Tobacco cessation among smokers under substance use treatment for alcohol and/or cannabis: study protocol and pilot study.

BACKGROUND: Approximately 80% of people with a substance use disorder (SUD) are smokers. Starting SUD treatment offers the opportunity to also quit smoking. The ACT-ATAC project aims to identify the predictors associated with smoking cessation among persons treated for alcohol and/or cannabis use disorder in Barcelona. This manuscript reports its methodology and the experience of carrying it out during the COVID-19 pandemic. METHODS: Mixed methods project with three substudies. Substudy 1 (S1) comprises heterogeneous discussion groups among clinicians. S2 has two prospective cohorts composed of smokers under treatment for alcohol and/or cannabis use disorder and the clinicians in charge of these patients. Participating smokers will be followed for 12 months and interviewed about their substance use and the tobacco cessation services received using the Spanish version of the users' Knowledge, Attitudes, and Services (S-KAS) scale. The clinicians will be asked about their self-reported practices in smoking cessation using the Knowledge, Attitudes, and Practices (S-KAP) scale. S3 comprises heterogeneous discussion groups with smokers. Data will be triangulated using qualitative and quantitative analyses. To facilitate the recruitment process, the researchers have introduced several strategies (design clear protocols, set monthly online meetings, extend the project, provide gift cards, etc.). DISCUSSION: The results of S1 were used to develop the questionnaires. S2 required some adjustments due to the COVID-19 pandemic, particularly the follow-up interviews being conducted by phone instead of face-to-face, and the recruitment rhythm was lower than expected. Recruitment will last until reaching at least 200-250 users. The fieldwork could not have been possible without the collaboration of the ACT-ATAC team and the introduction of several strategies. Trial registration The ACT-ATAC project has been successfully registered at Clinicaltrials.gov [NCT04841655].

Rehabilitación neuropsicológica en niños con tumores del sistema nervioso central y lecucemias irradiadas / No disponible

Actualmente la intervención e investigación en psicooncología pediátrica se dirige hacia la evaluación de las consecuencias de la enfermedad y los efectos secundarios de los tratamientos, y a los factores predictivos tanto de desajustes como de aspectos adaptativos a la enfermedad del paciente y de su familia. Las tasas de curación alcanzadas en la actualidad, nos permiten contar con un número considerable de supervivientes de cáncer infantil, susceptibles de ser evaluados y poder determinar así las secuelas a largo plazo de la enfermedad y sus procedimientos terapéuticos. Además de incrementar considerablemente la supervivencia, también se ha mejorado la calidad de vida de los niños, mediante el tratamiento de soporte que amortigua notablemente los efectos secundarios de los tratamientos y su toxicidad, permitiendo de este modo, junto con la intervención temprana de los equipos multidisciplinares, que el niño mantenga continuidad con sus actividades habituales, aún estando en el periodo de tratamiento. Durante la última década, diversos estudios ponen de manifiesto la ausencia de diferencias significativas entre niños enfermos oncológicos, en relación a la población de niños sanos, en cuanto al funcionamiento psicosocial se refiere. No obstante, los pacientes afectos de tumores cerebrales y leucemias u otros tumores que han recibido quimioterapia intratecal y/o irradiación cráneo-espinal, constituyen un grupo de riesgo que requiere de una evaluación y un tratamiento específico (AU)

Nowadays, intervention and research in pediatric psychooncology is leading towards evaluation of neoplastic disease and treatment consequences, as well as predictive factors of adaptative aspects related to disease and family. High rates of survival in pediatric oncology imply an important number of pediatric cancer survivors, whose psychological and neuropsychological evaluation is crucial to determine long term sequelae. Quality of survival has also improved considerably due to improvements in supportive treatment along years, decreasing acute side effects. This fact as well as early intervention by multidisciplinary teams let the child continue his/her daily activities, even during oncologic treatment. In the last decade, several studies have shown the absence of significative differences between cancer patients and their peers, as far as social functioning is concerned. Nevertheless, patients with brain tumors and leukemias treated with radiotherapy/intrathecal chemotherapy are a risk group that required a specific evaluation and treatment (AU)

Instrumentos y procedimientos en evaluación neuropsicológica en niños oncológicos con riesgo de desarrollar deficits cognitivos / No disponible

En los últimos años el número de supervivientes del cáncer infantil ha aumentado considerablemente, esto ha permitido conocer las secuelas derivadas de la enfermedad y de sus tratamientos. Diversos estudios han demostrado como la afectación de la sustancia blanca y gris por radioterapia y quimioterapia, y la localización del tumor, provocan diversas secuelas cognitivas y conductuales en estos niños. El objetivo del presente trabajo pretende dar a conocer los instrumentos y procedimientos más utilizados en la exploración neuropsicológica infantil. Puesto que en los niños los déficit pueden no aparecer hasta pasados varios años, planteamos la necesidad de realizar estudios neuropsicológicos amplios y de seguimiento que permitan conocer estas secuelas tanto a corto, medio y largo plazo (AU)

Among the last years the survivor’s number of childhood cancer has increased considerably, this has allowed to know the consequences resulting from the disease and its treatments. Several studies have prooved how the involvement of white and gray matter radiotherapy and chemotherapy, and tumor location, lead to various cognitive and behavioral sequelae in these children. The aim of this paper seeks to highlight the instruments and procedures used in the neuropsychological examination of children. Because deficits in children may not appear until several years, that increases the need for extensive neuropsychological studies and monitoring that reveal these consequences in short, medium and long term (AU)

Caso clínico: síndrome opsoclonus-mioclonus asociado a un neuroblastoma abdominal / No disponible

Opsoclono-ataxia, también llamada “dancing eye sindrome”, es un trastorno neurológico de importancia que a menudo se presenta como una manifestación paraneoplásica de neuroblastoma oculto en la primera infancia. Aunque la supervivencia con tratamiento antitumoral y terapia inmunosupresora es elevada, el resultado general indica importantes secuelas en el desarrollo y en la conducta. Presentamos un caso de una niña diagnosticada a los nueve meses de edad, tratada en nuestra Unidad y que fue derivada a un programa de rehabilitación interdisciplinar y neuropsicológica cuando la niña tenía 4 años de edad (AU)

Opsoclonus-ataxia, also called “dancing eye syndrome,” is a serious neurologic condition that is often a paraneoplastic manifestation of occult neuroblastoma in early childhood. Although survival is high with anti-tumoral treatment and immunosuppressive therapy, outcome generally includes significant developmental and behavioral sequelae. We report a case diagnosed at nine month of age, treated in our Unit and refered for a multidisciplinary neuropsychological rehabilitation when she was 4 year old (AU)

Atención interdisciplinar a las secuelas de la enfermedad y/o tratamientos en oncología pediátrica / Interdisciplinary attention to the sequels of the disease and/or treatments in pediatric oncology

Los avances en la medicina de las últimas décadas han permitido el aumento del número de supervivientes en oncología. La mayor supervivencia ha hecho que sean visibles secuelas, de distinto grado, a corto y largo plazo por la enfermedad y/o tratamientos. Recientes estudios de imagen muestran daño cerebral (afectando de sustancia blanca y gris) tanto por quimio como radioterapia. La patología, tratamientos, edad, sexo modulan el daño cerebral y sus secuelas.Junto con los déficit neuropsicológicos, ampliamente descritos, son frecuentes los problemas motores, actividades de la vida diaria que condicionan a su posterior adaptación escolar, laboral y social. Proponemos la atención y seguimiento interdisciplinar de especialistas en daño cerebral para algunos casos con secuelas más acusadas. La interacción de distintas disciplinas (neuropsicología, neuropediatría, terapia familiar, fisioterapia terapia ocupacional, logopedia…) en estos equipos puede mejorar la calidad de vida de los pacientes y sus familias (AU)

Medical advances in the last decades have increased the cancer survival rate, leading to short-and long term sequelae caused by the disease and/or treatment and with different degrees of severity. Recent imaging studies have shown brain damage (white and grey matter involvement) by chemo- and radiotherapy. Pathology, treatments, age, sex, etc. modulate brain damage and its sequelae. Together with neuropsychological deficit, which has been largely described, motor problems and daily life activities are frequent and determine subsequent social, school and work adaptation. We propose specialist´s interdisciplinary involvement in and follow- up of brain damage in children with more serious sequelae. Interaction of different disciplines (neuropsychology, pediatric neurology, family therapy, physiotherapy, occupational therapy and speech therapy, among others) in these teams can improve quality of life of patients and their families (AU)

Duplication of the Williams-Beuren critical region: case report and further delineation of the phenotypic spectrum.

Only 12 patients with a duplication of the Williams-Beuren critical region (WBCR) have been reported to date, with variable developmental, psychomotor and language delay, in the absence of marked dysmorphic features. In this paper we present a new WBCR microduplication case, which supports the wide variability displayed by this duplication in the phenotype. The WBCR microduplication may be associated with autistic spectrum disorder, but most reported cases do not show this behavioral disorder, or may even show a hypersociable personality, as with our patient. From the present case and a review of the 12 previously described,1(-)6 we conclude that the phenotype associated with duplication of WBCR can affect the same domains as WBCR deletion, but that they cluster near the polar ends of social relationship (autism-like v hypersociability), language (expressive language impairment v "cocktail party" speech), visuospatial (severe v normal), mental retardation (severe v mild) and dysmorphic (severe v mild) features.

Grief support provided to caregivers of palliative care patients in Spain.

Grief support for relatives of patients in palliative care is recognized as a fundamental practice within palliative medicine. The aim of this research was to determine the nature and extent of grief support programs offered to relatives of patients in palliative care in Spain. A postal survey was carried out among members of the Spanish Society of Palliative Care. The members' names were obtained through the Society's 2000 Directory, which lists 160 different teams, of which 50% answered a questionnaire made up of 34 questions, some open-ended and others multiple choice. Results show that 88.6% of the services include grief support, that mainly emotional and one-to-one care is provided (92.4 and 89.9%, respectively), and that the number of psychologists and social workers in each team is limited. The risk factors most commonly taken into account by professionals are: absence of family support (36.92%) and the bereaved's case history (21.54%); while the most widely used diagnostic criteria for complicated bereavement are blame and depression (12.5 and 11.36%). In conclusion, it can be seen that bereavement services are not completely consolidated in Spain and there is a need for a greater variety of intervention strategies.