Relación entre la capacidad adquirida y el riesgo suicida / Relationship between acquired capacity and suicidal risk

La Teoría interpersonal del suicidio señala que la capacidad adquirida hace referencia a que la exposición repetida al dolor conlleva una habituación a estas experiencias, esto es lo que conlleva que el individuo, si cuenta también con la ideación suicida, pueda llevar a cabo el suicidio consumado. Por eso, el objetivo de este estudio es analizar las diferencias en la capacidad adquirida sobre la base de la existencia o no de riesgo suicida. Los resultados avalan los encontrados en otras investigaciones, observándose que, entre las personas con riesgo suicida y sin riesgo, existen diferencias estadísticamente significativas, siendo los que están en riesgo los que obtienen las medias más elevadas. Por lo tanto, la variable capacidad adquirida se muestra como una variable altamente relacionada con el riesgo suicida. (AU)

The Interpersonal Theory of Suicide states that acquired capability refers to the fact that repeated exposure to pain leads to habituation to these experiences, which is what leads the individual, if he or she also has suicidal ideation, to commit suicide. Therefore, the aim of this study is to analyze the differences in the acquired capability on the basis of the existence or not of suicidal risk. The results support those found in other studies, showing that there are statistically significant differences between those at risk and those not at risk, with those at risk having the highest mean scores. Therefore, the acquired capability variable is shown to be a variable highly related to suicidal risk. (AU)

The effect of an anti-inflammatory diet on chronic pain: a pilot study.

Objective: Rheumatic diseases result in chronic pain (CP) and require treatment with drugs whose prolonged administration is associated with side effects. However, publications in the academic literature have suggested that diet modification and food supplementation can play a crucial role in alleviating the symptoms of inflammatory disease. Thus, it is hoped that the use of an anti-inflammatory diet for pain management might result in improved quality of life. Hence, here we aimed to investigate the effect of anti-inflammatory foods in patients with CP caused by rheumatic diseases. Methods: After an exhaustive bibliography search, we designed a 13-item anti-inflammatory dietary guide based on a Mediterranean diet without red meat, gluten, or cow's milk (the AnMeD-S). We then conducted a pilot study to evaluate the efficacy of this anti-inflammatory diet in patients with CP. A food consumption score (with a maximum of 156 points) was then applied to evaluate patient adhesion to the proposed diet. Forty-five patients with CP were followed-up for 4 months. Variables related with quality of life (including pain perception, depression status, and sleep satisfaction) were measured using 9 validated questionnaires and anthropometric measurements were recorded before and after the participants followed the anti-inflammatory diet. Results: We found a correlation between increased anti-inflammatory food intake and improved physical characteristics, stress, and pain in the patients we assessed. Moreover, decreased consumption of pro-inflammatory foods was positively correlated with sleep satisfaction. Following the AnMeD-S was associated with improved physical characteristics and quality-of-life in patients with CP. Conclusion: The AnMeD-S, includes anti-inflammatory foods and restricts the consumption of certain pro-inflammatory foods (such as those containing gluten). This dietary pattern could provide relief from CP and improve the symptoms of stress and depression, as well as reducing sleep disturbances.

Efficacy of diet on fatigue, quality of life and disability status in multiple sclerosis patients: rapid review and meta-analysis of randomized controlled trials.

BACKGROUND: Multiple sclerosis is an inflammatory and neurodegenerative disease. People with multiple sclerosis (pwMS) experience chronic fatigue which is difficult to deal with therapeutically and greatly affects health-related quality of life (QOL). PwMS are aware of the lack of generalized dietary advice related to their disease, leading to self-experimentation with diet. It is necessary to provide objective information about dietary interventions for pwMS. We aim to provide an objective synthesis of the evidence for efficacy and safety of specific diets in pwMS through a rapid review and meta-analyses of randomized controlled trials (RCTs), examining symptomatic fatigue (MFIS), QOL, Expanded-Disability-Status-Scale (EDSS), and severe adverse events. METHODS: We have carried out a rapid review (MEDLINE and EMBASE) up to December 2021, with PRISMA methodology, and meta-analyses, of (RCTs). All statistical analyses were performed using the comprehensive meta-analysis (CMA) -RStudio 4.1.3. The analysis used weighted mean differences (WMD) and a 95% confidence interval (CI) using a random-effects model to compare the effects of the dietary intervention with the control. RESULTS: Eight studies met the inclusion criteria. Of these eight studies, five analyzed EDSS, three MFIS, and three QOL. A total of 515 patients were analyzed. These meta-analyses cumulative evidence support that dietary intervention is associated with a trend of reduction in fatigue (308 patients studied) -the difference between means (SMD) of the control group and intervention group was -2,033, 95%-IC (-3,195, -0,152), a p-value of 0.0341)-, an increase in QOL (77 patients studied), no significant effect on EDSS (337 patients studied), and no severe adverse events. CONCLUSIONS: It is difficult to reach a high level of evidence in dietary studies. Our findings show that dietary intervention is associated with a trend of reduction in fatigue in MS. Taking into account the potential of dietary interventions and the benefit/risk ratio in their favor, neurologists must be aware of the great importance of making interventions on diet in MS if necessary. There are dietary interventions with some evidence of benefit for patients with MS, which could be chosen based on adherence, patient preferences, and individual outcomes. Large prospective clinical trials are needed to shed further light on this topic.

Lifestyle Variables Such as Daily Internet Use, as Promising Protective Factors against Cognitive Impairment in Patients with Subjective Memory Complaints. Preliminary Results.

Subjective memory complaints (SMCs) may be important markers in the prediction of cognitive deterioration. The aim of this study was to find associations between individual lifestyle factors, which may contribute to cognitive impairment (CI) in people with SMCs and to conduct a literature review on the relationship between internet use and CI in subjects over 50 years old, as a related factor. This was a case-controlled study that included 497 subjects aged over 50 years with SMCs who were recruited from 19 community pharmacies. Three screening tests were used to detect possible CIs, and individuals with at least one test result compatible with a CI were referred to primary care for evaluation. Having self-referred SMC increased the odds of obtaining scores compatible with CI and this factor was significantly related to having feelings of depression (OR = 2.24, 95% CI [1.34, 3.90]), taking anxiolytics or antidepressants (OR = 1.93, 95% CI [1.23, 3.05]), and being female (OR = 1.83, 95% CI [1.15, 2.88]). Thirty percent of our sample obtained scores compatible with CI. Age over 70 years increased the odds of obtaining scores compatible with CI. A high-level education, reading, and daily internet use were factors associated with a reduced risk of positive scores compatible with CI (37-91%, 7-18%, and 67-86%, respectively), while one extra hour television per day increased the risk by 8-30%. Among others, modifiable lifestyle factors such as reading, and daily internet usage may slow down cognitive decline in patients over 50 with SMCs. Four longitudinal studies and one quasi-experimental study found internet use to be beneficial against CI in patients over 50 years of age.

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment.

Mild cognitive impairment (MCI) is the first sign of dementia among elderly populations and its early detection is crucial in our aging societies. Common MCI tests are time-consuming such that indiscriminate massive screening would not be cost-effective. Here, we describe a protocol that uses machine learning techniques to rapidly select candidates for further screening via a question-based MCI test. This minimizes the number of resources required for screening because only patients who are potentially MCI positive are tested further. This methodology was applied in an initial MCI research study that formed the starting point for the design of a selective screening decision tree. The initial study collected many demographic and lifestyle variables as well as details about patient medications. The Short Portable Mental Status Questionnaire (SPMSQ) and the Mini-Mental State Examination (MMSE) were used to detect possible cases of MCI. Finally, we used this method to design an efficient process for classifying individuals at risk of MCI. This work also provides insights into lifestyle-related factors associated with MCI that could be leveraged in the prevention and early detection of MCI among elderly populations.

Characterization of HLA-A*01:302 in two Spanish individuals by sequencing-based typing.

HLA-A*01:302 was likely generated by intralocus conversion between an A*01:01:01 allele and an A*29 allele.

Decision Tree for Early Detection of Cognitive Impairment by Community Pharmacists.

Purpose: The early detection of Mild Cognitive Impairment (MCI) is essential in aging societies where dementia is becoming a common manifestation among the elderly. Thus our aim is to develop a decision tree to discriminate individuals at risk of MCI among non-institutionalized elderly users of community pharmacy. A more clinically and patient-oriented role of the community pharmacist in primary care makes the dispensation of medication an adequate situation for an effective, rapid, easy, and reproducible screening of MCI. Methods: A cross-sectional study was conducted with 728 non-institutionalized participants older than 65. A total of 167 variables were collected such as age, gender, educational attainment, daily sleep duration, reading frequency, subjective memory complaint, and medication. Two screening tests were used to detect possible MCI: Short Portable Mental State Questionnaire (SPMSQ) and the Mini-Mental State Examination (MMSE). Participants classified as positive were referred to clinical diagnosis. A decision tree and predictive models are presented as a result of applying techniques of machine learning for a more efficient enrollment. Results: One hundred and twenty-eight participants (17.4%) scored positive on MCI tests. A recursive partitioning algorithm with the most significant variables determined that the most relevant for the decision tree are: female sex, sleeping more than 9 h daily, age higher than 79 years as risk factors, and reading frequency. Moreover, psychoanaleptics, nootropics, and antidepressants, and anti-inflammatory drugs achieve a high score of importance according to the predictive algorithms. Furthermore, results obtained from these algorithms agree with the current research on MCI. Conclusion: Lifestyle-related factors such as sleep duration and the lack of reading habits are associated with the presence of positive in MCI test. Moreover, we have depicted how machine learning provides a sound methodology to produce tools for early detection of MCI in community pharmacy. Impact of findings on practice: The community of pharmacists provided with adequate tools could develop a crucial task in the early detection of MCI to redirect them immediately to the specialists in neurology or psychiatry. Pharmacists are one of the most accessible and regularly visited health care professionals and they can play a vital role in early detection of MCI.

Cirrosis septal incompleta: una condición infrecuente / Incomplete septal cirrhosis: An uncommon condition

No disponible

Evaluación de la pérdida osea y del éxito / fracaso de implantes de titanio de posicionamiento inmediato y tardío con carga inmediata, usados para restauraciones de arco completo a 12 meses de su implantación / Evaluation of bone loss and success / failure of titanium implant positioning with immediate and late charge, used in full arch restorations at 12 months of implant

El propósito de esteestudio fue evaluar elnivel óseo y el éxito y fracaso de implantes con carga inmediata posicionados inmediatamentedespués de la extracciónpara rehabilitaciones de arco completo ycompararlos con los resultados obtenidos con implantes situados en alvéolos cicatrizados, en un periodo de 12 meses, para determinar la mejor alternativa de uso. Se efectúo una revisión sistemática en base aensayos clínicos aleatorios prospectivos y los ensayos clínicos aleatorizado o no aleatorizados, controlados o no controlados que evaluaron el fracaso yreabsorción ósea de implantes con carga inmediata posicionados en alveolos post-extracción y en alvéolos cicatrizados en pacientes adultos para rehabilitaciones de arco completo. Los datos de los ensayos clínicos fueron ingresados al software Review Manager®. Se realizaron dos metaanálisis para las distintas variables a analizar y posteriormente un análisis de sensibilidad para eliminar los estudios que causaban sesgo. De un total de 431 implantes analizados, 16 de ellos fracasaron, 11 de los cuales habían sido posicionados inmediatamente luego de la exodoncia. Tres de losautores considerados en la revisión, concuerdan en que hay un mayor éxito y menor pérdida ósea en aquellos implantes posicionados de manera tardía. Para rehabilitaciones implanto-soportadasde arco completo fijas o removibles, el protocolo de posicionamiento tardío, demostró ser una mejor alternativa puesto que manifestó una menor tasa de fracaso y una menor pérdida ósea.

The purpose of this study was to evaluate the bone level and the success and failure of loaded implants positioned immediately after extraction for full-arch restorations and compare the results obtained with implants placed in healed alveoli, in a period of 12 months, to determine the best alternative. A systematic review based on prospective randomized clinical trials, and randomized or nonrandomized controlled and uncontrolled trials evaluating failure and bone resorption of immediate loaded implants, positioned in post extraction and healed sockets in adult patients for full arch rehabilitations. Data from clinical trials were entered into Review Manager® software. Two meta-analyzes for different variables to analyze and subsequently a sensitivity analysis to eliminate bias caused studies were performed. From a total of 431 implants studied, 16 of them failed, 11 of which had been positioned immediately after the extraction. Three of the authors of the review considered agree that there are more successful and less bone loss in implants positioned so late. To implant-supported full-arch restorations fixed or removable, late positioning protocol proved to be a better alternative since it showed a lower failure rate and less bone loss.

Anti-inflammatory and analgesic activity of a novel inhibitor of microsomal prostaglandin E synthase-1 expression.

In a previous study, we reported a new gamma-hydroxybutenolide derivative, 4-benzo[b]thiophen-2-yl-3-bromo-5-hydroxy-5H-furan-2-one (BTH), as inhibitor of microsomal prostaglandin E synthase-1 (mPGES-1) expression in lypopolysaccharide (LPS) stimulated RAW 264.7 and TPH-1 cells, without affecting cyclooxygenase-2 (COX-2). In this study, we evaluated the in vivo effect of BTH on some acute and chronic inflammatory animal models in relation to its inhibitory profile on mPGES-1 expression. In the zymosan-induced mouse air pouch model, BTH produced a dose-dependent inhibition of prostaglandin E(2) (PGE(2)) production and mPGES-1 protein expression in pouch exudates without any effect on COX-2 protein expression. This behavior was confirmed in the chronic model of collagen-induced arthritis, where administration of BTH (5 mg/kg) clearly reduced PGE(2) and mPGES-1 expression in joint tissues, whereas COX-2 was unaffected. These effects were accompanied by the suppression of clinical and histopathological manifestations of disease such as the loss of proteoglycan, and the destruction of surface cartilage. Other enzymes participating in the metabolism of arachidonic acid, such as prostaglandin I(2) synthase, tromboxane A(2) synthase or 5-lipoxygenase were unaffected by this compound. The acetic acid-induced hyperalgesia model in LPS-sensitized mice showed a dose-dependent analgesic effect of BTH, exerting an ED(50) value of 6.2 mg/kg. Our data suggest that inhibition of mPGES-1 protein expression in acute and chronic inflammatory models by BTH, could provide a potential therapeutic target and a pharmacological tool to discern the role of the inducible enzymes COX-2 and mPGES-1 in inflammatory pathologies.