RESUMEN
BACKGROUND: Users may have difficulty calculating DTI group statistics since they need to master several complex tools that require high user intervention. A tool called DTIStatistics for the automatic and easy calculation of DTI group statistics was developed to reduce analysis times and possible errors. METHODS: The proposed software was designed by using a user-centred methodology in which we performed an iterative usability evaluation with an expert committee. Once the experts׳ requirements were fulfilled, we performed a validation of the final version of DTIStatistics with target users, comparing the execution time of this tool and the standard pipeline normally used. RESULTS: Target users needed significantly less time to complete the tasks with DTIStatistics, reducing the analysis time from 1383.78 to 57.2s. They were able to complete all the tasks and barely made errors. Moreover, target users were not able to display the analysis results with the standard pipeline, but when using our tool they only needed 34s. Target users found DTIStatistics easy to learn, use and interact with, and they concluded that they could effectively complete the tasks with it. Additionally, we present example results in the study of depression to demonstrate the validity of DTIStatistics for clinical research. CONCLUSIONS: DTIStatistics facilitates and significantly automates the calculation of DTI group statistics by reducing the analysis times, which implies lower costs. DTIStatistics is highly applicable in clinical research, as demonstrated by the fact that it is currently being used at the University Hospital, University of Navarra (Spain).
Asunto(s)
Imagen de Difusión Tensora/métodos , Procesamiento de Imagen Asistido por Computador/métodos , Modelos Estadísticos , Interfaz Usuario-Computador , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Adulto JovenRESUMEN
Con los distintos avances técnicos y estadísticos que se han ido incorporando a la investigación en Psiquiatría, y el mejor conocimiento de la alteración que subyace a la enfermedad psiquiátrica, los tratamientos para nuestros pacientes deberían ser más curativos. Sin embargo, el reto al que nos enfrentamos los que trabajamos en esta área de la ciencia es el de ser capaces de ensamblar las distintas piezas del rompecabezas que vamos conociendo para que los tratamientos que utilicemos, ya sean biológicos o psicológicos, se dirijan a las causas que originan la enfermedad además de a sus síntomas. En este sentido, son evidentes los progresos para el estudio del enfermo mental tanto en lo estructural como en lo funcional, y son numerosos, también, los trabajos que describen distintas alteraciones o que proponen modelos para explicar lo que sucede en las distintas situaciones de nuestros pacientes. también en el conocimiento de la enfermedad psiquiátrica que afecta al paciente de edad avanzada se ha avanzado en nuestros días, aunque solo sea impulsado por el creciente patrón demográfico que nos habla de que en solo unas décadas este grupo de la población constituirá un tercio del total. El verdadero reto al que nos enfrentamos en Medicina es la posibilidad de (..) (AU)
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Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Depresión/terapia , Antidepresivos/uso terapéutico , Psicoterapia , Prevención Primaria/métodos , Depresión/prevención & control , Edad de Inicio , Suicidio/prevención & control , Factores de RiesgoRESUMEN
BACKGROUND: The development, evaluation and use of biological markers is extremely important in Psychiatry. However, with certain exceptions, truly sensitive and specific markers have not still emerged. Several studies have reported immune cellular and humoral dysfunction during depression. We specifically focused on the study of the monocyte because it has a key role in the activation of the immune response. We also investigated the relationship between the immune apparatus and the hypothalamic-pituitary activity in depressed patients. METHODS: We used a longitudinal design and assessed monocyte parameters (HLA-DR, CD 35, vimentin filaments and phagocytosis index) and neuroendocrine tests (DST and TRH-test) at intake (pretreatment phase: phase I) and at follow-up (post-treatment phase: phase II) in 49 depressed patients according to Research Diagnostic Criteria (RDC). The mean follow-up interval was 12.2 +/- 2 weeks. The severity of illness was measured by means of the Hamilton Depression Rating Scale (HDRS). RESULTS: Seventy per cent of patients showed a pretreatment marked monocyte dysfunction (82.5% had at least one parameter altered). After treatment, alterations in immunological variables were significantly associated (p < 0.05) with depression scores higher than 15). We did not find any significant association between the severity of depressive symptoms and the results of the neuroendocrine tests. The combined use of both immunological and neuroendocrine tests did not add sensitivity to the immunological identification of depressed patients. Before and after treatment the immunoreactive vimentin filaments significantly increased (p < 0.01) after incubation of monocyte with naloxone. There was a significant correlation (p < 0.05) between the immune parameters studied in both phases of the study. CONCLUSIONS: The findings indicate that the monocyte dysfunction is temporally associated with the state of depression and lead us to consider the role of the monocyte parameters as sensitive depressive state markers, while the combined use of both neuroendocrine and immunological tests in current clinical practice would be debatable. On the other hand, as the cytoskeletal dysfunction was reversed with naloxone, our findings underline previous reports suggesting that an increased opioid activity could mediate monocyte dysfunction.