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1.
J Marital Fam Ther ; 50(2): 495-507, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38356121

RESUMO

The aims of the current study are to describe the basic family relationships, parental bonding patterns, and dyadic adjustment of families with offspring diagnosed with borderline personality disorder (BPD) and to explore the correlations between these variables related to family relations and BPD symptomatology. The sample consisted of 194 participants, including parents from the control (N = 76) and clinical group (N = 76), and patients with BPD (N = 42). All progenitors completed a measure of family relations, parental bonding, and dyadic adjustment. Patients completed a measure of parental bonding and borderline symptomatology. The results showed significant differences between both groups in marital and parental functioning, marital satisfaction, dyadic adjustment, and care. Correlations among family variables and BPD symptomatology were also found. In summary, findings underscore the significance of comprehending the complexity of family relationships in BPD while advocating for a relational perspective when examining the family dynamics.


Assuntos
Transtorno da Personalidade Borderline , Humanos , Transtorno da Personalidade Borderline/diagnóstico , Relações Familiares , Pais , Apego ao Objeto
2.
Gastroenterol. hepatol. (Ed. impr.) ; 45(10): 805-818, dic. 2022. tab
Artigo em Espanhol, Português | IBECS | ID: ibc-211885

RESUMO

Los pacientes con enfermedad inflamatoria intestinal (EII) pueden requerir diferentes tratamientos inmunosupresores a lo largo del curso de su enfermedad. Por ello, es fundamental evaluar el estado de inmunización en el momento del diagnóstico o, si no es posible, siempre antes de iniciar un tratamiento inmunosupresor, y administrar las vacunas apropiadas. El objetivo del presente documento es establecer unas recomendaciones claras y concisas sobre la vacunación en pacientes con EII en diferentes escenarios de práctica clínica, incluyendo situaciones especiales como la vacunación en la edad pediátrica, el embarazo, la lactancia o en viajes al extranjero. Se presentan las diferencias entre vacunas inactivadas y atenuadas, los diferentes grados de inmunosupresión y su relación con las pautas de administración de las diferentes vacunas (tanto obligatorias como opcionales) recomendadas a los pacientes con EII. En el documento, se establecen 17 recomendaciones basadas en la evidencia científica disponible y opinión de expertos. En la elaboración de estas recomendaciones del Grupo Español de Trabajo en Enfermedad de Crohn y Colitis Ulcerosa ha participado un equipo multidisciplinar con amplia experiencia en EII y vacunación formado por especialistas de gastroenterología, pediatría, enfermería y farmacia.(AU)


Patients with inflammatory bowel disease (IBD) may require different immunosuppressive treatments throughout their illness. It is essential to assess the immunization status of patients at diagnosis or, if this is not possible, at least before the beginning of immunosuppressive therapy and, subsequently, administering the appropriate vaccines. Therefore, the aim of this work is to establish clear and concise recommendations on vaccination in patients with IBD in the different settings of our clinical practice including vaccination in children, during pregnancy, breastfeeding or on trips. This consensus document emphasises the differences between inactivated and attenuated vaccines and the different degrees of immunosuppression and correlates them with the administration of both mandatory and optional vaccines recommended to our patients with IBD. Finally, as a summary, 17 recommendations are established based on the available scientific evidence and expert opinion. A multidisciplinary team with extensive experience in IBD and vaccination, made up of specialists in gastroenterology, paediatrics, nursing and pharmacy, has participated in the preparation of these recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis.


Assuntos
Humanos , Doença de Crohn , Colite Ulcerativa , Pacientes , Programas de Rastreamento , Prevenção de Doenças , Infecções , Doenças Inflamatórias Intestinais , Gastroenterologia , Gastroenteropatias
3.
Gastroenterol Hepatol ; 45(10): 805-818, 2022 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35577225

RESUMO

Patients with inflammatory bowel disease (IBD) may require different immunosuppressive treatments throughout their illness. It is essential to assess the immunization status of patients at diagnosis or, if this is not possible, at least before the beginning of immunosuppressive therapy and, subsequently, administering the appropriate vaccines. Therefore, the aim of this work is to establish clear and concise recommendations on vaccination in patients with IBD in the different settings of our clinical practice including vaccination in children, during pregnancy, breastfeeding or on trips. This consensus document emphasises the differences between inactivated and attenuated vaccines and the different degrees of immunosuppression and correlates them with the administration of both mandatory and optional vaccines recommended to our patients with IBD. Finally, as a summary, 17 recommendations are established based on the available scientific evidence and expert opinion. A multidisciplinary team with extensive experience in IBD and vaccination, made up of specialists in gastroenterology, paediatrics, nursing and pharmacy, has participated in the preparation of these recommendations of the Spanish Working Group on Crohn's Disease and Ulcerative Colitis.


Assuntos
Colite Ulcerativa , Doença de Crohn , Doenças Inflamatórias Intestinais , Gravidez , Feminino , Humanos , Criança , Colite Ulcerativa/tratamento farmacológico , Doença de Crohn/tratamento farmacológico , Doenças Inflamatórias Intestinais/tratamento farmacológico , Imunossupressores/efeitos adversos , Vacinação , Doença Crônica
4.
Clin Child Psychol Psychiatry ; 27(1): 157-176, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34875884

RESUMO

The aim of this study was to explore the impact of the coronavirus pandemic on adolescents diagnosed with Borderline Personality Disorder (BPD) and their mothers. This exploratory study used a qualitative focus group approach. This study's sample group consisted in nine participants: five adolescents diagnosed with BPD and their four mothers. Patients were recruited from a specialized BPD outpatient unit of a university hospital psychiatry department. The results are divided into two main areas, the first regarding the lockdown period and the second examining the period of gradual relaxation of lockdown restrictions. The results show that the adolescents had difficulties in the management of their interpersonal relationships, especially in striking a balance between individual and family space, as well as in communication, cohesion, and family dynamics. During the COVID lockdown, adolescents experienced a stabilization of psychopathological symptoms, but these symptoms worsened when the lockdown restrictions were lifted. Nevertheless, they reported having learned and implemented self-care strategies. The findings are discussed in terms of both individual and family impact, shedding light on some of the challenges precipitated by the COVID-19 pandemic.


Assuntos
Transtorno da Personalidade Borderline , COVID-19 , Adolescente , Controle de Doenças Transmissíveis , Feminino , Grupos Focais , Humanos , Mães , Pandemias , SARS-CoV-2
5.
Community Ment Health J ; 56(7): 1262-1268, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32080779

RESUMO

The aim of the current study is to describe and explore basic family relations, parental bonding, and dyadic adjustment in families with offspring diagnosed with a psychotic disorder. The sample was made up of 120 participants, 60 in the clinical group (GCL) and 60 in the comparison group (GCP). All participants were assessed using the basic family relations evaluation questionnaire (CERFB), the parental bonding instrument (PBI), and the dyadic adjustment scale (DAS). The results showed differences between the clinical and comparison groups in terms of perceptions of basic family relations, dyadic adjustment and parental bonding. The clinical group recorded less favorable results for all of these variables. More specifically, the study observed significant differences between the groups in parental function, overprotection and caring. This study deepens our understanding of how family assessment and relational diagnoses can serve as prevention and intervention tools for families affected by a psychotic disorder.


Assuntos
Relações Familiares , Transtornos Psicóticos , Humanos , Apego ao Objeto , Relações Pais-Filho , Poder Familiar , Pais
6.
Eur J Drug Metab Pharmacokinet ; 36(1): 25-33, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21347736

RESUMO

The use of tacrolimus is complicated by its narrow therapeutic index and wide intra- and interpatient variability. We have previously described a tacrolimus population pharmacokinetics model obtained in an adult kidney transplant cohort. The aims of the present study were (1) to validate that model using an external dataset and (2) to evaluate the prediction using a Bayesian method. Data were retrospectively collected from 34 adult patients receiving kidney transplantation. Trough blood concentrations of tacrolimus were predicted using the empirical Bayesian method with sparse samples obtained during the previous week. The system performance was evaluated by the mean prediction error (ME), mean absolute prediction error (MAE). and root mean square error (RMSE). Patients were administrated oral or intravenous tacrolimus as part of a triple immunosuppressive regimen with mycophenolate mofetil and corticosteroids. Subsequent doses were adjusted on the basis of clinical evidence of efficacy and toxicity and by routine therapeutic drug monitoring. In our previous model, clearance increased with post transplantation days and with prednisone dosage. Concentrations predicted by the population mean pharmacokinetic parameter values match well with observed concentrations during oral therapy. Bayesian prediction using trough concentrations obtained after 21 days of treatment significantly decreased ME, MAE, and RMSE compared with predictions from data including this period. After 21 days of treatment, there was an insignificant bias ME (0.22 ± 2.59 ng/ml), a reasonable precision MAE (1.97 ± 1.69 ng/ml) and RMSE (1.28 ± 0.58 ng/ml). The present study demonstrates the suitability of the Bayesian method for the prediction of trough blood concentrations of tacrolimus using only few samples in adult kidney transplantation recipients.


Assuntos
Imunossupressores/sangue , Transplante de Rim , Tacrolimo/sangue , Adulto , Idoso , Teorema de Bayes , Citocromo P-450 CYP3A/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polimorfismo Genético
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