Procesamiento de estímulos novedosos como terapia de remediación cognitiva en pacientes con trastorno alimentario / Processing of novel stimuli as cognitive remediation therapy in patients with eating disorder

Resumen Estudios previos han indicado la utilidad de la terapia de remediación cognitiva (TRC) en pacientes con trastornos de conducta alimentaria (TCA). El objetivo de este estudio fue evaluar una nueva técnica de innovación cognitiva llamada "Con la cabeza en las nubes" (CCN). Participaron 22 mujeres con TCA (13 con anorexia nerviosa y 9 con bulimia nerviosa), de entre 14 y 29 años de edad (M = 19.0, DE = 3.4), quienes completaron las seis sesiones grupales de que consta dicha técnica. Bajo un diseño pre-post intervención, las participantes fueron evaluadas en cuanto a: funciones viso-constructivas (Copia de la Figura Compleja de Rey-Osterrieth [CFCR]), pensamiento creativo (Test de Pensamiento Creativo de Torrance [TPCT]), flexibilidad cognitiva (CFCR y TPCT) y control cognitivo (Test de Stroop). La intervención generó una mejora en distintos dominios cognitivos, como son: mayor coherencia global, pensamiento creativo y resistencia al cierre, así como menor fragmentación. Basada en la TRC, encaminada a estimular el procesamiento novedoso de estímulos visuales, la técnica CCN mostró mejorar algunos de los procesos cognitivos implicados en la generación de los síntomas de pacientes con TCA.

Abstract Previous studies have shown the usefulness of cognitive remediation therapy (CRT) in patients with eating disorders (ED). The objective of this study was to assess a new cognitive technique called "With the head in the clouds" (WHC). A total of 22 women with ED (13 with anorexia nervosa and nine with bulimia nervosa), between 14 and 29 years (M = 19.0, SD = 3.4), completed the six group sessions of this technique. Under a design pre-post intervention, participants were assessed in: visuo-constructive functions (Copy of the Rey-Osterrieth Complex Figure [CRCF]), creative thinking (Torrance Creative Thinking Test [TCTT]), cognitive flexibility (CRCF and TCTT), and cognitive control (Stroop Test). The intervention improved different cognitive domains, such as: greater global coherence, creative thinking and resistance to closure, as well as less fragmentation. Based on CRT, aimed at stimulating the new processing of visual stimuli, the technique WHC showed an improvement in some of the cognitive processes involved in the onset of symptoms in patients with ED.

Primary dentin etching time, bond strength and ultra-structure characterization of dentin surfaces.

OBJECTIVES: To evaluate the effect of shortening the etching time on roughness, microhardness and bond strength of three adhesive systems to primary tooth dentin. METHODS: Flat dentin surfaces from primary molars were randomly assigned to six experimental groups. Three different adhesive systems were used: an etch-and-rinse adhesive (Single Bond), a two-step self-etching (Clearfil SE Bond), and a one-step self-etching (One-Up Bond F) adhesive. In half of the specimens, the recommended etching time was used, in the other half the etching time was 50% reduced. After applying the adhesive, resin composite build-ups were constructed and stored in a humid environment for 24h at 37 degrees C. Specimens were sectioned into 1mm(2) beams and tested for microtensile bond strength (MTBS). Debonded surfaces were analyzed by scanning electron microscopy (SEM). Additional surfaces were conditioned for microhardness measurements (KHN) and for atomic force microscopy (AFM) analysis. Intertubular and total surface roughness (Ra) were recorded. Results were analyzed with ANOVA and Student-Newman-Keuls tests (P<0.05). RESULTS: Single Bond and Clearfil SE Bond showed higher MTBS than One-Up Bond F. Bond strength and intertubular roughness increased when Single Bond and One-Up Bond F were used with a reduced etching time. For Clearfil SE Bond no differences in MTBS were detected when reducing the etching time. The application of phosphoric acid, Clearfil SE Bond primer and One-Up Bond F decreases dentin microhardness. CONCLUSIONS: Shortening One-Up Bond F application time and reducing the etching time of phosphoric acid to one-half of the manufacturer's recommended etching time when using Single Bond are recommended when bonding to primary dentin.

Adequate systemic perfusion maintained by a CentriMag during acute heart failure.

Mechanical circulatory support during severe acute heart failure presents options for myocardial recovery or cardiac replacement. Short-term circulatory support with the newest generation of magnetically levitated centrifugal-flow pumps affords several potential advantages. Herein, we present our experience with such a pump-the CentriMag Levitronix LLC; Waltham, Mass) centrifugal-flow ventricular assist device-in 4 critically ill patients who were in cardiogenic shock. From November 2007 through March 2008, 3 patients were supported after cardiac surgery, and 1 after chronic heart failure worsened. Two patients were bridged to heart transplantation, and 2 died during support. Perfusion during support was evaluated in terms of serum lactic acid levels and oxygenation values. In all of the patients, the CentriMag's pump flow was adequate, and continuous mechanical ventilation support was provided. Lactic acid levels substantially improved with CentriMag support and were maintained at near-normal levels throughout. At the same time, arterial pH, PO2, and carbon dioxide levels remained within acceptable ranges. No thromboembolic events or mechanical failures occurred. Our experience indicates that short-term use of the CentriMag ventricular assist device during acute heart failure can restore and adequately support circulation until recovery or until the application of definitive therapy.

Tratamiento de la succión digital en dentición temporal y mixta / Thumb sucking treatment in primary and mixed dentition

Se presenta una actualización del hábito de succión digital y su relación con las maloclusiones bucodentarias, así como los diferentes enfoques de tratamiento para la eliminación de la conducta de succión y sus secuelas. Presentamos dos casos clínicos razonando los diferentes tipos de tratamiento realizados según la afectación oclusal, funcional y psicológica que presenta cada paciente (AU)