Self-assembled gelatin-ι-carrageenan encapsulation structures for intestinal-targeted release applications.

In this work, natural biopolymeric encapsulation structures were developed through the self-assembly of gelatin and ι-carrageenan in aqueous solutions. The interactions of this binary system and of a ternary system containing a polyphenol-rich extract were deeply explored for the development of intestinal delivery systems. The processing of the structures (extrusion vs. freeze-drying) greatly influenced release properties, explained by the specific interactions between gelatin and polyphenols, thus allowing for tuning the processing conditions depending on the desired target application. Release was further controlled by incorporating a divalent salt, giving raise to extract-loaded ι-carrageenan/gelatin capsules with adequate release profiles for intestinal targeted delivery. These results demonstrate the potential of exploiting biopolymer interactions for designing bioactive delivery systems using environmentally friendly processes which do not involve the use of toxic or harsh solvents or cross-linkers.

Quantification of HBsAg to predict low levels and seroclearance in HBeAg-negative patients receiving nucleos(t)ide analogues.

BACKGROUND: HBeAg-negative chronic hepatitis B patients require long-term nucleos(t)ide analogues(NAs) because loss of surface antigen (HBsAg) is unusual. Low quantitative HBsAg (qHBsAg) levels can identify patients with higher probability of seroclearance. The aim of our study was to evaluate qHBsAg in HBeAg-negative patients receiving NAs to predict a reduction of HBsAg levels and seroclearance. METHODS: Retrospective analysis of qHBsAg in HBeAg-negative patients before and at years 1, 3, 5, 8 and over of NAs treatment. RESULTS: From 1999 to 2015, HBsAg was quantified in 358 serum samples from 95 HBeAg-negative patients. Low qHBsAg (<120 IU/mL) was identified at baseline or during follow-up in 14% of patients and HBsAg loss in 4%. No baseline variables predicted seroclearance and only treatment duration predicted low qHBsAg. The annual decline of qHBsAg was -0.102 log IU/mL and the median time to HBsAg loss was 6.04 years. The decline was greater in patients achieving low HBsAg levels (-0.257) than in those who did not (-0.057)(p<0.001). The diagnostic accuracy (ROC curve, 95%CI) of qHBsAg delta at year 3 was 0.89 (0.81-0.97), with cut-off >0.3 log IU/mL showing a positive and negative predictive value of 42% and 100% to identify patients achieving low levels of HBsAg. CONCLUSIONS: Reduction of qHBsAg is slow in HBeAg-negative patients receiving NAs, although low levels or faster qHBsAg decline may occur in 14%. A qHBsAg reduction >0.3 log IU/mL at year 3 can identify patients with a higher probability of achieving low levels and HBsAg seroclearance.

Psicoterapia relacional del Trastorno Límite de Personalidad - Parte II / Relational psychotherapy of borderline personality disorder, II

El presente artículo constituye la segunda parte de dos artículos dedicados a la psicoterapia relacional del trastorno límite de personalidad. En el artículo se describen los métodos relacionales de tratamiento y las distintas dimensiones en la relación terapéutica que ayudan a reintegrar los aspectos escindidos o disociados de la personalidad, entre ellas la implicación del terapeuta, la sintonía con el paciente, la indagación multidimensional de la experiencia de éste, el abordaje relacional de la transferencia y la contratransferencia. El objetivo del tratamiento es reparar los aspectos deficitarios del self, mejorar la contención de los afectos, estabilizar las relaciones afectivas y reducir la impulsividad mediante la resolución del sistema relacional escindido del paciente (AU)

The current article is the second part of two devoted to relational psychotherapy in borderline personality disorders. The relational methods of treatment are described and also different dimensions of therapeutic relationship that help to reintegrate split or dissociated fragments of personality, among others therapist involvement, attunement to the patient, multidimensional inquiry and a relational approach to transferential and counter transferential reactions. The goal or treatment is to repair deficits of self experience, to improve emotional regulation, to establish affective relationships and to reduce impulsiveness by means of integration of the split relational system of the patient (AU)

Psicoterapia relacional del Trastorno Límite de Personalidad - Parte I / Relational psychotherapy of borderline personality disorder

El presente artículo constituye la primera parte de dos artículos dedicados a la Psicoterapia Relacional del Trastorno límite de personalidad. A pesar de que muchos modelos de psicoterapia entienden que las relaciones con personas significativas forman la base de la personalidad, no todos conciben la relación terapéutica como la herramienta fundamental del cambio personal. En el presente artículo, se describen en primer lugar los presupuestos básicos del Movimiento relacional que ha aproximado numerosas corrientes de psicoterapia. Posteriormente, se resumen las aportaciones de los principales autores que han realizado avances significativos en el tratamiento psicoterapéutico del trastorno límite de personalidad. La última parte describe los principios básicos de una psicoterapia relacional de este trastorno utilizando un abordaje que prima la relación como eje vertebral del tratamiento y la implicación y sintonía del terapeuta (AU)

The current article is the first part of two devoted to Relational Psychotherapy in Borderline Personality disorders. Although a lot of Psychotherapy models support the idea that meaningful relationships in childhood with significant people are at the base of personality development not all think about therapeutic relationship as the main tool to achieve personal change. In this article the basic principles of Relational movement, one that is currently helping different psychotherapy schools to get closer, are described. Then the development of meaningful approaches to Borderline Personality Disorder psychotherapy is summarized. The last part presents the basic principles of a Relational Psychotherapy of these disorders with an approach which underlines therapeutic relationship and the involvement and attunement of psychotherapist as the core of treatment (AU)

Drug-drug interactions of telaprevir and boceprevir in HCV-monoinfected and HIV/HCV-coinfected patients can modify the adherence.

BACKGROUND & AIMS: The first generation protease inhibitors, boceprevir (BOC) and telaprevir (TVR), are both CYP3A4 inhibitors, which predispose drug-drug interactions (DDIs). The aim of this study was to evaluate the prevalence of potential DDIs, the management of outpatient medication and its impact on adherence and efficacy to antiviral treatment in hepatitis C virus (HCV)-monoinfected and human immunodeficiency virus (HIV)/HCV-coinfected patients receiving BOC and TVR. METHODS: The usual medication starting with BOC or TVR was screened by the pharmacist of the multidisciplinary support programme (MSP) for potential DDIs. Recommendations were made to avoid significant DDIs, and changes in the baseline medication were recorded. Adherence to antiviral treatment was considered as 80/80/95% of total doses. Sustained virological response was assessed at week 12 (SVR12). RESULTS: At least one potential DDI was found in 70 (64.8%) patients, 45 (54.2%) being HCV-monoinfected and 25 (100%) HIV/HCV-coinfected (P < 0.01). Baseline treatment modifications were required in 38 (35.2%) patients. Adherence and SVR12 were higher in patients without DDIs (86.8%) and (67.6%) compared to those with DDIs (62.8%) (P = 0.021) and (47.2%) (P = 0.097) respectively. CONCLUSIONS: More than half of the patients were at risk of presenting DDIs, leading to changes in the baseline medication in one-third of the patients. Drug interactions are frequent in patients with lower adherence.

Psicoterapia de grupo en una unidad de agudos / Group psychotherapy in an acute psychiatric admission ward

Se describe el proceso de puesta en marcha y desarrollo de una terapia de grupo en una Unidad de Agudos (AU)

The starting process and development of a group therapy in an acute-care unit is described (AU)