Assessment of the efficacy of a Crisis Intervention Team (CIT): experience in the Esplugues Mental Health Center (Barcelona).

AIM: Crisis Resolution Teams (CRT) have shown positive clinical and service-use results in various countries but evidence in the south of Europe is scarce. The aim is to assess the impact of the Crisis Intervention Team (CIT) in Spain with respect to the course of symptomatology and mental health services use in patients served. METHODS: Prospective observational cohort study. Assessment of the psychopathological severity (HoNOS scale) of the clinical course (CGI scale) and use of medical services. RESULTS: A positive clinical course was observed following the intervention. The mean difference in HoNOS (Health of the Nation Outcome Scales) scores between baseline and discharge was 7 points (p < 0.05). On discharge, more than 60% of patients had improved their symptomatology according to the CGI scale (Clinical Global Impression) and most were discharged due to improvement or goal achievement. A tendency to reduction in the number of admissions to acute units and day hospital was observed, along with fewer emergency room visits. In contrast, an increase in the number of admissions to subacute units was seen. During the intervention, the median number of visits to the center was 15 and the median duration of care provision by the CIT was 39 days. CONCLUSIONS: The CIT intervention promotes patients' clinical improvement and has a positive impact in terms of reducing acute hospitalizations and emergency room visits.

The Influence of Green Entrepreneurship on Sustainable Development in Saudi Arabia: The Role of Formal Institutions.

This study explores the influence of green entrepreneurial activity on sustainable development, using institutional economics as a theoretical framework. Also, the role of entrepreneurship policy is analysed in the context of Saudi Arabia. Using information from the General Authority for Statistics from 13 Saudi Arabian cities, the main findings show that green entrepreneurship positively contributes to the economic, social, and environmental components of sustainable development during the period 2012-2017. These results demonstrate a measurable indication of sustainable development outcomes, whereby Saudi Arabian institutions align entrepreneurial activities with a positive triple bottom line effect. Accordingly, these findings contribute new evidence to justify government commitment to supporting green entrepreneurship in Saudi Arabia and encourage future domestic policies.

Identification of PARP-1 in cancer stem cells of gastrointestinal cancers: A preliminary study.

Advanced-stage gastrointestinal tumors have high mortality due to chemotherapy limitations. One of the causes of treatment failure is the presence of cancer stem cells (CSCs), which show resistance mechanisms against DNA damage, such as poly (adenosine diphosphate-ribose) polymerase 1 (PARP-1). However, little is known about the relevance of PARP-1 in these tumor cells. Our purpose is to analyze the expression of PARP-1 in cancer cells and CSCs from gastrointestinal tumors, its relationship with the DNA damage repair process and its modulation by cytotoxic and PARP-1 inhibitors. We used pancreatic, liver and colon cancer cell lines and isolated CSCs using Aldefluor technology to analyze PARP-1 expression. In addition, we examined the effect of classic cytotoxic drugs (Doxorubicin, Gemcitabine, Irinotecan and 5-Fluorouracil) and a PARP-1 inhibitor (Olaparib) in cultured cells and 3D tumorspheres. We demonstrated that PARP-1 is highly expressed in pancreatic, liver and colon tumor cells and that this expression was significantly higher in cell populations with CSC characteristics. In addition, Doxorubicin and Gemcitabine increased their cytotoxic effect when administered simultaneously with Olaparib, decreasing the formation of 3D tumorspheres. Our findings suggest that PARP-1 is a common and relevant resistance mechanism in CSCs from gastrointestinal tumors and that the use of PARP-1 inhibitors may be an adjuvant therapy to increase apoptosis in this type of cells which are responsible to cancer recurrence and metastasis.

Conservative management of femoroacetabular impingement (FAI) in professional basketball

Femoroacetabular impingement (FAI) is a common injury in basketball, having a difficult therapeutic approach because it requires an extended period of time to be resolved once it appears. Therefore, preventing the onset of this condition seems critical in maintaining athletes' health, and availability to compete. Because reducing training and competition volume in a professional team context is complex, the exercises presented here offer a good option for managing injured players without compromising their availability during the season. However, offseason and preseason periods are key to developing, protecting and strengthening the injured joint and its functionality for the competitive season

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Grado de implementación de actividades preventivas por parte de los médicos residentes de Medicina Familiar y Comunitaria en las consultas de Atención Primaria / Implementation of preventive activities by family and community medicine residents in primary care clinics

ObjetivoDeterminar el grado en que los médicos residentes de medicina familiar y comunitaria realizan actividades preventivas durante su estancia en el centro de salud, así como estimar el tiempo empleado en llevarlas a cabo.DiseñoEstudio observacional, descriptivo y transversal.EmplazamientoCentros de salud docentes de los distritos de atención primaria de Córdoba (centro) y Guadalquivir.ParticipantesCuarenta médicos residentes y 384 entrevistas clínicas realizadas con pacientes que acuden a la consulta.Mediciones principalesTres médicos residentes videograban y visualizan las consultas que registran las actividades preventivas efectuadas según las recomendaciones del Programa de Actividades Preventivas y de Promoción de la Salud del año 2005 y el tiempo empleado en cada entrevista en llevar a cabo estas actividades.ResultadosEn el 72,1% de las consultas (IC del 95%: de 67,6 a 76,5) no se realiza ninguna actividad preventiva. Las actividades más frecuentes son las de prevención secundaria (70,1%), destaca en primer lugar la toma de la presión arterial (8,1%). El tiempo medio por consulta en aquéllas en las que no se realizan actividades preventivas es de 5,6min (DE=3,1), mientras que en las que sí se realizan es de 7,04 (DE=3,05) (p<0,0001).ConclusionesLa realización de actividades preventivas por parte de los médicos residentes en las consultas de atención primaria es muy escasa. Una consulta que incluya actividades preventivas requiere de un tiempo significativamente mayor que una que no las incluya(AU)

ObjectiveTo determine the level of preventive activities carried out by Family and Community Medicine medical residents during their stay in the Health Centre, as well as to estimate the time involved in carrying them out.DesignCross-sectional, descriptive, observational study.SettingTeaching Health Centres in the Central- Cordoba and Guadalquivir Primary Care Districts.ParticipantsForty medical residents and 384 clinical interviews with patients who were seen at the clinic.Main measurementsThe consultations were video recorded and looked at by three medical residents who recorded the preventive activities carried out according to the 2005 PAPPS (Health Promotion and Disease Prevention Activities) recommendations, as well as the time employed in performing these activities.ResultsNo preventive activities were performed in 72.1% (95% CI: 67.6 to 76.5%) of the consultations. The most frequent activities were secondary prevention (70.1%), mainly the taking of blood pressure (8.1%). The mean consultation time when there were no preventive activities carried out was 5.6min (SD=3.1), whilst in those that did perform them it was 7.04min (SD=3.05) (P<0.0001).ConclusionsThe performing of preventive activities by medical residents in Primary Care clinics is very limited. A consultation that includes preventive activities requires a significantly longer time than in those that do not include them(AU)

[Implementation of preventive activities by family and community medicine residents in primary care clinics]. / Grado de implementación de actividades preventivas por parte de los médicos residentes de Medicina Familiar y Comunitaria en las consultas de Atención Primaria.

OBJECTIVE: To determine the level of preventive activities carried out by Family and Community Medicine medical residents during their stay in the Health Centre, as well as to estimate the time involved in carrying them out. DESIGN: Cross-sectional, descriptive, observational study. SETTING: Teaching Health Centres in the Central- Cordoba and Guadalquivir Primary Care Districts. PARTICIPANTS: Forty medical residents and 384 clinical interviews with patients who were seen at the clinic. MAIN MEASUREMENTS: The consultations were video recorded and looked at by three medical residents who recorded the preventive activities carried out according to the 2005 PAPPS (Health Promotion and Disease Prevention Activities) recommendations, as well as the time employed in performing these activities. RESULTS: No preventive activities were performed in 72.1% (95% CI: 67.6 to 76.5%) of the consultations. The most frequent activities were secondary prevention (70.1%), mainly the taking of blood pressure (8.1%). The mean consultation time when there were no preventive activities carried out was 5.6 min (SD=3.1), whilst in those that did perform them it was 7.04 min (SD=3.05) (P<0.0001). CONCLUSIONS: The performing of preventive activities by medical residents in Primary Care clinics is very limited. A consultation that includes preventive activities requires a significantly longer time than in those that do not include them.

Adicción a la gabapentina / Gabapentin abuse

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Simultaneous bilateral fracture of femoral neck in elderly patients: report on two cases.

Bilateral fractures of the femoral neck are very rare. We report two cases of elderly patients with simultaneous and bilateral femoral neck fractures.