Ansiedad y Depresión en una Muestra de Músicos Militares y Civiles / Anxiety and Depression in a Sample of Military and Civilian Musicians

Diferentes estudios muestran que dos grupos tan diferentes como los militares y los músicos suelen manifestar altos niveles de ansiedad y depresión. Por ello, el objetivo de este estudio es medir estas variables clínicas en músicos militares comparándolo con músicos civiles. La muestra está compuesta por 266 músicos, representada al cincuenta por ciento por músicos militares y civiles provenientes de todo el territorio nacional. Para medir los niveles de ansiedad y depresión se utilizaron el Inventario de Ansiedad de Beck (BAI) y el Inventario de Depresión de Beck (BDI). Los resultados muestran una relación directa entre la ansiedad y la depresión en el total de la muestra y en ambos grupos, encontrando que los músicos militares puntúan más alto que los civiles en ambas variables, y que en el ámbito militar afecta el escalafón, siendo la tropa la que presenta niveles más elevados en ansiedad y especialmente en depresión.(AU)

Different studies show that two groups as different as militaries and musicians usually demonstrate high levels of anxiety and depression. So, the objective of this study is measuring these clinics variables in military musicians comparing with civil musicians. The sample is composed of 266 musicians, represented fifty percent by military and civilian coming from all over the national territory. To measure the levels of anxiety and depression were used the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). The results show a direct relationship between anxiety and depression in the sample total and in both groups, finding that military musicians score higher than civilians in both variables, and that in the military sphere it affects the Ladder, being the troop that presents higher levels of anxiety and especially depression.(AU)

Managing the Next Wave of Influenza and/or SARS-CoV-2 in the ICU-Practical Recommendations from an Expert Group for CAPA/IAPA Patients.

The aim of this study was to establish practical recommendations for the diagnosis and treatment of influenza-associated invasive aspergillosis (IAPA) based on the available evidence and experience acquired in the management of patients with COVID-19-associated pulmonary aspergillosis (CAPA). The CAPA/IAPA expert group defined 14 areas in which recommendations would be made. To search for evidence, the PICO strategy was used for both CAPA and IAPA in PubMed, using MeSH terms in combination with free text. Based on the results, each expert developed recommendations for two to three areas that they presented to the rest of the group in various meetings in order to reach consensus. As results, the practical recommendations for the management of CAPA/IAPA patients have been grouped into 12 sections. These recommendations are presented for both entities in the following situations: when to suspect fungal infection; what diagnostic methods are useful to diagnose these two entities; what treatment is recommended; what to do in case of resistance; drug interactions or determination of antifungal levels; how to monitor treatment effectiveness; what action to take in the event of treatment failure; the implications of concomitant corticosteroid administration; indications for the combined use of antifungals; when to withdraw treatment; what to do in case of positive cultures for Aspergillus spp. in a patient with severe viral pneumonia or Aspergillus colonization; and how to position antifungal prophylaxis in these patients. Available evidence to support the practical management of CAPA/IAPA patients is very scarce. Accumulated experience acquired in the management of CAPA patients can be very useful for the management of IAPA patients. The expert group presents eminently practical recommendations for the management of CAPA/IAPA patients.

La terapia de grupo online en el juego patológico: una modalidad desconocida descubierta en tiempos de pandemia / Online group therapy in gambling: an unknown treatment modality discovered in times of pandemic

En los últimos años el uso de las tecnologías en el ámbito de la psicoterapia está en un crecimiento continuo, por lo que resulta fundamental investigar sobre sus ventajas y limitaciones.Producto de la actual pandemia y de la importancia que está adquiriendo la teleterapia comoalternativa terapéutica, surge el objetivo de este trabajo que es revisar la literatura científicaexistente sobre la terapia de grupo online para las adicciones en general y en el juego patológico en particular, además de trasladar nuestra propia experiencia de terapia grupal, onliney en vivo en el campo del juego patológico. Se han realizado búsquedas en las bases de datosPsycINFO, MEDLINE, PubMed y Web of Science, en las que se examinaron los resultadospublicados desde enero de 2010 hasta agosto de 2020 combinando diferentes descriptores.Tras realizar dichas búsquedas los resultados encontrados mostraron que en la actualidad noexisten trabajos que investiguen la terapia de grupo online en vivo como modalidad terapéutica en el ámbito de las adicciones, en dichas bases de datos y con los descriptores utilizados.Por ello, ante la ausencia de literatura científica relacionada con el tema a tratar, se proponenuna serie de cuestiones a considerar en futuras investigaciones basadas en la experienciarecogida en las terapias de grupo online en vivo con jugadores patológicos desarrolladaspor la Asociación de Psicoterapeutas para el Estudio de las Adicciones Psicológicas ante lanecesidad de distancia social producto de la pandemia ocasionada por el virus SARS-CoV-2. (AU)

In recent years the use of technologies in the field of psychotherapy has been growing continuously, this rapid development creates the need of evaluate its advantages and limitations intherapy. As a result of the current pandemic and the importance that teletherapy is acquiring asa therapeutic alternative, the goal of this paper is to carry out a review of the existing scientificliterature on internet-based group intervention in addictions and in pathological gambling in particular. Additionally, experience from the authors on group intervention (internet and live) willbe described and used as a resource for conclusions. Searches have been carried out in the databases PsycINFO, MEDLINE, PubMed and Web of Science, in which the results published fromJanuary 2010 to August 2020 were examined by combining different descriptors. After performing these searches, the results found showed that there are currently no published paper thatresearch group therapy live online as a therapeutic modality in the field of addiction, in those databases with the descriptors used. For this purpose, in the absence of scientific literature relatedto the subject, some ideas are proposed in this paper to be considered for future research, basedon the experience gathered in the group therapy live online with players pathological developedby the Association of Psychotherapists for the Study of Addiction Psychological response to theneed for social distance product of the pandemic caused by the virus SARS-CoV-2. (AU)

Attitudes Toward Hypnosis Based on Source of Information and Experience With Hypnosis.

Attitudes and beliefs toward hypnosis are relevant in promoting hypnotic responses, in predicting the efficacy of interventions that include hypnosis, and in reducing iatrogenic effects in hypnotized individuals. The goal of the present study is to test the impact of previous knowledge about hypnosis and past experiences being hypnotized on attitudes and beliefs about hypnosis. A sample of 1,977 Portuguese students participated in the study; they responded to the Valencia Scale of Attitudes and Beliefs Toward Hypnosis-Client Version (VSABH-C) on two different occasions (test-retest method). Significant differences were found (p ≤ 0.001) on participants' attitudes and beliefs about hypnosis depending on the source of knowledge about hypnosis. Results also showed significant differences (p ≤ 0.001) in the multivariate profile analysis of the scale's factors based on whether participants had a previous history of hypnosis and depending on who hypnotized them. Participants who reported no previous knowledge about hypnosis or who acquired their knowledge from nonscientific sources scored significantly higher in the negative factors (fear, memory, magical, and marginal), therefore reporting more negative beliefs. Likewise, these participants scored lower in the positive factors (help, control, collaboration, and interest). Participants who had been previously hypnotized showed higher scores in the positive factors. In addition, when hypnosis had been utilized by a psychologist, these scores were even higher. However, some participants who had been previously hypnotized scored high in some of the negative factors (memory and magical), which indicates that some professionals using hypnosis are fostering some misconceptions about hypnosis.

Suplementos proteicos en el tratamiento y prevención de la sarcopenia en ancianos. Revisión sistemática / Protein supplements in the treatment and prevention of sarcopenia. A systematic review

Objetivo: Conocer los resultados de las últimas publicaciones sobre sarcopenia en el anciano y el uso de complementos proteicos para su tratamiento y/o prevención. Metodología: Revisión sistemática sobre el uso de complementos proteicos en el tratamiento y prevención de la sarcopenia. La búsqueda se realizó en MEDLINE, Science Direct, SciELO, TRIP database y Dialnet. Se acotó al periodo 2011-2016. Se incluyeron ensayos clínicos aleatorizados y para valorar su calidad metodológica se usó la escala PEDro, seleccionando aquellos que tenían una puntuación igual o superior a 6. Resultados: El modo de aportar las proteínas en los 13 artículos revisados es muy variable. Estas se pueden dar diariamente, en 2-3 tomas, tras el ejercicio físico, generalmente de resistencia, con una frecuencia de 3-5 sesiones/semana. Las proteínas se suelen dar en forma de carne roja, queso, suero de leche o en estado puro, en cantidades que oscilan entre 20 y 45 g/día. Los aminoácidos esenciales rondan los 9 g/día y la leucina oscila entre 4 y 9 g/día. La suplementación con ß-hidroxi-ß-metilbutirato se encuentra entre 1,5-3,0 g/día. Estos aportes produjeron en general un aumento de la masa y la fuerza muscular, así como un incremento de la síntesis de proteínas musculoesqueléticas y del tamaño de la fibra muscular en el anciano. Conclusiones: En el enfoque terapéutico del síndrome de sarcopenia es fundamental la incorporación de proteínas de alto valor biológico a la dieta, que, junto al ejercicio de resistencia, van a tener un efecto sinérgico sobre el tejido muscular

Objective: To know the results of the latest researches on sarcopenia in the elderly and the use of protein supplements for their treatment and / or prevention. Methodology: Systematic review on the use of protein supplements in the treatment and prevention of sarcopenia. The search was carried out in MEDLINE, Science Direct, SciELO, TRIP database and Dialnet. It was limited to the period 2011/2016. Randomized clinical trials were included and PEDro scale was used to assess the methodological quality of them, including those with a score of 6 or higher. Results: The way to provide the proteins in the 13 articles reviewed is very variable. These can be given daily, times, after physical exercise, usually resistance, with a frequency of 3-5 sessions / week. Proteins are usually provided in the form of red meat, cheese, buttermilk or pure, in amounts ranging from 20-45 g / day. Essential amino acids are around 9 g / day and leucine ranges from 4-9 g / day. Supplementation with ß-hydroxy-ß-methylbutyrate is between 1.5-3.0 g / day. These contributions generally resulted in an increase in muscle mass and strength, as well as an increase in the synthesis of musculoskeletal proteins and muscle fiber size in the elderly. Conclusions: In the therapeutic approach of sarcopenia syndrome, it is essential the incorporation of proteins of high biological value into the diet, which, together with resistance exercise, are going to produce a synergistic effect on muscle tissue

Ejercicios de resistencia en el tratamiento y prevención de la sarcopenia en ancianos. Revisión sistemática / Resistance exercises for the treatment and prevention of sarcopenia in the elderly. A systematic review

Objetivos: Conocer los resultados de las últimas investigaciones sobre sarcopenia en el anciano y la prescripción de ejercicios de resistencia como pauta principal en el tratamiento y prevención de dicho síndrome. Metodología: Revisión sistemática sobre el uso de ejercicios de resistencia en el tratamiento y prevención de la sarcopenia. La búsqueda se realizó en MEDLINE, Science Direct, SciELO, Trip Database y Dialnet. Se acotó al periodo 2011-2016. Se incluyeron ensayos clínicos aleatorizados, y para valorar la calidad metodológica de estos se usó la escala PEDro, incluyendo aquellos que presentaban una puntuación igual o superior a 6. Resultados: En los 22 trabajos revisados, los ejercicios de resistencia se realizan mediante sesiones de 20 a 60 minutos, 2 a 5 veces por semana, 2-4 series de 8-15 repeticiones y de un modo progresivo. Estos ejercicios de resistencia, solos o en combinación con otros tipos de ejercicios y en algunos casos con diferentes pautas nutricionales, produjeron un aumento de la masa y la fuerza muscular, así como incremento en la síntesis de proteínas musculoesqueléticas y tamaño de la fibra muscular. Conclusiones: La realización de ejercicios de resistencia progresiva parece ser la pauta más adecuada para prevenir y tratar la sarcopenia, solos o combinados con otros ejercicios, logrando beneficios sobre la masa, fuerza muscular y funcionalidad en el anciano. La incorporación de proteínas de alto valor biológico a la dieta tiene un efecto sinérgico sobre el tejido muscular

Objective: To understand the results of the latest research in sarcopenia in the elderly and the prescription of strengthening exercises as the principal guideline in the treatment and prevention of this syndrome. Methodology: A systematic review of the use of resistance exercises in the treatment and prevention of sarcopenia. The sources MEDLINE, Science Direct, SciELO, Trip Database and Dialnet were searched and narrowed for data to between 2011 and 2016. Various clinical studies were included and their methodology was tested by using the PEDro scale, including those that had an overall score of 6 or more. Results: In all 22 revised projects the strengthening exercises were conducted progressively in 20-60 minutes sessions, 2-5 times a week, in 2-4 series of 8-15 repetitions. These resistance exercises, alone or in combination with other types of exercises or nutritional guidelines, resulted in an increase of muscle mass and strength. Conclusions: The implementation of these progressive resistance training seems to be the most apt guideline for the prevention and treatment of sarcopenia, alone or in combination with other exercises, resulting in improvements in muscle mass, muscle strength and mobility in the elderly. The incorporation high biological value proteins in the diet appears to have a synergic effect on muscle tissue

Confirmatory Factor Analysis of the Valencia Scale of Attitudes and Beliefs Toward Hypnosis-client Version in a Portuguese Sample.

Research literature about hypnosis highlights the importance of clients' attitudes and beliefs toward hypnosis because they promote hypnotic responses and may predict the effectiveness of hypnotic interventions as well as minimize iatrogenic effects for clients. This study analyzes the factorial structure and psychometric properties with confirmatory methodology of the Valencia Scale of Attitudes and Beliefs Toward Hypnosis-Client Version, using a Portuguese sample. We expected to replicate the results obtained in previous research conducted with samples from various countries. The Portuguese sample comprised 1,977 participants. We found a structure of 8 factors, with an adequate internal consistency and test-retest reliability. Results are similar to those found in exploratory and confirmatory factor analyses with samples from other countries.

Hipnosis Clínica: Evaluación de su Eficacia y Calidad de la Investigación en Psicología / Clinical Hypnosis: Evaluation of its efficacy and quality of research in Psychology

Introducción: La hipnosis, es un campo de investigación experimental, pero también un conjunto de procedimientos terapéuticos. La investigación y el conocimiento actualizado sobre su valor clínico son necesarios para profesionales vinculados a la práctica y a la investigación en esta esfera. Objetivo: Valorar la calidad de la investigación sobre la eficacia de la hipnosis clínica en Psicología, así como revisar cualitativamente su evidencia empírica en este campo. Método: En este trabajo se revisaron estudios publicados hasta 2015. Los criterios para la selección de los estudios fueron los de Chambless y Hollon de 1998 y los de Nathan y Gorman de 1998 y 2015. Las bases de datos consultadas fueron: PubMed, PsycInfo, PsycArticles, Psyke y Psicodoc. Resultados: En relación con la calidad y cantidad predominan los estudios con un rigor metodológico que debe mejorarse, excluyendo el ámbito del dolor. Además, la revisión cualitativa sugiere que no hay evidencias concluyentes sobre la eficacia de la hipnosis como única intervención ni como coadyuvante en Psicología, excepto, de nuevo, para el caso del dolor. Conclusiones: Hasta el momento no se aprecian adelantos significativos relacionados con la eficacia y la calidad de la investigación sobre hipnosis clínica en Psicología. Es perentorio realizar más investigaciones con metodología rigurosa y seguimientos más largos que mejoren la calidad de los estudios(AU)

Introduction: Hypnosis is an experimental field of research, but also a set of therapeutic procedures. Research and updated knowledge about its clinical value are necessary for professionals involved in the practice and research in this field.Objective: To assess the quality of research on the efficacy of clinical hypnosis in Psychology, as well as to review qualitatively its empirical evidence in this field. Method: In this paper studies published until the year 2015 were reviewed. The criteria for selection of studies reviewed were those of Chambless and Hollonof 1998 and Nathan and Gorman (1998, 2015). The databases examined were PubMed, PsycINFO, PsycArticles, Psyke and Psicodoc. Results: Regarding the quality and quantity, predominated studies with methodological rigor to be improved, excluding the area of ​​pain. In addition, qualitative review suggests that there is no conclusive evidence on the efficiency of hypnosis as unique intervention or as an adjunct in psychology, except, again, for the case of pain. Conclusions: So far, no significant developments relevant to efficiency and quality of research on clinical hypnosis in Psychology are appreciated. More research is imperative, with rigorous methodology and longer follow-ups to improve the quality of the studies(AU)

Hipnosis Clínica: Evaluación de su Eficacia y Calidad de la Investigación en Medicina / Clinical Hypnosis: Assessment of its Effectiveness and the Quality of the Investigation of it in Medicine

Introducción: La utilización de la hipnosis para condiciones médicas es muy antigua, ha progresado con el paso del tiempo a partir de estudios cada vez mejor diseñados, razón por la que se considera importante el conocimiento de su valor terapéutico. Objetivo: Evaluar la calidad de la investigación sobre la eficacia de la hipnosis clínica en Medicina, así como sistematizar su evidencia empírica en este campo. Método: En este trabajo se revisaron estudios publicados hasta el 2015. Los criterios para la selección de los estudios fueron los de Chambless y Hollon de 1998 y los de Nathan y Gorman (1998, 2015). Las bases de datos consultadas fueron: PubMed, PsycInfo, PsycArticles, Psyke y Psicodoc. Resultados: La hipnosis se considera eficaz como coadyuvante a la terapia cognitivo-comportamental para varias condiciones médicas, como coadyuvante es probablemente eficaz en procederes oncológicos y odontológicos y una intervención prometedora en la diabetes y el virus del papiloma humano. Desde el 2009 hasta el 2015se han producido un incremento de estudios, aunque como tendencia la calidad de las investigaciones no ha mejorado, y la inclusión de la hipnosis en guías de intervención no está lo suficientemente extendida. Conclusiones: Se considera importante la realización de futuros estudios con metodologías más rigurosas, sobre todo en áreas de la medicina que todavía no cuentan con estudios de suficiente calidad, así como, la formación de los profesionales de la salud en su manejo y la inclusión de la hipnosis en protocolos médicos en las áreas donde hay suficiente evidencia(AU)

Introduction: The use of hypnosis for medical conditions is very old, and it has progressed with the time from studies better and better designed. Thats why, it is considered important the knowledge of its therapeutic value. Objective: Assess the quality of the investigation about the effectiveness of clinical hypnosis in Medicine, and systematize its empirical evidence in this field. Methods: Studies published up to 2015 were reviewed in this paper. Chambless and Hollons (1998) and Nathan and Gormans (1998, 2015) criteria were taken into account for the selection of the studies. PubMed, PsycInfo, PsycArticles, Psyke and Psicodoc were the database consulted.Results: Hypnosis is considered effective as something that helps cognitive-behavioral therapy for several medical conditions. It is probably effective in oncological and odontological procedures, and a promising intervention in diabetes and the human papilloma virus. Since 2009 till 2015 there has been an increase of studies about hypnosis, however as a tendency, the quality of the investigations has not improved, and the inclusion of it in intervention guides is not sufficiently extended. Conclusions: Future studies using more thorough methodology, above all in some fields of Medicine that do not have studies of good quality yet, as well as the training of health professionals in the management of hypnosis, and the inclusion of it in medical protocols in areas where there is enough evidence, are considered very important(AU)

Exposure to tobacco, alcohol and drugs of abuse during pregnancy. A study of prevalence among pregnant women in Malaga (Spain).

The prevalence of substance abuse in women who become pregnant is similar to that of the general population, resulting in a high fetal exposure rate during the most vulnerable period regarding neurodevelopment and organogenesis. The present study was intended to assess the level of prenatal exposure to tobacco, alcohol or illicit drugs in the city of Málaga (Spain). It was designed as a cross-sectional study, and based on the anonymous self-reports of participants. A total of 451 pregnant women were recruited in the first, second or third trimester. The prevalence in each of the quarters respectively was 21.2%, 18.5% and 13.3% for smoking, 40.7%, 23.1% and 17.1% for alcohol and 4.8%, 1.9% and 1.2% for cannabis. We also found that a higher educational level was associated with a lower consumption of tobacco (RR 0.659 [0.537-0.810] p<0.0001) and greater exposure to alcohol (RR 1.87 [1.30-2.69] p<0.0007). These results, particularly in regard to alcohol intake, are sufficiently alarming to alert obstetric care providers about the need to implement preventive measures.

La prevalencia de hábitos tóxicos en la población de mujeres que quedan embarazadas es similar a la de la población general, por lo que la exposición fetal a tóxicos es elevada en el período de mayor vulnerabilidad, sobre todo en relación al neurodesarrollo y la organogénesis. El presente estudio ha sido desarrollado para conocer el nivel de exposición prenatal a tabaco, alcohol u otras drogas en la ciudad de Málaga (España). El trabajo responde a un diseño observacional de corte transversal sobre el consumo de tóxicos durante el embarazo, y se basa en la autodeclaración de las gestantes mediante la cumplimentación de un cuestionario. Se reclutaron 451 gestantes de primer, segundo y tercer trimestre. La prevalencia de consumo en cada uno de los trimestres resultó ser respectivamente del 21.2%, 18.5% y 13.3% para el tabaco, 40.7%, 23.1% y 17.1% para el alcohol y del 4.8%, 1.9% y 1.2% para cannabis. En los tres trimestres, un mayor nivel de estudios se asoció a un menor consumo de tabaco (RR 0,659 [0.537-0.810] p< 0.0001) y una mayor exposición al alcohol (RR 1.87 [1.30-2.69] p< 0.0007). Los resultados obtenidos, sobre todo en relación al consumo de alcohol, son suficientemente llamativos como para alertar a los proveedores de atención obstétrica sobre la necesidad de poner en marcha medidas preventivas.

Exposición a tabaco, alcohol y drogas de abuso en gestantes. Estudio de prevalencia en gestantes de Málaga (España) / Exposure to tobacco, alcohol and drugs of abuse during pregnancy. A study of prevalence among pregnant women in Malaga (Spain)

La prevalencia de hábitos tóxicos en la población de mujeres que quedan embarazadas es similar a la de la población general, por lo que la exposición fetal a tóxicos es elevada en el período de mayor vulnerabilidad, sobre todo en relación al neurodesarrollo y la organogénesis. El presente estudio ha sido desarrollado para conocer el nivel de exposición prenatal a tabaco, alcohol u otras drogas en la ciudad de Málaga (España). El trabajo responde a un diseño observacional de corte transversal sobre el consumo de tóxicos durante el embarazo, y se basa en la autodeclaración de las gestantes mediante la cumplimentación de un cuestionario. Se reclutaron 451 gestantes de primer, segundo y tercer trimestre. La prevalencia de consumo en cada uno de los trimestres resultó ser respectivamente del 21.2%, 18.5% y 13.3% para el tabaco, 40.7%, 23.1% y 17.1% para el alcohol y del 4.8%, 1.9% y 1.2% para cannabis. En los tres trimestres, un mayor nivel de estudios se asoció a un menor consumo de tabaco (RR 0,659 [0.537-0.810] p< 0.0001) y una mayor exposición al alcohol (RR 1.87 [1.30-2.69] p< 0.0007). Los resultados obtenidos, sobre todo en relación al consumo de alcohol, son suficientemente llamativos como para alertar a los proveedores de atención obstétrica sobre la necesidad de poner en marcha medidas preventivas

The prevalence of substance abuse in women who become pregnant is similar to that of the general population, resulting in a high fetal exposure rate during the most vulnerable period regarding neurodevelopment and organogenesis. The present study was intended to assess the level of prenatal exposure to tobacco, alcohol or illicit drugs in the city of Málaga (Spain). It was designed as a cross-sectional study, and based on the anonymous self-reports of participants. A total of 451 pregnant women were recruited in the first, second or third trimester. The prevalence in each of the quarters respectively was 21.2%, 18.5% and 13.3% for smoking, 40.7%, 23.1% and 17.1% for alcohol and 4.8%, 1.9% and 1.2% for cannabis. We also found that a higher educational level was associated with a lower consumption of tobacco (RR 0.659 [0.537-0.810] p<0.0001) and greater exposure to alcohol (RR 1.87 [1.30-2.69] p<0.0007). These results, particularly in regard to alcohol intake, are sufficiently alarming to alert obstetric care providers about the need to implement preventive measures

Catalytic role of TiO(2) terminal oxygen atoms in liquid-phase photocatalytic reactions: oxidation of aromatic compounds in anhydrous acetonitrile.

On the basis of experiments carried out with controlled amounts of residual oxygen and water, or by using oxygen-isotope-labeled Ti(18) O2 as the photocatalyst, we demonstrate that (18) Os atoms behave as real catalytic species in the photo-oxidation of acetonitrile-dissolved aromatic compounds such as benzene, phenol, and benzaldehyde with TiO2 . The experimental evidence allows a terminal-oxygen indirect electron-transfer (TOIET) mechanism to be proposed, which is a new pathway that involves the trapping of free photogenerated valence-band holes at Os species and their incorporation into the reaction products, with simultaneous generation of oxygen vacancies at the TiO2 surface and their subsequent healing with oxygen atoms from either O2 or H2 O molecules that are dissolved in the liquid phase. According to the TOIET mechanism, the TiO2 surface is not considered to remain stable, but is continuously changing in the course of the photocatalytic reaction, challenging earlier interpretations of TiO2 photocatalytic phenomena.

A comparison of the environmental impact of different AOPs: risk indexes.

Today, environmental impact associated with pollution treatment is a matter of great concern. A method is proposed for evaluating environmental risk associated with Advanced Oxidation Processes (AOPs) applied to wastewater treatment. The method is based on the type of pollution (wastewater, solids, air or soil) and on materials and energy consumption. An Environmental Risk Index (E), constructed from numerical criteria provided, is presented for environmental comparison of processes and/or operations. The Operation Environmental Risk Index (EOi) for each of the unit operations involved in the process and the Aspects Environmental Risk Index (EAj) for process conditions were also estimated. Relative indexes were calculated to evaluate the risk of each operation (E/NOP) or aspect (E/NAS) involved in the process, and the percentage of the maximum achievable for each operation and aspect was found. A practical application of the method is presented for two AOPs: photo-Fenton and heterogeneous photocatalysis with suspended TiO2 in Solarbox. The results report the environmental risks associated with each process, so that AOPs tested and the operations involved with them can be compared.

Maternal-fetal thyroid function at the time of birth and its relation with iodine intake.

BACKGROUND: The effects of moderate variations in dietary iodine intake on maternal and fetal thyroid function are poorly understood. Recent studies question the usefulness of neonatal screening of congenital hypothyroidism as a tool for monitoring iodine deficiency. We proposed to test the hypothesis of an association between iodine intake during the last trimester of pregnancy and fetal thyroid function at the time of birth. METHODS: The study was undertaken at term in 233 healthy pregnant women (29.7±5.6 years) and in their newborn. Inclusion of women in the study was done within the 24 hours before delivery. RESULTS: The median maternal urinary iodine concentration was 126.5 µg/L. The maternal free triiodothyronine (FT3), although not thyrotropin (TSH) and free thyroxine (FT4), correlated significantly with the urinary iodine concentration (r=0.17, p=0.013). The cord blood TSH, FT4, and FT3 correlated positively with the maternal urinary iodine concentration at the time of delivery (r=0.24, p=0.001; r=0.16, p=0.032; and r=0.24, p=0.003, respectively). The cord blood and heel blood TSH correlated positively with the amniotic fluid iodine concentration (r=0.21, p=0.015 and r=0.15, p=0.036). The cord blood TSH correlated positively with the cord blood FT4 (r=0.21, p=0.022) and FT3 (r=0.32, p=0.017). The maternal TSH correlated significantly with the cord blood TSH (r=0.22, p=0.014) and with the heel blood TSH (r=0.13, p=0.050). CONCLUSIONS: The results of this study show the presence of a positive association of TSH-FT4 at the time of delivery, which may be modulated by the amount of iodine consumed by the mother during pregnancy.

Manejo perinatal en el límite de la viabilidad. Propuestas de abordaje en un hospital terciario / Perinatal management at the threshold of viability. An approach to practice at a tertiary care hospital

El objetivo de este artículo es realizar un protocolo de manejo perinatal para aquellos fetos/neonatos nacidos en el límite de la viabilidad (por debajo de la semana de gestación 256/7). Para ello se han revisado las principales publicaciones que hacen referencia a su asistencia en los últimos años. Partiendo de los resultados de morbimortalidad en nuestro hospital y en consenso con los neonatólogos, hemos establecido un protocolo de manejo en nuestro centro. Proponemos un esquema en el que según la edad gestacional y, en su defecto, el peso al nacimiento, establecemos cuál debe ser el tipo de vigilancia fetal anteparto, necesidad de transporte neonatal, administración de corticoides prenatales, vía del parto y tipo de reanimación al nacimiento. Todo ello se realiza en estrecha colaboración con los neonatólogos y haciendo partícipes a los progenitores en la toma de decisiones(AU)

This article aims to provide a clinical practice guideline on perinatal management in fetuses/neonates at the threshold of viability (below a gestational age of 256/7 weeks). We reviewed the main literature published in the last few years. On the basis of outcomes in morbidity and mortality in our hospital and consensus with neonatologists, we established a management protocol in our center. We propose a protocol in which, gestational age or, in its absence, birth weight are used to determine the kind of prenatal care provided, the need for neonatal transport, use of prenatal corticosteroids, mode of delivery and neonatal resuscitation. This protocol is applied in close collaboration with neonatologists and with parents’ participation in the decision to treat(AU)

Neuroprotección antenatal en recién nacidos pretérmino. Propuesta de un centro terciario / Prenatal neuroprotection in preterm neonates. A proposal made by a tertiary hospital

Diversos trabajos publicados en últimos años apoyan que el uso del sulfato de magnesio como neuroprotector antenatal administrado ante la inminencia de un parto pretérmino reduce el riesgo de padecer severas secuelas neurológicas en los recién nacidos. Guías clínicas de actuación de diversos países apoyan la instauración de estos tratamientos neuroprotectores. En nuestro trabajo haremos una revisión del problema, de la bibliografía al respecto y realizaremos una propuesta metódica de un protocolo de neuroprotección dirigido a intentar reducir la morbilidad neurológica de los nacidos pretérmino con una terapia que ya ha demostrado su efectividad. Al mismo tiempo, invitamos a diferentes hospitales a sumarse a nuestra propuesta aportando elementos de mejora y participando en estudios multicéntricos que nos permitan evaluar en un tiempo razonable los resultados de esta actuación cotejándolos con los publicados hasta ahora en la literatura (AU)

Several recent studies provide evidence that the use of magnesium sulfate as a prenatal neuroprotector administered in imminent preterm delivery reduces the risk of severe neurologic sequelae in newborns. Clinical guidelines from various countries support the implementation of these neuroprotective therapies. The present study provides a review of the problem and of the pertinent literature and describes a protocol for neuroprotection that attempts to reduce neurological morbidity in preterm newborns by using a treatment with proven effectiveness. At the same time we invite other hospitals to join our proposal, contribute improvements, and participate in multicenter studies that would allow us to evaluate in a timely manner the results of this protocol by comparing them with data published in the literature (AU)

Incidence and costs of multifetal pregnancies in Andalusia (2000-2010).

In the past 50 years the incidence of multiple pregnancies has increased dramatically due almost exclusively to two factors: delayed childbearing and assisted reproductive techniques. In this paper we analyze the variations in the incidence of multiple gestations in Andalusia, one of the biggest administrative regions in Spain, over the last decade. Assisted reproduction techniques are very often evaluated only in terms of implantation and pregnancy rates per cycle, ignoring everything related to complications of multiple births, prematurity or economic overload. The rate of twins in Andalusia has increased from 10.9 per thousand in 2000 to 16.2 per thousand in 2009. The rate of triplet births has also increased in recent years. After a decline in 2003, motivated by promulgation of the first Human Assisted Reproduction Law, there was an increase after a second law came into effect in 2006. Health care spending attributable to the excess of multiple pregnancies reported in the decade 2000-2010 may have been much higher than € 25 million.

Surface chemistry and interfacial charge-transfer mechanisms in photoinduced oxygen exchange at O2-TiO2 interfaces.

Experimental results obtained over the last three decades on photoinduced oxygen isotopic exchange (POIE) of TiO2 oxygen atoms with those of adsorbed water molecules and gaseous O2 are analyzed in the light of recent information from the literature on the interaction of water and O2 species with the TiO2 surface (obtained by application of surface spectroscopy techniques in combination with high-resolution scanning tunnelling microscopy). The analysis emphasizes the singular role that bridging oxygen ions and bridging oxygen vacancies play in TiO2 surface chemistry and interfacial electron transfer at the gas phase-TiO2 interface in the absence and presence of water. The observed competition between POIE and the photo-oxidation (PO) of organic compounds is analyzed in terms of the recently developed direct-indirect (D-I) kinetic model for heterogeneous photocatalysis (D. Monllor-Satoca et al., Catal. Today, 2007, 129, 247, and references therein).

Life cycle assessment of solar photo-Fenton and solar photoelectro-Fenton processes used for the degradation of aqueous α-methylphenylglycine.

A comparative Life Cycle Assessment (LCA) of solar photo-Fenton and solar photoelectro-Fenton, two solar-driven advanced oxidation processes (AOPs) devoted to the removal of non-biodegradable pollutants in water, is performed. The study is based on the removal, at laboratory scale, of the amino acid α-methylphenylglycine, a good example of soluble and non-biodegradable target pollutant. The system under study includes chemicals, electricity, transport of all raw materials to the plant site, and the generation of emissions, but it does not take into account the impact of the infrastructure needed to build a hypothetical solar plant. Nine environmental impact categories are included in the LCA: global warming potential, ozone depletion potential, aquatic eutrophication potential, acidification potential, human toxicity potential, photochemical ozone formation potential, fresh water aquatic ecotoxicity potential, marine aquatic ecotoxicity potential, and terrestrial ecotoxicity potential and abiotic resource depletion potential. Although previous experimental results show that both AOPs are able to efficiently degrade the pollutant, the LCA indicates that solar-driven photo-Fenton is the most environmentally friendly alternative, mainly because the use of electricity in solar photoelectro-Fenton experiments involves high environmental impacts.