Genotipificación del gen RHD en ADN fetal libre en plasma de embarazadas RhD negativo / Genotyping of the RHD gene in free fetal DNA in plasma of RhD negative pregnant women

Objetivo: Determinar el grupo RhD fetal a través del estudio del gen RHD en ADN fetal que se encuentra libre en plasma de embarazadas RhD negativo. Método: Se analizó la presencia de los genes RHD, SRY y BGLO en ADNfl obtenido de plasma de 51 embarazadas RhD negativo no sensibilizadas, utilizando una qPCR. Los resultados del estudio genético del gen RHD se compararon con el estudio del grupo sanguíneo RhD realizado por método serológico en muestras de sangre de cordón, y los resultados del estudio del gen SRY fueron cotejados con el sexo fetal determinado por ecografía. Se calcularon la sensibilidad, la especificidad, los valores predictivos y la capacidad discriminativa del método estandarizado. Resultados: El gen RHD estaba presente en el 72,5% de las muestras y el gen SRY en el 55,5%, coincidiendo en un 100% con los resultados del grupo RhD detectado en sangre de cordón y con el sexo fetal confirmado por ecografía, respectivamente. Conclusiones: Fue posible deducir el grupo sanguíneo RhD del feto mediante el estudio del ADN fetal que se encuentra libre en el plasma de embarazadas con un método molecular no invasivo desarrollado y validado para este fin. Este test no invasivo puede ser utilizado para tomar la decisión de administrar inmunoglobulina anti-D solo a embarazadas RhD negativo que portan un feto RhD positivo.

Objective: To determine the fetal RhD group through the study of the RHD gene in fetal DNA found free in plasma of RhD negative pregnant women. Method: The presence of the RHD, SRY and BGLO genes in fetal DNA obtained from plasma of 51 non-sensitized RhD negative pregnant women was analyzed using qPCR. The results of the genetic study of the RHD gene were compared with the RhD blood group study performed by serological method in cord blood samples, and the results of the SRY gene study were compared with the fetal sex determined by ultrasound. Sensitivity, specificity, predictive values and discriminative capacity of the standardized method were calculated. Results: The RHD gene was present in 72.5% of the samples and the SRY gene in 55.5%, coinciding 100% with the results of the RhD group detected in cord blood, and with the fetal sex confirmed by ultrasound, respectively. Conclusions: It was possible to deduce the RhD blood group of the fetus through the study of fetal DNA found free in the plasma of pregnant women with a non-invasive molecular method developed and validated for this purpose. This non-invasive test can be used to make the decision to administer anti-D immunoglobulin only to RhD-negative pregnant women carrying an RhD-positive fetus.

Primary adenocarcinoma at colostomy site: report of a clinical case

Colorectal cancer (CRC) is the fourth most frequently diagnosed cancer in the United States and it is found in 17% of patients thought to have complicated diverticular disease. However, primary adenocarcinoma rarely occur in the colostomy site and the risk of developing malignancy is similar to that of any other colonic segment. Polyps found in CRC screenings can be divided into the following types: hyperplastic polyps, polyps with no malignant potential, adenomatous polyps, polyps with malignant potential, and malignancies. Local complications of the colostomy can appear in the immediate, early, or late postoperative period, with an incidence ranging from 15 to 30%; neoplasia is even less common. (AU)

Nutritional phases of Prader-Willi syndrome. / Fases nutricionales en Síndrome de Prader-Willi.

INTRODUCTION: Prader-Willi Syndrome (PWS) is the most common cause of genetic obesity. Hyperphagia and obe sity are the most associated concepts with this condition. However, undernutrition secondary to severe hypotonia and feeding difficulties is the predominant initial feature. OBJECTIVE: to reprodu ce and communicate the nutritional phases on a series of Chilean cases with PWS. PATIENTS AND METHOD: Cross-sectional study in which clinical records of PWS individuals under nutritional con trol at the Clínica Santa María in Santiago, Chile between 2017 and 2018 were analyzed. The anthro pometric references of the World Health Organization were used to carry out the nutritional as sessment. The classification into nutritional phases was according to the Miller criteria. RESULTS: 24 patients from infants to adults were included. All children aged under 9 months were in phase I and had malnutrition or were eutrophic; those between 9 and 25 months were classified in phase 2a; pa tients between 2.1 and 4.5 years were distributed between phases 1 and 2 and 66% were eutrophic; those between 4.5 to 8 years, 80% were in phase 2a and 2b and obesity begins to appear, and patients over 8 years of age, 75% were in phase 3 and all are overweight or obese. There was an association bet ween nutritional phase and age but not between it and nutritional status. CONCLUSIONS: In our series, the nutritional phases described according to age were reproduced according to those internationally described. There was no association between nutritional status and age.

Efficacy of a two-session repetitive negative thinking-focused acceptance and commitment therapy (ACT) protocol for depression and generalized anxiety disorder: A randomized waitlist control trial.

This parallel randomized controlled trial aimed to evaluate the effect of acceptance and commitment therapy (ACT) focused on disrupting repetitive negative thinking (RNT) versus a waitlist control (WLC) in the treatment of depression and generalized anxiety disorder (GAD). Forty-eight participants with a main diagnosis of depression and/or GAD were allocated by means of simple randomization to a 2-session RNT-focused ACT intervention or to the WLC. The primary outcomes were emotional symptoms as measured by the Depression, Anxiety, and Stress Scales-21. Process outcomes included ACT- and RNT-related measures: general RNT, experiential avoidance, cognitive fusion, values, and generalized pliance. At the 1-month follow-up, linear mixed effects models showed that the intervention was efficacious in reducing emotional symptoms (d = 2.42, 95% confidence interval [1.64, 3.19]), with 94.12% of participants in the RNT-focused ACT condition showing clinically significant change in the Depression, Anxiety, and Stress Scales-21 total scores versus 9.09% in the WLC condition (70% vs. 8% in intention-to-treat analysis). The intervention effects were maintained at the 3-month follow-up. No adverse events were found. A very brief RNT-focused ACT intervention was highly effective in the treatment of depression and GAD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Single-case experimental design evaluation of repetitive negative thinking-focused acceptance and commitment therapy in generalized anxiety disorder with couple-related worry

Young adults suffering from generalized anxiety disorder (GAD) show high levels of worry about different domains, with couple relationships being the most frequent one. Excessive worry in this domain might lead to couple dysfunction, which is associated with lower outcomes of cognitive behavioral therapy. The current study analyzes the effect of an individual, 3-session, acceptance and commitment therapy (ACT) protocol focused on repetitive negative thinking (RNT) in the treatment of GAD with couple relationship as the main worry domain. Three young adults with GAD participated in this study. A delayed multiple-baseline design was implemented. All participants completed a 5 to 7-week baseline without showing improvement trends in couple-related worry (Experiences in Close Relationships -Anxiety; ECR-A) and general pathological worry (Penn State Worry Questionnaire; PSWQ). Afterwards, they received the ACT protocol, and a 3-month follow-up was conducted. All 3 participants showed evidence of intervention effects on the ECR-A and PSWQ. The standardized mean difference effect sizes for single-case experimental design were very large for the ECR-A (g= 5.93) and PSWQ (g= 3.19). No adverse events were found. Brief, RNT-focused ACT protocols for treating GAD with couple relationship as the main worry domain deserve further empirical tests

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Penn State Worry Questionnaire-11 validity in Colombia and factorial equivalence across gender and nonclinical and clinical samples / Validez del Penn State Worry Questionnaire-11 en Colombia y equivalencia factorial a través de género y muestras clínicas y no clínicas

The Penn State Worry Questionnaire (PSWQ) is the gold standard measure of the unspecific worry that characterizes generalized anxiety disorder. This study aims to explore the validity of the PSWQ in Colombia and its measurement invariance across gender and clinical and nonclinical participants. An abbreviated, 11-item version of the PSWQ by Sandín, Chorot, Valiente, and Lostao (2009) was used because the negatively worded items have shown to be problematic for Spanish speakers. Additionally, research has suggested that the negatively worded items of the PSWQ lack of practical utility. The PSWQ-11 was administered to a total of 1045 participants, including a sample of nonclinical participants (N = 710) and a sample of clinical participants (N = 335). The internal consistency of the PSWQ-11 across samples was excellent. The one-factor model showed an acceptable fit to the data. Metric and scalar invariance were observed across gender and clinical and nonclinical samples. In conclusion, the PSWQ-11 seems to be a valid measure of GAD-related worry in Colombia, whereas data on factorial equivalence data warrant the comparison of scores across gender and clinical and nonclinical samples

El Penn State Worry Questionnaire (PSWQ) es la medida principal de la preocupación inespecífica que caracteriza al trastorno de ansiedad generalizada (TAG). Este estudio explora la validez del PSWQ en Colombia y su invarianza de medida entre género y participantes clínicos y no clínicos. Se utilizó la versión abreviada de 11 ítems de PSWQ propuesta por Sandín, Chorot, Valiente y Lostao (2009) porque los ítems redactados negativamente han mostrado ser problemáticos para los hispanohablantes. Adicionalmente, la investigación ha sugerido que los ítems redactados en negativa carecen de utilidad práctica. El PSWQ-11 se administró a un total de 1045 participantes, incluyendo una muestra de participantes no clínicos (N = 710) y una muestra de participantes clínicos (N = 335). La consistencia interna del PSWQ-11 a través de muestras fue excelente. El modelo de un factor mostró un ajuste aceptable a los datos. Se observó invarianza métrica y escalar a través de género y muestras clínicas y no clínicas. En conclusión, el PSWQ-11 parece ser una medida válida de la preocupación tipo TAG, mientras que los datos sobre equivalencia factorial permiten la comparación de puntuaciones a través de género y participantes clínicos y no clínicos

Mindfulness: ¿proceso, habilidad o estrategia? Un análisis desde el análisis del comportamiento y del contextualismo funcional / Mindfulness: processus, compétence ou stratégie ? Étude de l'analyse comportementale et du contextualisme fonctionnel / Mindfulness: processo, habilidade ou estratégia? Estudo a partir da análise comportamental e do contextualismo funcional / Mindfulness: process, skill or strategy? A behavioral-analytic and functional-contextualistic analysis

Los efectos positivos del mindfulness en el tratamiento de múltiples problemas psicológicos en diversas poblaciones han popularizado su uso dentro de la psicología clínica en los últimos años. No obstante, las investigaciones empíricas y revisiones teóricas sobre el mindfulness muestran tres usos diferentes del mindfulness dentro de las aproximaciones conductuales: como proceso, como habilidad y como estrategia. Las discrepancias en las definiciones de mindfulness han generado ambigüedad con respecto a qué y cómo se investiga este fenómeno. En este trabajo se realizó un análisis conceptual de las definiciones del mindfulness de acuerdo con los supuestos filosóficos analíticos-conductuales y contextualistas-funcionales. Finalmente, se discutió la importancia de contar con una definición precisa y unánime con el fin de desarrollar una agenda coordinada de investigación en esse campo.

Les effets positifs du mindfulness dans le traitement de plusieurs problèmes psychologiques dans différentes populations ont encouragé la psychologie clinique à l'utiliser au cours des dernières années. Cependant, la recherche théorique et empirique sur les examens de pleine conscience montrent trois utilisations différentes de l'attention dans les approches comportementales: comme un processus, comme une compétance et en tant que stratégie. Les divergences dans les définitions de la pleine conscience ont créé une ambiguïté quant à pourquoi et comment ce phénomène est étudié. Cet article est une analyse conceptuelle de la pleine conscience ayant comme paramètres philosophiques l'analyse du comportement et le contextualisme fonctionnel. La discussion finale tourne autour de l'importance d'avoir une définition précise et unanime en vue d'élaborer un programme coordonné de recherche dans ce domaine.

Os efeitos positivos do mindfulness no tratamento de vários problemas psicológicos em diferentes populações incentivaram a psicologia clínica a utilizá-lo nos últimos anos. No entanto, pesquisas empíricas e revisões teóricas sobre o mindfulness mostraram três usos diferentes desse termo segundo perspectivas comportamentais: como processo, como habilidade e como estratégia. As discrepâncias nas definições do mindfulness geraram ambiguidade em relação àquilo que é pesquisado e como é pesquisado. Neste texto, realizou-se uma análise conceitual das definições do mindfulness tendo como bases filosóficas a análise do comportamento e o contextualismo funcional. Por último, discutiu-se a importância de ter uma definição precisa e unânime com o objetivo de desenvolver uma agenda coordenada de pesquisa nesse campo.

Mindfulness has been widely disseminated in clinical psychology in recent years, due to the positive effects on treating several psychological issues in diverse population. Nonetheless, empirical research and theoretical reviews show three different meanings of mindfulness within behavioral approaches: as a process, as skill, and as a strategy. Discrepancies about mindfulness definitions have brought ambiguity to what and how this phenomenon is studied. A conceptual analysis of mindfulness according to behavioral-analytic and functional-contextualistic philosophical traditions is presented. Finally, it was discussed the relevance of employing a precise and consensual definition of mindfulness to develop a coordinated research agenda in this field.

Assessment of the Usefulness of the Quantitative Methods for the Response Evaluation of Solid Tumors: Analysis Using Four Cancer Types.

BACKGROUND: The evidence provided by medical imaging techniques for the staging and follow-up is relevant in oncology. OBJECTIVES: The aims were (i) to compare the monitoring methods, (ii) to analyze the response variability between different tumors, and (iii) to decipher a general response curve that is independent of tumor type and drug treatment. METHODS: We analyzed the response variability in four cancer types, looking for a general response curve independent of the tumor type and drug treatment. We compared the response of different types of lesions within each cancer type via an intra-class correlation coefficient, determining the minimum number of lesions suitable for monitoring. RESULTS: The tested metrics allowed an objective evaluation of the response of solid tumors. The response was homogeneous between different cancer types. The intra-class correlation was high, allowing the monitoring of the response with a low number of lesions (2-4). The currently used metrics misrepresent the changes in the lesion volumes. Indeed, we observed non-linear overestimations of the RECIST and WHO values, which were more pronounced for the intermediate values. Additionally, the inclusion of lymphadenopathy among the target lesions produced a distortion in the evaluation of the response. CONCLUSION: The quantitative counts allowed an objective evaluation of the response of the solid tumors to therapy, showing that the response was homogeneous but variable between different types of tumors. Although the currently used metrics lead to misrepresentations of the changes in the lesion volume, they allowed setting a response pattern for tracking these lesions.