The Effects of Early Onset Tranquilizers, Sedatives, and Sleeping Pills Use on Recent Consumption Among Adolescents.

BACKGROUND: Adolescents' consumption of tranquilizers, sedatives, and sleeping pills (TSSp) has increased during the last few decades, and TSSp are currently among the substances with the lowest age-of-onset. We characterized current-use patterns of TSSp consumers by age when first taken. METHODS: This study used individualized secondary data retrieved from the 2016 Spanish State Survey on Drug Use in Secondary Education (16-18-year-olds), and included all subjects who reported having taken TSSp at any point, but excluded those who had started during the previous year (n = 1502). Logistic regression models were used to obtain adjusted odds ratios (aOR) for associations between early TSSp consumption (<14 years) and current TSSp use patterns, adjusted for sociodemographic factors. RESULTS: About 17.9% of respondents had taken TSSp (average age-of-onset = 13.7) and 45% of these without a prescription. TSSp consumption at <14 years was higher for males and nonrepeaters. Having begun to use TSSp < 14 years was associated with both higher probability of consumption in the last month (aOR = 1.41; 95%CI:1.12-1.77) and daily/almost daily consumption in the last month (aOR = 1.56; 95CI%:1.16-2.08). CONCLUSIONS: The results of this study show there is a high proportion of 16 to 18 TSSp student consumers - both prescribed and nonprescribed; it also establishes that early onset-of-use is associated with higher levels of intensive use later on.

Risk factors related to intimate partner violence police recidivism in Spain / Factores de riesgo asociados con la reincidencia policial en violencia contra la pareja en España

Background/Objective: Some professionals, such as police officers, are required to prevent violent behavior, such as intimate partner violence (IPV). For this task they use actuarial tools designed to estimate the risk of occurrence of further violence after a previous complaint (police recidivism), taking into account risk and protective indicators which they can observe, in spite of they are not behavioral assessment experts. Method: To try to refine the police risk assessments carried out in Spain since 2007 and to improve the two tools available on the Spanish VioGén System, Police Risk Assessment and Risk Evolution (VPR3.1 and VPER3.0), this paper, using an epidemiological design, in a sample of 6,613 new cases of IPV of Spain, studies empirical relationships among 65 indicators (56 risk and 9 protection) and IPV police recidivism up to six months. Results: It resulted in a recidivism rate of 7.4%, finding statistically significant associations of 46 indicators. Conclusions: Empirical evidence about static indicators and new relevant dynamic indicators in the victims’ police protection management is presented. Practical implications for future police risk assessments are discussed (AU)

Antecedentes/Objetivo: Algunos profesionales, como los policías, tienen la obligación de actuar para prevenir comportamientos violentos, como en la violencia contra la pareja (VCP). Para ello se ayudan de herramientas actuariales diseñadas para estimar el riesgo de ocurrencia de nueva violencia después de una denuncia previa (reincidencia en el ámbito policial), atendiendo a aquellos indicadores de riesgo y de protección que estén a su alcance al no ser expertos en evaluación de conductas. Método: Para tratar de afinar más en las valoraciones policiales de riesgo que se realizan en España desde el año 2007 y perfeccionar las dos herramientas con que cuenta el Sistema VioGén español, Valoración Policial del Riesgo y Evolución del Riesgo (VPR3.1 y VPER3.0), en este trabajo se ha utilizado un diseño epidemiológico para estudiar, en una muestra de 6.613 nuevos casos de VCP de España, las relaciones empíricas existentes entre 65 indicadores (56 de riesgo y 9 de protección) y la reincidencia policial en VCP a seis meses. Resultados: Resultó una tasa de reincidencia del 7,4%, encontrándose asociaciones estadísticamente significativas en 46 indicadores. Conclusiones: Se presenta evidencia empírica sobre indicadores estáticos y nuevos indicadores dinámicos importantes en la gestión de la protección policial de las víctimas. Se discuten las implicaciones prácticas para futuras valoraciones policiales de riesgo (AU)

Risk factors related to intimate partner violence police recidivism in Spain.

Background/Objective: Some professionals, such as police officers, are required to prevent violent behavior, such as intimate partner violence (IPV). For this task they use actuarial tools designed to estimate the risk of occurrence of further violence after a previous complaint (police recidivism), taking into account risk and protective indicators which they can observe, in spite of they are not behavioral assessment experts. Method: To try to refine the police risk assessments carried out in Spain since 2007 and to improve the two tools available on the Spanish VioGén System, Police Risk Assessment and Risk Evolution (VPR3.1 and VPER3.0), this paper, using an epidemiological design, in a sample of 6,613 new cases of IPV of Spain, studies empirical relationships among 65 indicators (56 risk and 9 protection) and IPV police recidivism up to six months. Results: It resulted in a recidivism rate of 7.4%, finding statistically significant associations of 46 indicators. Conclusions: Empirical evidence about static indicators and new relevant dynamic indicators in the victims' police protection management is presented. Practical implications for future police risk assessments are discussed.

Antecedentes/Objetivo: Algunos profesionales, como los policías, tienen la obligación de actuar para prevenir comportamientos violentos, como en la violencia contra la pareja (VCP). Para ello se ayudan de herramientas actuariales diseñadas para estimar el riesgo de ocurrencia de nueva violencia después de una denuncia previa (reincidencia en el ámbito policial), atendiendo a aquellos indicadores de riesgo y de protección que estén a su alcance al no ser expertos en evaluación de conductas. Método: Para tratar de afinar más en las valoraciones policiales de riesgo que se realizan en España desde el año 2007 y perfeccionar las dos herramientas con que cuenta el Sistema VioGén español, Valoración Policial del Riesgo y Evolución del Riesgo (VPR3.1 y VPER3.0), en este trabajo se ha utilizado un diseño epidemiológico para estudiar, en una muestra de 6.613 nuevos casos de VCP de España, las relaciones empíricas existentes entre 65 indicadores (56 de riesgo y 9 de protección) y la reincidencia policial en VCP a seis meses. Resultados: Resultó una tasa de reincidencia del 7,4%, encontrándose asociaciones estadísticamente significativas en 46 indicadores. Conclusiones: Se presenta evidencia empírica sobre indicadores estáticos y nuevos indicadores dinámicos importantes en la gestión de la protección policial de las víctimas. Se discuten las implicaciones prácticas para futuras valoraciones policiales de riesgo.

A reappraisal of Gaucher disease-diagnosis and disease management algorithms.

Type 1 (non-neuronopathic) Gaucher disease was the first lysosomal storage disorder for which an effective enzyme replacement therapy was developed and it has become a prototype for treatments for related orphan diseases. There are currently four treatment options available to patients with Gaucher disease, nevertheless, almost 25% of Type 1 Gaucher patients do not gain timely access to therapy because of delays in diagnosis after the onset of symptoms. Diagnosis of Gaucher disease by enzyme testing is unequivocal, but the rarity of the disease and nonspecific and heterogeneous nature of Gaucher disease symptoms may impede consideration of this disease in the differential diagnosis. To help promote timely diagnosis and optimal management of the protean presentations of Gaucher disease, a consensus meeting was convened to develop algorithms for diagnosis and disease management for Gaucher disease.

[Vitamin B12 deficiency: a challenging diagnosis and treatment]. / Hypovitaminose E12: challenge diagnostique et thérapeutique.

Vitamin B12 deficiency is usually evoked in presence of compatible hematologic or clinical (usually neurologic) signs. However, many cases of deficiency are little or not symptomatic. Pernicious anemia, caused by a deficiency in intrinsic factor, is a rare cause of vitamin B12 deficiency. The most frequent causes are gastric disorders, pancreatic insufficiency, or chronic drug treatment (proton pump inhibitors or metformin) that interfere with the digestion of vitamin B12 digestion, or disorders of the ileum mucosa reducing the absorption of vitamin B12. Oral treatment of vitamin B12 deficiency is possible whatever the etiology, but it has only been validated in small series. Parenteral treatment remains indicated for severe neurologic deficits or whenever patient adherence with treatment is doubtful.

Proposal of a morphologic bone marrow response score for imatinib mesylate treatment in chronic myelogenous leukemia.

Cytogenetic and molecular analyses are essential disease-monitoring parameters in chronic myelogenous leukemia (CML) treated with imatinib. However, a bone marrow morphologic response has not been defined. We reviewed bone marrow histology and cytology of 39 imatinib-treated patients with CML over 49 weeks and introduced a morphologic response score. A significant positive correlation with a complete cytogenetic response was shown for absence of dry tap (P = .04) and abnormal megakaryocytes (P < 0.001), normalization of cellularity (P = .001) and reduction of fibrosis (P = .01), myelopoiesis:erythropoiesis index (P = .001), blast (P = .001) and basophil count (P < 0.001). The morphologic score integrating these parameters showed an early and late correlation with cytogenetic response. In conclusion, morphologic criteria for complete cytogenetic response in patients with CML treated with imatinib can be defined. Persistent high-level morphologic abnormalities herald early on a high likelihood to fail treatment and call for more intense or alternative therapy.