ABSTRACT
Complications in hemodialysis patients are increasingly rare thanks to advances in technology, including more compatible membranes, more flexible lines, safety in water treatments, alarms in the circuit, and standardization in dialysate fluids plus exhaustive chemical and microbiological tests. In addition, it is highly unusual having hemolysis on hemodialysis; however, it is a life-threatening complication, so the cause must be identified and early managed. The etiology can be chemical or mechanical; however, so far, there are no reports in the literature of an association with severe stenosis of the vena cava, as it is described in the case reported here, where a patient presented hemolysis in two hemodialysis sessions, without initially being possible to find the cause; the only identifiable factor was that he had a dysfunctional tunneled jugular catheter, with a history of difficult vascular access. The patient underwent interventional radiology, finding 99% stenosis of the vena cava, which prevented the passage of the contrast agent to the atrium. Angioplasty and catheter replacement were performed, with a resolution of the complication; the subsequent dialysis therapies were satisfactory.
ABSTRACT
Selection of elderly patients (aged ≥60 years) for intensive chemotherapy treatment of acute myeloblastic leukaemia (AML) remains challenging. Several cooperative groups such as Acute Leukaemia French Association (ALFA), Haematological Oncology Clinical Studies Group (HOCSG) and MD Anderson Cancer Center (MDACC) have developed predictive models to select those patients who can benefit from intensive chemotherapy. Our purpose is to validate and compare these three models in a cohort of patients treated in real-life setting. For this, a total of 1724 elderly AML patients and treated with intensive chemotherapy regimens were identified in the PETHEMA registry. Median age was 67.2 years (range, 60-84,9) and median overall survival [OS] 9 months (95 % confidence interval [CI], 8.2-9.7). Taking into account the ALFA group's model, patients likely to benefit from intensive chemotherapy had longer OS (14 months, 95 % CI 12.3-15.7) than those unlikely to benefit (5 months, 95 % CI 4.1-5.9; p < 0.001). Significant differences in OS were observed between patients with favourable risk (17 months, 95 % CI 13.2-20.7), intermediate risk (11 months, 95 % CI 9.3-12.6) and adverse risk (6 months, 95 % CI 5.1-6.4; p < 0.001) according to the HOCSG model. No significant differences in OS were observed between patients with 0, 1, 2 or ≥3 points according to the MDACC model. However, when patients with ≥1 point were compared with those with 0 points, median OS was significantly longer in the latter [15 months (95 % CI 12.1-17.8) vs 7 (95 % CI 5.7-8.5)]. This retrospective study validates predictive models proposed by the ALFA, HOCSG and MDACC groups in this real-life cohort.
ABSTRACT
The objective of this study was to measure the effects of a 90-day mindful rational living (MRL) program on the experience of destructive emotions-anger, anxiety, depression, guilt-among a normal population in a pilot trial. The MRL program combines mindfulness meditation techniques with rational emotive behavior therapy (REBT) strategies. Participants were 17 adults who completed the MRL program. Participants completed pre- and post-intervention assessments, which included scales measuring anger, anxiety, depression, guilt, rumination, shame, and subjective happiness. As hypothesized, participants showed significant decreases in anger, rumination, anxiety, depression, and shame after participating in the MRL program. There were no significant increases in subjective happiness. Findings from this pilot study provide preliminary support for the potential utility of interventions that combine mindfulness meditation with REBT strategies and can be used as the basis of future studies.
ABSTRACT
La violencia de género cometida contra las mujeres por parte de sus parejas o exparejas es una lacra que azota a todas las sociedades con unas consecuencias terribles, especialmente para la salud física y emocional de las víctimas. Debido a la complejidad de este tipo de maltrato y la magnitud de sus consecuencias, las mujeres víctimas de violencia de género requieren de una atención integral, multidisciplinar y especializada. Con el objetivo de atender a las víctimas de violencia de género, el Gobierno Autónomo Municipal de La Paz (Bolivia) a través de los Servicios Legales Integrales Municipales (SLIM), comenzó a implementar un programa de atención terapéutica para víctimas de violencia de género el año 2014, siendo el primero de toda Bolivia en ofrecer este servicio de terapia psicológica a mujeres víctimas de malos tratos por parte de sus parejas o exparejas. Este trabajo analiza los primeros dos años de la implementación del programa terapéutico con el objetivo de mejorar el servicio y concienciar de su necesidad a toda la sociedad, especialmente al personal responsable de la administración de Bolivia, de manera que el programa de atención terapéutica a mujeres víctimas de violencia de género se amplíe y pueda ser replicado en los diferentes departamentos del país
Gender based violence committed against women by their current partners or former partner is a scourge that plagues all societies with terrible consequences, especially for the victim´s physical and emotional health. Due the complexity of this type of abuse and the magnitude of its consequences, women victims of gender violence require comprehensive, multidisciplinary and specialized care. The Municipal Autonomous Government of La Paz (Bolivia), with objective of assisting victims of gender violence, through the Municipal Integrated Legal Services (SLIM), in 2014 began the implementation of a therapeutic care program for victims of gender based violence, being the first in all Bolivia to offer this psychological therapy service to women victims of abuse by their current partners or former partners. This paper analyzes the first two years of the implementation of the therapeutic program with the aim of improving the service and making society aware of its need, especially for the personnel responsible of this subjects, so that the program of therapeutic care for women Victims of gender based violence is expanded and can be replicated in other parts of Bolivia
