Thirty-day suicidal thoughts and behaviours in the Spanish adult general population during the first wave of the Spain COVID-19 pandemic.

AIMS: To investigate the prevalence of suicidal thoughts and behaviours (STB; i.e. suicidal ideation, plans or attempts) in the Spanish adult general population during the first wave of the Spain coronavirus disease 2019 (COVID-19) pandemic (March-July, 2020), and to investigate the individual- and population-level impact of relevant distal and proximal STB risk factor domains. METHODS: Cross-sectional study design using data from the baseline assessment of an observational cohort study (MIND/COVID project). A nationally representative sample of 3500 non-institutionalised Spanish adults (51.5% female; mean age = 49.6 [s.d. = 17.0]) was taken using dual-frame random digit dialing, stratified for age, sex and geographical area. Professional interviewers carried out computer-assisted telephone interviews (1-30 June 2020). Thirty-day STB was assessed using modified items from the Columbia Suicide Severity Rating Scale. Distal (i.e. pre-pandemic) risk factors included sociodemographic variables, number of physical health conditions and pre-pandemic lifetime mental disorders; proximal (i.e. pandemic) risk factors included current mental disorders and a range of adverse events-experiences related to the pandemic. Logistic regression was used to investigate individual-level associations (odds ratios [OR]) and population-level associations (population attributable risk proportions [PARP]) between risk factors and 30-day STB. All data were weighted using post-stratification survey weights. RESULTS: Estimated prevalence of 30-day STB was 4.5% (1.8% active suicidal ideation; n = 5 [0.1%] suicide attempts). STB was 9.7% among the 34.3% of respondents with pre-pandemic lifetime mental disorders, and 1.8% among the 65.7% without any pre-pandemic lifetime mental disorder. Factors significantly associated with STB were pre-pandemic lifetime mental disorders (total PARP = 49.1%) and current mental disorders (total PARP = 58.4%), i.e. major depressive disorder (OR = 6.0; PARP = 39.2%), generalised anxiety disorder (OR = 5.6; PARP = 36.3%), post-traumatic stress disorder (OR = 4.6; PARP = 26.6%), panic attacks (OR = 6.7; PARP = 36.6%) and alcohol/substance use disorder (OR = 3.3; PARP = 5.9%). Pandemic-related adverse events-experiences associated with STB were lack of social support, interpersonal stress, stress about personal health and about the health of loved ones (PARPs 32.7-42.6%%), and having loved ones infected with COVID-19 (OR = 1.7; PARP = 18.8%). Up to 74.1% of STB is potentially attributable to the joint effects of mental disorders and adverse events-experiences related to the pandemic. CONCLUSIONS: STB at the end of the first wave of the Spain COVID-19 pandemic was high, and large proportions of STB are potentially attributable to mental disorders and adverse events-experiences related to the pandemic, including health-related stress, lack of social support and interpersonal stress. There is an urgent need to allocate resources to increase access to adequate mental healthcare, even in times of healthcare system overload. STUDY REGISTRATION NUMBER: NCT04556565.

The role of stress-regulation genes in moderating the association of stress and daily-life psychotic experiences.

OBJECTIVE: The interaction of single nucleotide polymorphisms with both distal and proximal environmental factors across the extended psychosis phenotype is understudied. This study examined (i) the interaction of relevant SNPs with both early-life adversity and proximal (momentary) stress on psychotic experiences (PEs) in an extended psychosis sample; and (ii) differences between early-psychosis and non-clinical groups for these interactions. METHODS: Two hundred and forty-two non-clinical and 96 early-psychosis participants were prompted randomly eight times daily for 1 week to complete assessments of current experiences, including PEs and stress. Participants also reported on childhood trauma and were genotyped for 10 SNPs on COMT, RGS4, BDNF, FKBP5, and OXTR genes. RESULTS: Unlike genetic variants, distal and proximal stressors were associated with PEs in both samples and were more strongly associated with PEs in the early-psychosis than in the non-clinical group. The RGS4 TA and FKBP5 CATT haplotypes interacted with distal stress, whereas the A allele of OXTR (rs2254298) interacted with proximal stress, increasing momentary levels of PEs in the early-psychosis group. No interactions emerged with COMT or BDNF variants. CONCLUSION: Individual differences in relevant stress-regulation systems interact with both distal and proximal psychosocial stressors in shaping the daily-life manifestation of PEs across the psychosis continuum.

Cistoadenocarcinoma mucinoso pulmonar difuso en paciente asintomático. Revisión de la literatura a propósito de un caso / No disponible

Presentamos un caso con infiltrados pulmonares múltiples cavitados en paciente asintomático, con dos estudios broncoscópicos cuyas muestras citológicas y microbiológicas del broncoaspirado y cepillado fueron negativas, y su diagnóstico final fue un "cistoadenocarcinoma mucinoso" tras análisis de las muestras obtenidas por punción tru-cut. La rareza de la presentación clínico-radiológica, las dificultades diagnósticas y la actualización de esta patología son revisadas a propósito del caso

We report a case with multiple cavitary pulmonary infiltrates in asymptomatic patients, with two studies whose samples bronchoscopic cytological and microbiological and bronchial brushing were negative, and final diagnosis was "a mucinous cystadenocarcinoma" after analysis of samples obtained tru-cut needle . The rarity of clinical-radiological presentation, diagnostic difficulties and updating of this disease are reviewed regarding the situation

Tratamiento con sonda de yeyunostomía en hiperemesis gravídica refractaria / Treatment of persistent hyperemesis gravidarum with jejunostomy catheter

La hiperemesis gravídica es una entidad importante que evoluciona con vómitos graves que no ceden a tratamiento, con trastornos del equilibrio electrolítico, pérdida de peso del 5% o más, presencia de cetonuria, trastornos neurológicos, lesión hepática, hemorragias retinianas y lesión renal en etapas avanzadas. La prevalencia de la enfermedad oscila entre 3-5 casos por cada 1.000 gestantes, cifra que tiende a disminuir quizá por una mejor orientación y educación de la gestante. Es más frecuente en las primíparas, en las menores de 18 años, en las gestaciones múltiples y en la mola hidatidiforme. Existe un importante componente psicosocial en la mayoría de los casos (AU)

[Transcription regulation in the ribosomal RNA operon of mycobacteria]. / Regulación de la transcripcion en el operon de ARN ribosomal en micobacterias.

Tuberculosis is a extremely important infectious disease, caused by the bacilli Mycobacterium tuberculosis. One of the characteristic of this bacteria is its very slow rate of growth, that allows it to survive for long periods of time inside the host cells. Among the genetic elements involved in growth regulation the operon rrn is of extreme importance. This operon contains the genes that code the three rRNA molecules, essential components of the bacterial ribosome. The tuberculosis bacilli, differently from most of the microorganisms, has a single copy of the rrn operon per genome, meaning that it must be submitted to very strict control mechanisms. Another important conclusion is that the sequences of the rrn operon constitute ideal targets for anti-mycobacterial drugs. In this work we have studied some of the elements involved in transcription control in M. tuberculosis, particularly those present in the leader region of the operon. By using basic molecular biology techniques we have identified sequence elements in the leader region that seem to be involved in the control of transcription elongation, by a mechanism related to anti-termination.

Esteatohepatitis no alcohólica y obesidad / Fatty liver no alcoholic and obesity

Presentamos el primer caso pediatrico diagnosticado en nuestro medio de un paciente de 13 años de edad con esteatohepatitis no alcohólica (NASH) fibrosis hepática incipiente, ausencia de ingesta de medicamentos, obesidad y presencia de "transaminitis" en hiperlipidemia, a quien accidentalmente se le detecta hepatomegalia

[Decubitus ulcers: evaluation of a protocol]. / Ulceras por presión. Evaluación de un protocolo.

An evaluation of the incidence, treatment and prevention of decubitus ulcers is presented within the framework of an Internal Medicine unit. Chosen for the study from a pool of admitted hospital patients were 60 people believed to be at risk of ulceration. They were evaluated according to established criteria and they were then followed during the length of their stay. Of these 60 patients, 38 later developed lesions. Of these 38, 63.2% were admitted with ulcers and 36.8% developed their pressure sores while in the hospital. 65.3% of those ulcers healed completely during the patients stay; 7.6% actually got worse. A significant statistical risk between the appearance of ulcers and the evaluated at risk factors was not found.