Factores de riesgo transdiagnósticos de los trastornos emocionales en adultos: una revisión sistemática / Transdiagnostic risk factors of emotional disorders in adults: A systematic review

La comorbilidad es más la regla que la excepción en salud mental y, sobre todo, en el caso de la ansiedad y la depresión. Los modelos transdiagnósticos estudian los procesos subyacentes para mejorar el tratamiento y la comprensión de la salud mental. Objetivo: Esta revisión sistemática busca evidencias sobre los factores de riesgo transdiagnósticos para la ansiedad y la depresión en la población clínica diagnosticada de estas condiciones psicopatológicas, analizando los diferentes tipos o categorías de factores identificados. Método: Se registró una revisión sistemática en PROSPERO (número de registro CRD42022370327) y se diseñó de acuerdo con las guías PRISMA-P. La calidad del estudio fue evaluada por dos revisores independientes con conocimiento del campo para reducir el posible sesgo. Resultados: Cincuenta y tres artículos fueron examinados y las variables transdiagnósticas fueron agrupadas en tres categorías: psicológicas, biológicas y socioculturales. Conclusiones: La categoría más estudiada fue la de variables psicológicas, en especial los procesos cognitivos, afecto negativo y neuroticismo, intolerancia a la incertidumbre, sensibilidad a la ansiedad. Los factores biológicos y socioculturales requieren más estudio para sustentar su enfoque transdiagnóstico.(AU)

Comorbidity is more the rule than the exception in mental health, specifically in the case of anxiety and depression. Transdiagnostic models studied the underlying processes to improve mental health treat-ment and understating. Objective:This systematic review searchs for evi-dence on transdiagnostic risk factors for anxiety and depression in the clin-ical population diagnosed with these psychopathological conditions, by an-alysing the different types or categories of factors identified.Methods:A sys-tematic review was registered in PROSPERO (registration number CRD42022370327) and was designed according to PRISMA-P guidelines. Two independent reviewers with field knowledge assessed the study quality to reduce bias.Results: Fifty-three articles were examined, and the transdi-agnostic variables were grouped into three categories: psychological, bio-logical, and sociocultural.Conclusions:The most studied category was that of psychological variables, especially cognitive processes, negative affect, and neuroticism, intolerance of uncertainty, anxiety sensitivity. Biological and sociocultural factors require more study to support their transdiagnos-tic approach.(AU)

Characterization of an energy efficient pulsed current TIG welding process on AISI 316 and 304 stainless steels.

This paper presents the characterization of a TIG welding process carried out by means of an arc welding power supply able to provide dc or pulsed current. The arc welding power supply is based on resonant power converters and an FPGA-based control circuit. Dc and multiple pulsed operations up to 1 kHz with different pulse widths have been tested. The operation of the proposed welding power supply has been compared to that of a high-quality commercial welding machine. Regarding performance, the investigated electrical parameters are: power factor, power conversion efficiency and the energy consumption of the process. The radiography and mechanical properties of the welds have been examined. The mechanical properties of the welded joints characterized through tensile tests are the yield stress, tensile strength and the strain under maximum stress. In addition, the impact properties of the joints were determined through Charpy tests and the curves relating energy absorbed and temperature were obtained. The results show an improved performance of the proposed arc welding power supply over the commercial counterpart, with higher efficiency and power factor, as well as lower energy consumption. The yield stress and tensile strength results indicate that the welded plates using pulsed modes with the proposed power supply are comparable to the reference weld performed with dc operation using the commercial welder. Remarkably, it was observed that the ductility of the welded plates using pulsed modes with the proposed power supply outperforms those of the reference weld carried out with dc arc using the commercial welder.

Analyzing the Relationship Between Child-to-Parent Violence and Perceived Parental Warmth.

The relationship between child-to-parent violence (CPV) and the perceived parental warmth dimension has been well established. However, it is necessary to further investigate the nature of this relationship considering the involvement of other variables. The objective of this study was to analyze the role of cognitive (hostile attribution), emotional (anger), and social variables (deviant peer group and drug use) in the relationship between the perceived parental warmth dimension (warmth-communication and criticism-rejection) and CPV motivated by reactive or instrumental reasons. The community sample consisted of 1,599 Spanish adolescents (54.8% girls) between the ages of 12 and 18 years (M age = 14.6, SD = 1.6 years) from different secondary schools in Jaén (75.3%) and Oviedo (24.7%) (Spain). Each participant completed the Child-to-Parent Violence Questionnaire (CPV-Q), the Warmth Scale (WS), adolescents' version, the Social Information Processing (SIP) in Child-to-parent Conflicts Questionnaire and Deviant Peers and Drug Use Questionnaires. The results indicate that perceived parental warmth is negatively correlated with hostile attribution, adolescent anger, relationship with a deviant peer group, while perceived parental criticism is positively linked to these variables. Likewise, hostile attribution and adolescent anger are positively linked to reactive CPV. Relationship with a deviant peer group is associated with drug use, which also predicts both reactive and instrumental CPV. In sum, a lack of perceived parental warmth has important repercussions in the form of the psychological and social maladjustment of children, which in turn is differentially correlated with reactive or instrumental CPV. Thus, prevention and intervention programs for CPV should consider, on the one hand, working with parents on parental practices that incorporate parental warmth as a fundamental element and, on the other hand, working with children on cognitive, emotional, and social aspects, taking into account the different motivations for this type of violence.

Actitudes sexistas y reconocimiento del maltrato en parejas jóvenes / Sexist attitudes and recognition of abuse in young couples

OBJETIVO: Explorar la asociación entre las actitudes de rol de género y el reconocimiento del maltrato en jóvenes. DISEÑO: Estudio transversal. Emplazamiento: Cincuenta y siete centros de educación secundaria, formación profesional y universitaria de 5 provincias españolas (Huelva, Sevilla, A Coruña, Pontevedra y Asturias). PARTICIPANTES: Un total de 4.337 estudiantes de entre 15 y 26 años (40,6% chicos y 59,4% chicas) que mantuvieron una relación de pareja durante un mes o más. Mediciones principales: Se utilizó la Escala de Actitudes de Rol de Género, con 20 indicadores de actitudes igualitarias o sexistas a nivel familiar, social y laboral. También se estudió si la persona estaba en una situación de maltrato percibido (MP), maltrato no percibido (MNP) o no maltrato (NM). RESULTADOS: En el conjunto de la muestra, el 68,6% se declaró NM, el 26,4% vivía una situación de MNP y el 5,0% reconoció sufrir maltrato. El MP fue más frecuente entre las chicas (6,3%), en los/as ≥ 18 años (6,4%) y en el alumnado universitario (6,9%). El MNP fue más habitual en los chicos (30,2%). Las actitudes más sexistas se encontraron en la dimensión laboral, y especialmente en varones y en adolescentes (15-17 años). Las actitudes menos sexistas se asociaron con menor probabilidad de vivir situaciones de MNP (odds ratio = 0,71; p-tendencia < 0,001). CONCLUSIONES: El sexismo parece dificultar el reconocimiento del maltrato. Lograr la equidad de género en la adolescencia y juventud es imprescindible. Los esfuerzos deberían centrarse en los varones, por ser el grupo con actitudes más sexistas y con mayor prevalencia de MNP

AIM: To explore the association between gender-role attitudes and the recognition of abuse among adolescents and young adults during dating relationships. DESIGN: Cross-correlation study. LOCATION: 57 schools of secondary education, vocational education and university in five provinces of Spain (Huelva, Seville, A Coruña, Pontevedra and Asturias). PARTICIPANTS: 4,337 students aged between 15 and 26 years (40.6% males and 59.4% female) who had a dating relationship that lasted more than a month. MAIN MEASUREMENTS: The Gender Role Attitudes Scale was used, which consists of 20 indicators of egalitarian or sexism attitudes at the family, social and occupational level. The students also reported whether they suffered from recognized abuse (RA), unperceived abuse (UPA), or not abused (NA). RESULTS: In the whole sample, 68.6% declared themselves NA, 26.4% were under a situation of UPA, and 5.0% were RA. The RA group was more frequent among the females (6.3%), ≥ 18 years (6.4%) and university students (6.9%). UPA was more common in males (30.2%). The most sexist attitudes were found in the occupational dimension and especially in men and adolescents (15-17 years). Less sexist attitudes were associated with a lower probability of experiencing UPA (odds ratio = .71; P-trend < .001). CONCLUSIONS: Sexism seems to hinder the recognition of abuse. Achieving gender equity in adolescence and youth is imperative. Public health efforts should focus on men, as they constitute the group with more sexist attitudes and with higher prevalence of UPA

[Sexist attitudes and recognition of abuse in young couples]. / Actitudes sexistas y reconocimiento del maltrato en parejas jóvenes.

AIM: To explore the association between gender-role attitudes and the recognition of abuse among adolescents and young adults during dating relationships. DESIGN: Cross-correlation study. LOCATION: 57 schools of secondary education, vocational education and university in five provinces of Spain (Huelva, Seville, A Coruña, Pontevedra and Asturias). PARTICIPANTS: 4,337 students aged between 15 and 26 years (40.6% males and 59.4% female) who had a dating relationship that lasted more than a month. MAIN MEASUREMENTS: The Gender Role Attitudes Scale was used, which consists of 20 indicators of egalitarian or sexism attitudes at the family, social and occupational level. The students also reported whether they suffered from recognized abuse (RA), unperceived abuse (UPA), or not abused (NA). RESULTS: In the whole sample, 68.6% declared themselves NA, 26.4% were under a situation of UPA, and 5.0% were RA. The RA group was more frequent among the females (6.3%), ≥18 years (6.4%) and university students (6.9%). UPA was more common in males (30.2%). The most sexist attitudes were found in the occupational dimension and especially in men and adolescents (15-17 years). Less sexist attitudes were associated with a lower probability of experiencing UPA (odds ratio=.71; P-trend<.001). CONCLUSIONS: Sexism seems to hinder the recognition of abuse. Achieving gender equity in adolescence and youth is imperative. Public health efforts should focus on men, as they constitute the group with more sexist attitudes and with higher prevalence of UPA.

The Dating Violence Questionnaire: Validation of the Cuestionario de Violencia de Novios Using a College Sample From the United States.

This study provides psychometric information for the Dating Violence Questionnaire (DVQ), an instrument developed to assess intimate partner victimization among adolescents and youths. This instrument, an English version of Cuestionario de Violencia de Novios, assesses both frequency and discomfort associated with 8 types of abuse (detachment, humiliation, sexual, coercion, physical, gender-based, emotional punishment, and instrumental). Participant included 859 U.S. students enrolled in undergraduate psychology courses in a mid-Atlantic university (M = 19 years; SD = 1.5 years). One-third of the participants were males, and two-thirds were females. Regarding racial identity, around 55% of participants identified themselves as White, 22% as African American, 12% as Asian, whereas 11% selected other identities. Around 9% of participants identified themselves as Hispanic. Confirmatory factor analysis shows that the DVQ achieved adequate goodness-of-fit indexes for the original eight-factor model (X(2)/df <5; root mean square error of approximation [RMSEA] <.080), as well as higher parsimony when compared to simpler alternative models. The 8 scales demonstrated acceptable internal consistency indexes (α >.700), surpassing those found in the original Spanish validation. Descriptive analysis suggests higher victimization experience on subtle aggressions (detachment, coercion, and emotional punishment), with overt abuses (physical, instrumental) obtaining the smallest means; these findings were similar across gender, race identity, and ethnicity. Results of this validation study encourage the inclusion of DVQ in both research and applied contexts.

Validación de las escalas de Braden y EMINA en pacientes de atención domiciliaria incluidos en programa de inmovilizados / Validity of Braden and EMINA’s scales for patients at home, include in the immobilized patients programmee

Objetivo: comprobar la validez de las escalas Braden y EMINA y seleccionar puntos de corte cuantitativos para discriminar el riesgo de úlcera por presión (UPP) en pacientes domiciliarios. Método: estudio longitudinal o de seguimiento de una cohorte de 6 meses de duración, con cuatro valoraciones, una cada 2 meses. Ámbito de estudio: áreas de gestión sanitaria Este de Málaga-Axarquía y Serranía, de Málaga. Sujetos de estudio: pacientes en programa de inmovilizados sin UPP. Cuestionario confeccionado por los autores que incluye entre otros: datos demográficos, ingreso hospitalario, escalas de Braden y EMINA. Muestra: 353 pacientes, usando muestreo aleatorio simple. Resultado: las escalas originales mantienen consistencia interna con alpha superior a 0,7. Se han establecido nuevos puntos de corte, discriminando pacientes con riesgo de UPP o sin él, resultando una sensibilidad del 61-89% y una especificidad del 64-70%. Las escalas categorizadas tienen exactitud como método diagnóstico igual o superior al 65%. Las odds ratio (OR) son significativas e indican que existen diferencias en el riesgo de UPP en función de nuevos puntos de corte. La determinación de los puntos de corte resultaron: riesgo alto: sensibilidad ≤ 10%, especificidad ≥ 95%, puntuación en la escala de Braden ≤ 10, EMINA 12-15; riesgo moderado: sensibilidad entre el 10% y el 83%, especificidad entre el 64% y el 95%, Braden 11-15 y EMINA 7-11; riesgo bajo: sensibilidad entre el 83% y el 100%, especificidad entre el 0% y el 64%, Braden 16-22 y EMINA 1-6; riesgo nulo: sensibilidad 100%, especificidad 0%, Braden 23, EMINA 0

Aim: Verifying Braden and EMINA's validity and select quantitative cut-off points to differentiate Ulcer by Pressure threat in home-care patients. Method: group monitor progress and longitudinal examination of a cohort of patients during 6 months, evaluating three times, once every two months. Scope of application: Health Care Administration Este Málaga-Axarquía and Serranía, Málaga. Subject of study: Immobilized Programme patients without UPP. Resources: Authors’ questionnaire including among others: demographic data, hospital admission date, Braden and EMINA scales. Sample: 353 patients, simple random sampling. Result: The original scales support internal consistency with alpha superior to 0.7. Establishing new cut-off points discriminating patients with or without UPP threat, resulting sensitivity of 61%- 89% and specificity 64%-70%. The classified scales have a precisions as a diagnostic method equal or superior to 65%. OR are significant, indicating existing differences under threat of UPP according to new cut-off points. Cut-off points’ selected resulted in: High sensitivity threat ≤10% ≥ 95%, Braden’s scale average ≤ 10, EMINA 12-15. Moderate threat 10%,

Percepción y etiquetado de la experiencia violenta en las relaciones de noviazgo juvenil / Perception and description of violent experience in youth dating relationships

Objetivo: Describir la violencia de pareja sufrida por los jóvenes e identificar las etiquetas que mejor la describen según el sexo. Métodos: Estudio descriptivo sobre una muestra de 3087 estudiantes adultos españoles. Se utilizó el Cuestionario de violencia entre novios (CUVINO), que mide ocho formas de violencia de pareja y tres etiquetas utilizadas para describirla (maltrato, miedo y atrapamiento). Se buscaron diferencias según el sexo y se utilizaron regresiones logísticas para encontrar asociaciones entre las distintas formas de violencia de pareja y su etiquetado. Resultados: El 44,6% sufrió alguna situación de violencia de pareja no percibida, fundamentalmente por 'desapego' (30,0%) y 'coerción' (25,1%). Toda forma de violencia de pareja fue más perpetrada por las mujeres. La mayor diferencia según sexo se encontró en 'castigo emocional' (sufrido por el 20,9% de los varones y el 7,6% de las mujeres) y en 'violencia física' (6,6% y 2,3%, respectivamente). El 28,7% se sintió atrapado/a, el 11,8% tuvo miedo y el 6,3% se percibió maltratado/a. Los varones se etiquetaron con más frecuencia como atrapados, pero con menos miedo y maltratados. Las forma de violencia de pareja más asociada con la sensación de atrapamiento fue la coerción, tanto en hombres (odds ratio [OR] = 3,8) como en mujeres (OR = 5,7). Conclusiones: Varones y mujeres se enfrentan a violencia de pareja durante el noviazgo de forma diferente, y sería necesario disponer de recursos para atenderlos de manera específica. Incluir preguntas sobre la sensación de atrapamiento podría contribuir a detectar precozmente la violencia de pareja. Formas de violencia sutiles, como la coerción, deberían tenerse más en cuenta en las campañas de sensibilización (AU)

Objective: To describe the intimate partner violence suffered by youth and to identify the descriptions that best classify it according to gender. Methods: A cross-sectional study was carried out among a sample of 3,087 adult Spanish students. The CUVINO questionnaire was used, which measures 8 forms of intimate partner violence and uses 3 descriptions to classify it (abuse, fear and entrapment). Logistic regressions were carried out to identify differences by gender and associations between the subtypes of intimate partner violence and descriptions of the violent experience. Results: Nearly half of the sample (44.6%) had some situation of unperceived violence, mainly of 'detachment' (30.0%) and 'coercion' (25.1%). All subtypes of intimate partner violence were more frequently perpetrated by women. The largest difference by gender was found in 'emotional punishment' (experienced by 20.9% of men vs. 7.6% of women) and 'physical violence' (6.6% vs. 2.3%). A total of 28.7% felt trapped, 11.8% felt fear and 6.3% felt mistreated. Men more frequently described themselves as trapped, but less often as afraid or abused. The subtype of intimate partner violence most associated with the feeling of entrapment was coercion in both men (OR = 3.8) and women (OR = 5.7). Conclusions: Men and women face intimate partner violence while dating differently; resources are needed to address them specifically. The inclusion of routine questions about the sense of entrapment may contribute to the early detection of intimate partner violence. Subtle forms of violence, such as coercion, should be taken into account in awareness campaigns (AU)

[Perception and description of violent experience in youth dating relationships]. / Percepción y etiquetado de la experiencia violenta en las relaciones de noviazgo juvenil.

OBJECTIVE: To describe the intimate partner violence suffered by youth and to identify the descriptions that best classify it according to gender. METHODS: A cross-sectional study was carried out among a sample of 3,087 adult Spanish students. The CUVINO questionnaire was used, which measures 8 forms of intimate partner violence and uses 3 descriptions to classify it (abuse, fear and entrapment). Logistic regressions were carried out to identify differences by gender and associations between the subtypes of intimate partner violence and descriptions of the violent experience. RESULTS: Nearly half of the sample (44.6%) had some situation of unperceived violence, mainly of "detachment" (30.0%) and "coercion" (25.1%). All subtypes of intimate partner violence were more frequently perpetrated by women. The largest difference by gender was found in "emotional punishment" (experienced by 20.9% of men vs. 7.6% of women) and "physical violence" (6.6% vs. 2.3%). A total of 28.7% felt trapped, 11.8% felt fear and 6.3% felt mistreated. Men more frequently described themselves as trapped, but less often as afraid or abused. The subtype of intimate partner violence most associated with the feeling of entrapment was coercion in both men (OR=3.8) and women (OR=5.7). CONCLUSIONS: Men and women face intimate partner violence while dating differently; resources are needed to address them specifically. The inclusion of routine questions about the sense of entrapment may contribute to the early detection of intimate partner violence. Subtle forms of violence, such as coercion, should be taken into account in awareness campaigns.

Fiabilidad de las escalas de Braden y EMINA en pacientes de atención domiciliaria incluidos en programa de inmovilizados / Reliability in Braden and EMINA's scales for patients in domiciliary, included in the immobilized patients' programme

Objetivo: comprobar la fiabilidad de las escalas de Braden y EMINA (escalas de valoración del riesgo de úlceras por presión) en atención domiciliaria. Método: estudio observacional de tipo transversal. Ámbito de estudio: Área de Gestión Sanitaria Este de Málaga-Axarquía y Área de Gestión Sanitaria Serranía, ambas de Málaga. Sujetos de estudio: pacientes incluidos dentro del Programa de Inmovilizados sin úlceras por presión. Instrumentos: escalas de Braden y EMINA. Muestra: 30 pacientes, usando una técnica de muestreo aleatorio simple. Resultados: Escala de Braden: Alfa de Cronbach de 0,78 para ambos observadores. Coeficiente de correlación intraclase (CCI) para la puntuación total de la escala, 0,968. El índice kappa ponderado para cada uno de los 6 ítems de la escala oscila entre 0,685 que es el más bajo y corresponde a fricción y deslizamiento y 1,00 para el más alto, que corresponde a percepción sensorial. Escala EMINA: el Alfa de Cronbach oscila entre 0,69 y 0,73 entre observadores. Coeficiente de correlación intraclase para la puntuación total de la escala, 0,974. El índice kappa ponderado para cada uno de los 5 ítems de la escala oscila entre 0,750, el más bajo que corresponde a la actividad, y 1,00 para el más alto, que corresponde a nutrición. Conclusiones: la escala de Braden tiene mayor consistencia interna, aunque el grado de acuerdo cuando se utilizan las escalas de manera categórica es superior en la EMINA. Ambas escalas son instrumentos fiables para el uso en atención domiciliaria, aunque sería conveniente establecer nuevos puntos de corte, para definir o categorizar el riesgo en esta población

Objective: Assessing reliability of the Braden and EMINA scales (Rating Scales for the Risk of pressure sores) in-home care. Method: Cross-sectional study. Population of study from Málaga: area of Heath Management East Málaga-Axarquia and mountainous region. Subjects of study: Patients entered in the programme of immobilize persons without pressure sore. Questionnaires: Braden and EMINA. Sample: 30 patients selected by simple randomisation. Results: Braden Scale: Cronbach's coefficient alpha 0.78 for both ratters. The Intraclass correlation coefficient (ICC) is 0.968. Kappa values for each of the 6 items vary from 0.685 for the friction and slipping item and 1 for the sensorial perception item. EMINA Scale: Cronbach's coefficent alpha 0.69 and 0.73 for each of the two raters, respectively. The Intraclass correlation coefficient (ICC) is 0.974. Kappa values for each of the 6 items vary from 0.750 for the activity item and 1 for the nutrition item Conclusions: The internal consistency of Braden scales is higher than the consistency of the EMINA scale. However, when the individual item agreement between raters was higher for the EMINA than for the Braden. Both scales, as continuous, are reliable instruments to be used for in-home care, although it would be convenient to establish new cut-off points for the scales in order to categorise the risk of pressure sores for this type of population

Hepatotoxicidad y pancreatitis por sales de oro: reporte de caso / Hepatotoxicity and pancreatitis by gold salts: case report

Se reporta el caso de una paciente de 37 años, natural y procedente de Lima, portadora de Artritis Reumatoide quien estuvo en tratamiento con prednisona, metotrexate y cloroquina. Esta terapia fue remplazada por sales de oro un mes antes de su ingreso, presentando luego de la aplicación de la tercera dosis dolor abdominal, diarrea, prurito e ictericia, asociado a astenia y sensación de alza térmica no cuantificada. Los exámenes auxiliares mostraron incremento de las transaminasas, bilirrubinas, fosfatasa alcalina, eosinofilia e inversión de la relación albúmina globulina, con incremento predominante de la inmunoglobulina G, así como de amilasa y lipasa. El estudio Anatomopatológico demostró: colestasis, balonamiento de hepatocitos y necrosis unifocal, a predominio de la zona 3 del lobulillo hepático, lo cual se encontró consistente con reacción tóxica.

The case of a patient, 37 years old, born and resident of Lima, suffering rheumatoid arthritis who underwent treatment with Prednisone, Methotrexate, and Chloroquine is reported. This therapy was substituted for gold salts one month before her admission. After the third dose she presented symptoms of abdominal pain and diarrhea, itching, and jaundice, associated with asthenia and a feverish sensation. Liver biochemistry demonstrated elevated transaminase, bilirubin, alkaline phosphatase, eosinophilia, inversion of the rate albumin / globulin, higher titer of immunoglobulin G, as well as an elevation of amylase and lipase. The anatomopathological study showed cholestasis, hepatocyte ballooning, spotty necrosis, predominantly in zone 3 of the acinus. These findings where found consistent with a toxic reaction.

Comparación in vitro de antiácidos líquidos de uso comercial / In vitro comparison of commercial liquid antiacids

El objetivo del presente estudio fue comparar la capacidad de diversos antiácidos de elevar el pH de una solución de ácido clohídrico. Se diseño un modelo experimental para medir la capacidad de elevar el pH de una solución de HCl de diferentes antiácidos de uso comercial. Se registró la variación del pH de una solución de HCl a la cual se agregó cada uno de los antiácidos líquidos estudiados. Encontramos diferencias entre los 4 antiácidos a base de OHMg-OHAl. Encontramos diferencias entre las 2 presentaciones de magaldrato existentes en nuestro medio; pero estas son mínimas.