los estudiantes de enfermería se encontraban en el nivel convencional de su desarrollo moral, aspecto que permite inferir que no existen diferencias entre los niveles académicos, excepto en los estudiantes del tercer nivel, quienes obtuvieron un mayor desarrollo moral post convencional, lo cual puede obedecer a la coincidencia entre la finalización de la asignatura de ética en enfermería, propia del plan curricular, y el momento en que se llevó a cabo la investigación.

Abstract Objective: To determine the level of moral development of the students of the Nursing program of the Universidad Industrial de Santander. Materials and methods: Cross-sectional study using the Opinion Questionnaire on Social Problems (COPS) based on the classification proposed by Kohlberg and restructured by Rest. The target population corresponded of 187 nursing students from the Universidad Industrial de Santander, enrolled in the thematic nuclei of carefulness. Results: It was possible to establish the development of moral competence in each of its levels: pre-conventional, conventional and post conventional, evidencing a correspondence of 42.9% for conventional moral development, followed by 39.4% for the conventional post, and 9.5 % for the pre-conventional. Conclusions: The majority of nursing students were at the conventional level of moral development, aspect that allows to infer that there are no differences between academic levels. Except in the third level students, whom obtained a greater post-conventional moral development, which can obey of the coincidence between the completion of the subject of ethics in nursing, contained in the curricular plan, and the time when the research was carried out.

Recommendations for the follow-up care of female breast cancer survivors: a guideline of the Spanish Society of Medical Oncology (SEOM), Spanish Society of General Medicine (SEMERGEN), Spanish Society for Family and Community Medicine (SEMFYC), Spanish Society for General and Family Physicians (SEMG), Spanish Society of Obstetrics and Gynecology (SEGO), Spanish Society of Radiation Oncology (SEOR), Spanish Society of Senology and Breast Pathology (SESPM), and Spanish Society of Cardiology (SEC)

The increased incidence and decreased mortality of breast cancer have produced an increased number of breast cancer survivors. The type of sequelae and comorbidities that these patients present call for a collaborative follow-up by hospital-based specialized care and primary care. In this document, we present a guideline drafted and agreed among scientific societies whose members care for breast cancer survivors. The purpose of this guideline is to achieve the shared and coordinated follow-up of these patients by specialized care and primary care professionals. In it, we review the health issues derived from the treatments performed, with recommendations about the therapeutic approach to each of them, as well as a proposal for joint follow-up by primary and specialized care

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[Adaptive behaviour and learning in children with neurodevelopmental disorders (autism spectrum disorders and attention deficit hyperactivity disorder). Effects of executive functioning]. / Conducta adaptativa y aprendizaje en niños con trastornos del neurodesarrollo (trastornos del espectro autista y trastorno por deficit de atencion/hiperactividad). Efectos del funcionamiento ejecutivo.

INTRODUCTION: Autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD) present difficulties in adaptive functioning and learning, possibly associated with failures in executive functioning characteristic of both disorders. AIM: To analyze the impact of executive functioning in the adaptive behaviors of socialization and daily life and in learning behaviors in children with ASD and children with ADHD. SUBJECTS AND METHODS: The participants were 124 children matched in age and intellectual quotient: 37 children with typical development, 52 children with ASD and 35 children with ADHD. Parents reported on their children's adaptive behaviors, while teachers provided information on learning behaviors and executive functioning in daily life. RESULTS: There are significant differences between the groups with ASD and ADHD with the typical development group in all domains evaluated. In addition, the group with ASD had worse socialization skills while persistence in learning was more affected in children with ADHD. Finally, the metacognitive index of executive functioning predicted the socialization and persistence of children with ASD. On the other hand, the index of behavioral regulation and the educational level of the parents predicted the socialization skills in children with ADHD. CONCLUSIONS: The results highlight the need to include differentiated executive strategies in the intervention of children with ASD and children with ADHD.

TITLE: Conducta adaptativa y aprendizaje en niños con trastornos del neurodesarrollo (trastornos del espectro autista y trastorno por deficit de atencion/hiperactividad). Efectos del funcionamiento ejecutivo.Introduccion. El trastorno del espectro autista (TEA) y el trastorno por deficit de atencion/hiperactividad (TDAH) presentan dificultades en el funcionamiento adaptativo y en el aprendizaje, que posiblemente estan asociadas a fallos en el funcionamiento ejecutivo caracteristicos de ambos trastornos. Objetivo. Analizar el impacto del funcionamiento ejecutivo en las conductas adaptativas de socializacion y de la vida diaria y en conductas de aprendizaje en niños con TEA y niños con TDAH. Sujetos y metodos. Los participantes fueron 124 niños igualados en edad y cociente intelectual: 37 con desarrollo tipico, 52 con TEA y 35 niños con TDAH. Los padres informaron sobre las conductas adaptativas, y los profesores, sobre las conductas de aprendizaje y del funcionamiento ejecutivo en la vida diaria. Resultados. Existen diferencias significativas entre los grupos con TEA y con TDAH y el grupo con desarrollo tipico en los dominios evaluados. Ademas, el grupo con TEA tenia peores habilidades de socializacion, pero la persistencia en el aprendizaje estaba mas afectada en los niños con TDAH. Por ultimo, el indice metacognitivo de funcionamiento ejecutivo predijo la socializacion y la persistencia de los niños con TEA, mientras que el indice de regulacion comportamental y el nivel educativo de los padres predijo las habilidades de socializacion en los niños con TDAH. Conclusiones. Los resultados sugieren la necesidad de incluir estrategias ejecutivas en la intervencion de niños con TEA y niños con TDAH.

Psychological impact of multigene cancer panel testing in patients with a clinical suspicion of hereditary cancer across Spain.

OBJECTIVE: Patients' psychological reactions to multigene cancer panel testing might differ compared with the single-gene testing reactions because of the complexity and uncertainty associated with the different possible results. Understanding patients' preferences and psychological impact of multigene panel testing is important to adapt the genetic counselling model. METHODS: One hundred eighty-seven unrelated patients with clinical suspicion of hereditary cancer undergoing a 25-gene panel test completed questionnaires after pretest genetic counselling and at 1 week, 3 months, and 12 months after results to elicit their preferences regarding results disclosure and to measure their cancer worry and testing-specific distress and uncertainty. RESULTS: A pathogenic variant was identified in 38 patients (34 high penetrance and 4 moderate penetrance variants), and 54 patients had at least one variant of uncertain significance. Overall, cancer panel testing was not associated with an increase in cancer worry after results disclosure (P value = .87). Twelve months after results, carriers of a moderate penetrance variant had higher distress and uncertainty scores compared with carriers of high penetrance variants. Cancer worry prior to genetic testing predicted genetic testing specific distress after results, especially at long term (P value <.001). Most of the patients reported the wish to know all genetic results. CONCLUSIONS: Our results suggest that patients can psychologically cope with cancer panel testing, but distress and uncertainty observed in carriers of moderate penetrance cancer variants in this cohort warrant further research.

Correction to: Recommendations for the follow-up care of female breast cancer survivors: a guideline of the Spanish Society of Medical Oncology (SEOM), Spanish Society of Primary Care Physicians (SEMERGEN), Spanish Society for Family and Community Medicine (SEMFYC), Spanish Society for General and Family Physicians (SEMG), Spanish Society of Obstetrics and Gynecology (SEGO), Spanish Society of Radiation Oncology (SEOR), Spanish Society of Senology and Breast Pathology (SESPM), and Spanish Society of Cardiology (SEC).

Correction to: Clin Transl Oncol https://doi.org/10.1007/s12094-017-1801-4.

Position paper on nasal obstruction: evaluation and treatment.

Nasal obstruction (NO) is defined as the subjective perception of discomfort or difficulty in the passage of air through the nostrils. It is a common reason for consultation in primary and specialized care and may affect up to 30%-40% of the population. It affects quality of life (especially sleep) and lowers work efficiency. The aim of this document is to agree on how to treat NO, establish a methodology for evaluating and diagnosing it, and define an individualized approach to its treatment. NO can be unilateral or bilateral, intermittent or persistent and may be caused by local or systemic factors, which may be anatomical, inflammatory, neurological, hormonal, functional, environmental, or pharmacological in origin. Directed study of the medical history and physical examination are key for diagnosing the specific cause. NO may be evaluated using subjective assessment tools (visual analog scale, symptom score, standardized questionnaires) or by objective estimation (active anterior rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow). Although there is little correlation between the results, they may be considered complementary and not exclusive. Assessing the impact on quality of life through questionnaires standardized according to the underlying disease is also advisable. NO is treated according to its cause. Treatment is fundamentally pharmacological (topical and/or systemic) when the etiology is inflammatory or functional. Surgery may be necessary when medical treatment fails to complement or improve medical treatment or when other therapeutic approaches are not possible. Combinations of surgical techniques and medical treatment may be necessary.