La dependencia: efectos en la salud familiar / Dependent relative: Effects on family health

Objetivos: Los objetivos de este trabajo son analizar cómo influye el hecho de que en el hogar haya una persona dependiente en el estado de salud de las personas con quien convive y en los estilos de vida; compararlo con otras situaciones que impliquen dedicación de tiempo y energía, y analizar diferencias de género y edad en cada etapa el ciclo vital. Diseño: Estudio descriptivo transversal analizando datos secundarios. Emplazamiento: El método de recogida de información es el de entrevista personal asistida por ordenador en las viviendas seleccionadas, realizada por el Ministerio de Sanidad, Servicios Sociales e Igualdad. Participantes: Un total de 19.351 individuos mayores de 25 años que realizaron la Encuesta Nacional de Salud 2011-2012 (ENSE 2011/2012). Mediciones principales: Estudio llevado a cabo con datos sobre la sociedad española procedentes de la ENSE 2011/12. Como marco empírico, seleccionamos el modelo Logit, reportando los datos en odds ratio. Las estimaciones se repiten de manera independiente por submuestras de edad y género. Resultados: La salud de las personas que conviven con una persona dependiente es peor que la de aquellas personas que no conviven (hasta 5 veces más riesgo de tener problemas de salud), especialmente si se es mujer, de edad avanzada, con un nivel educativo bajo o no trabaja. También ser cuidador reduce la probabilidad de mantener unos hábitos saludables como son el realizar ejercicio, el descanso o una dieta equilibrada. Conclusiones: Por lo general, convivir con una persona dependiente reduce la probabilidad de mantener estilos de vida saludables y deteriora la salud. Encontramos importantes diferencias de género y edad (AU)

Objetives: The purpose of this work is to analyse the effects on informal caregiver‘s health and lifestyle when living with a dependent person at home. A comparison will be made between this situation and other situations involving commitment of time and energy, taking into account gender and age differences in each stage of the life cycle. Design: Cross-sectional study analysing secondary data. Setting: The method used for collecting information is the computer assisted personal interview carried out in selected homes by the Ministry of Health, Social Services and Equality. Participants: The study included 19,351 participants aged over 25 years who completed the 2011-2012 Spanish National Health Survey. Main measurements: This research is based on demographic information obtained from a Spanish National Health Survey (2011/12). Using an empirical framework, the Logit model was select and the data reported as odds ratio. The estimations were repeated independently by sub-groups of age and gender. Results: The study showed that the health of people who share their lives with a dependent person is worse than those who do not have any dependent person at home (they are 5 times at higher risk of developing health problems). The study found that being a woman, advance age, low educational level and does not work, also has an influence. Being a caregiver reduces the likelihood of maintaining a healthy lifestyle through physical exercise, relaxation, or eating a balanced diet. Conclusions: Living with a dependent person reduces the likelihood of maintaining healthy lifestyles and worsens the state of health of family members. Significant differences in gender and age were found (AU)

[Dependent relative: Effects on family health]. / La dependencia: efectos en la salud familiar.

OBJETIVES: The purpose of this work is to analyse the effects on informal caregiver's health and lifestyle when living with a dependent person at home. A comparison will be made between this situation and other situations involving commitment of time and energy, taking into account gender and age differences in each stage of the life cycle. DESIGN: Cross-sectional study analysing secondary data. SETTING: The method used for collecting information is the computer assisted personal interview carried out in selected homes by the Ministry of Health, Social Services and Equality. PARTICIPANTS: The study included 19,351 participants aged over 25 years who completed the 2011-2012 Spanish National Health Survey. MAIN MEASUREMENTS: This research is based on demographic information obtained from a Spanish National Health Survey (2011/12). Using an empirical framework, the Logit model was select and the data reported as odds ratio. The estimations were repeated independently by sub-groups of age and gender. RESULTS: The study showed that the health of people who share their lives with a dependent person is worse than those who do not have any dependent person at home (they are 5 times at higher risk of developing health problems). The study found that being a woman, advance age, low educational level and does not work, also has an influence. Being a caregiver reduces the likelihood of maintaining a healthy lifestyle through physical exercise, relaxation, or eating a balanced diet. CONCLUSIONS: Living with a dependent person reduces the likelihood of maintaining healthy lifestyles and worsens the state of health of family members. Significant differences in gender and age were found.

Feto acardio en gestación gemelar a término / Acardiac fetus in a twin pregnancy at term

La secuencia TRAP (secuencia de perfusión arterial reversa) es una seria complicación de los embarazos gemelares monocoriales, donde el gemelo afectado (feto acardio) es perfundido de forma reversa por el gemelo bomba a través de una gran anastomosis arterio-arterial y veno-venosa. Presentamos un caso de una gestación gemelar monocorial a término, donde uno de los gemelos es un feto acardio, presentando únicamente un remedo de extremidad inferior y tejido colónico rudimentario. El otro gemelo nació sano, hecho poco frecuente en esta patología, donde el gemelo bombeador presenta distintos grados de sobrecarga cardiaca, llegando hasta un 50% de muertes intra-útero por fallo cardiaco (AU)

Twin reversed arterial perfusion sequence (TRAP) is a serious complication of monochorionic twin pregnancies, in which one twin perfuses the other twin (an acardiac fetus) via large arterio-arterial and veno-venous anastomoses. We report a case of monochorionic twin pregnancy at term, in which the second twin was an acardiac fetus with only an undeveloped lower limb and rudimentary colonic tissue. The first twin was born healthy, a very rare outcome in this entity as the pump twin usually shows distinct degrees of cardiac overload, leading to intrauterine death from heart failure in more than 50% of cases (AU)

Panoramic view of the Fifth International Symposium on Stem Cell Therapy and Applied Cardiovascular Biotechnology, April 2008, Madrid (Spain).

The Fifth International Symposium on Stem Cell Therapy and Applied Cardiovascular Biotechnology was held on April 24th-25th, 2008, at the Auditorium of the High Council of Scientific Research of Spain (CSIC) in Madrid, as a continuation of a series of yearly meetings, organized in an attempt to encourage translational research in this field and facilitate a positive interaction among experts from several countries, along with industry representatives and journalists. In addition, members of the Task Force of the European Society concerning the clinical investigation of the use of autologous adult stem cells for repair of the heart gathered and discussed an update of the previous consensus, still pending of publication. In this article, we summarize some of the main topics of discussion, the state-of-the-art and latest advances in this field, and new challenges brought up for the near future.

Present and future of stem cells for cardiovascular therapy.

In this review we summarize the available evidence regarding the application of stem cell therapy for human cardiovascular repair, going over the principal concepts that will help us understand the present and future of this therapy: first the different types of cells available in clinical practice, second the delivery approaches, and third highlighting the most important clinical studies and their efficacy and safety results. In addition, we also speculate on the value of current clinical data to gain an insight into the mechanism of stem cell-based cardiac repair and to design clinical trials in the future.

Documento A. E. N sobre la propuesta de regulación del tratamiento ambulatorio involuntario de las personas con trastornos psíquicos / Document S.N.A. regarding the proposal of regulation of the involuntary outpatient treatment of people with mental desorder

Recientemente se ha presentado en el Parlamento Español una Propuesta de Modificación de la ley de Enjuiciamiento Civil para regular los tratamientos no voluntarios de las personas con trastornos psíquicos. Este artículo recoge la opinión de la Asociación Española de Neuropsiquiatría al respecto. Tras analizar las posibles causas que pueden explicar la aparición de esta propuesta, se examina el marco legal, y se señalan los riesgos e implicaciones del tratamiento ambulatorio involuntario en los derechos humanos de las personas con trastorno mental. Entre las conclusiones figura el rechazo de esta propuesta por tratarse de una regulación legislativa específica para las personas que padecen trastornos psíquicos, al considerarla discriminatoria y estigmatizante, y no existir suficiente nivel de evidencia sobre su eficacia como para recomendar su aplicación

Recently, a new proposal had been reported in the Spanish Congress to regulate the Involuntary Outpatient Treatment of people with mental disorder. This article collect the opinion of the Spanish Neuropsychiatric Association. After analysing the possible causes that could explain the emergence of this proposal, we investigate the legal environment, and we indicate the risks and consecuences of the Involuntary Outpatient Treatment in the human rights of people with mental disorder. Among the conclusions we emphasize the refusal of this proposal because it is a specific regulation to people with mental disorder, it is discriminatory and stigmatize, and there isn't enough evidence level over its efficiency to recommend the application (AU)

Immunophenotypic analysis of myelodysplastic syndromes.

BACKGROUND AND OBJECTIVES: In contrast with hematologic malignancies in which the value of immunophenotypic studies is well established, information on the immunophenotypic characteristics of myelodysplastic syndromes (MDS) is scanty. The main goal of the present study was to explore the immunophenotypic differences between patients with MDS and normal individuals, including changes in distribution of cell lineages as well as phenotypic aberrations and blockades in cell maturation pathways. DESIGN AND METHODS: In MDS the proportion of bone marrow CD34+ cells was higher than in normal patients but the most immature progenitors (CD34+CD38-) were less represented. By contrast the proportion of myelomonocytic CD34+ cells was greater than in normal individuals, translating into an increased myeloid/non-myeloid CD34+ hematopoietic progenitor cell ratio. RESULTS: This suggests that in MDS, the majority of CD34+ cells are already committed to the myeloid lineage. Upon analyzing the granulo-monocytic differentiation pathway, MDS patients showed an increased proportion of monocytic cells with a decreased percentage of cells of neutrophil lineage, leading to a lower neutrophil/monocytic cell ratio. Maturational arrests in the monocytic but not in the neutrophil differentiation pathway were observed. In refractory anemia with excess blasts in transformation (RAEB-t) such blockades mainly occurred during the earliest stages of differentiation but in the other MDS subtypes they occurred in later stages. INTERPRETATION AND CONCLUSIONS: Phenotypic aberrations occurred in 90% of patients and a high proportion of cases showed >=2 aberrations. In summary, our results show that, in addition to an abnormal distribution of the bone marrow cell compartment, MDS patients frequently show aberrant phenotypes and maturational arrests. Some of these features may help in cases in which the diagnosis of MDS is questionable.