Diagnostic accuracy study of the VALENF instrument in hospitalization units for adults: a study protocol.

Recently, the VALENF instrument, Nursing Assessment by its acronym in Spanish, was developed as a meta-tool composed of only seven items with a more parsimonious approach for nursing assessment in adult hospitalization units. This meta-tool integrates the assessment of functional capacity, the risk of pressure injuries and the risk of falls. The general objective of this project is to validate the VALENF instrument by studying its diagnostic accuracy against the instruments commonly used in nursing to assess functional capacity, the risk of pressure injuries and the risk of falls. An observational, longitudinal, prospective study is presented, with recruitment and random selection based on admissions to six adult hospitalization units of the Hospital Universitario de La Plana. The study population will be made up of patients hospitalized in these units. The inclusion criteria will be patients over 18 years of age with a nursing assessment within the first 24 h of admission and an expected length of stay greater than 48 h and who sign the informed consent form. The exclusion criteria will be transfers from other units or centers. A sample of 521 participants is estimated as necessary. The evaluation test will be the VALENF instrument, and the reference tests will be the Barthel, Braden and Downton indices. Sociodemographic variables related to the care process and results such as functional loss, falls or pressure injuries will be collected. The evolution of functional capacity, the risk of falls and the risk of pressure injuries will be analyzed. The sensitivity, specificity and positive predictive values of the VALENF instrument will be calculated and compared to those of the usual instruments. A survival analysis will be performed for pressure injuries, falls and patients with functional loss. The VALENF instrument is expected to have at least the same diagnostic validity as the original instruments.Trial registration The study will be retrospectively registered (ISRCTN 17699562, 25/07/2023).

Experience sampling methods for the personalised prediction of mental health problems in Spanish university students: protocol for a survey-based observational study within the PROMES-U project.

INTRODUCTION: There is a high prevalence of mental health problems among university students. Better prediction and treatment access for this population is needed. In recent years, short-term dynamic factors, which can be assessed using experience sampling methods (ESM), have presented promising results for predicting mental health problems. METHODS AND ANALYSIS: Undergraduate students from five public universities in Spain are recruited to participate in two web-based surveys (at baseline and at 12-month follow-up). A subgroup of baseline participants is recruited through quota sampling to participate in a 15-day ESM study. The baseline survey collects information regarding distal risk factors, while the ESM study collects short-term dynamic factors such as affect, company or environment. Risk factors will be identified at an individual and population level using logistic regressions and population attributable risk proportions, respectively. Machine learning techniques will be used to develop predictive models for mental health problems. Dynamic structural equation modelling and multilevel mixed-effects models will be considered to develop a series of explanatory models for the occurrence of mental health problems. ETHICS AND DISSEMINATION: The project complies with national and international regulations, including the Declaration of Helsinki and the Code of Ethics, and has been approved by the IRB Parc de Salut Mar (2020/9198/I) and corresponding IRBs of all participating universities. All respondents are given information regarding access mental health services within their university and region. Individuals with positive responses on suicide items receive a specific alert with indications for consulting with a health professional. Participants are asked to provide informed consent separately for the web-based surveys and for the ESM study. Dissemination of results will include peer-reviewed scientific articles and participation in scientific congresses, reports with recommendations for universities' mental health policy makers, as well as a well-balanced communication strategy to the general public. STUDY REGISTRATION: osf.io/p7csq.

Spanish Adaptation and Validation of the World Health Organization's Violence Against Women Instrument

BACKGROUND: The World Health Organization (WHO) developed an instrument to detect violence against women that has been widely used in several countries. Despite this instrument's importance in identifying intimate partner violence against women (IPVAW), it has not been adapted for the Spanish population. The aim of this study was to adapt and validate the WHO violence against women instrument in a sample in Spain, facilitating the detection of IPVAW in this context and comparisons between countries. METHOD: After the instrument was translated and adapted into Spanish, 532 women from the general population in Spain completed it. The initial instrument consisted of 28 items. We deleted three items due to low internal consistency, resulting in 25 items in the final version. RESULTS: Suitable internal consistency was obtained through Confirmatory Factorial Analysis for physical (α = .92), psychological (α = .91), sexual (α = .86), and control behaviors subscales (α = .91) as well as for the total scale (α = .95). The instrument revealed highly prevalent IPVAW in our sample (79.7%). CONCLUSIONS: The use of the Spanish version of the WHO violence against women instrument in Spain seems justified.

Spanish Adaptation and Validation of the World Health Organization’s Violence Against Women Instrument / Adaptación y Validación Española del Instrumento de Violencia Contra las Mujeresde la Organización Mundial de la Salud

Background: The World Health Organization (WHO) developed an instrument to detect violence against women thathas been widely used in several countries. Despite this instrument’s importance in identifying intimate partner violenceagainst women (IPVAW), it has not been adapted for the Spanish population. The aim of this study was to adaptand validate the WHO violence against women instrument in a sample in Spain, facilitating the detection of IPVAWin this context and comparisons between countries. Method: After the instrument was translated and adapted intoSpanish, 532 women from the general population in Spain completed it. The initial instrument consisted of 28 items.We deleted three items due to low internal consistency, resulting in 25 items in the final version. Results: Suitableinternal consistency was obtained through Confirmatory Factorial Analysis for physical (α = .92), psychological (α =.91), sexual (α = .86), and control behaviors subscales (α = .91) as well as for the total scale (α = .95). The instrumentrevealed highly prevalent IPVAW in our sample (79.7%). Conclusions: The use of the Spanish version of the WHOviolence against women instrument in Spain seems justified.(AU)

Antecedentes: La Organización Mundial de la Salud (OMS) desarrolló un instrumento para detectar la violenciade género (VG) que ha sido ampliamente utilizado en varios países. A pesar de la importancia del instrumento paraidentificar la VG, éste no ha sido adaptado en población española. El objetivo de este estudio fue adaptar y validarel instrumento de VG de la OMS en España, facilitando la detección de la VG en este contexto y la comparaciónentre países. Método: 532 mujeres de la población general en España completaron el instrumento tras su traducción yadaptación al español. El instrumento inicial constaba de 28 ítems. Se eliminaron tres ítems debido a su baja consistenciainterna, resultando un total de 25 ítems en la versión final. Resultados: Se obtuvo una adecuada consistencia internamediante el análisis factorial confirmatorio para las subescalas de violencia física (α = .92), psicológica (α = .91), sexual(α = .86) y en conductas de control (α = .91), así como en la escala total (α = .95). El instrumento reveló alta prevalenciade VG (79,7%). Conclusiones: El uso de la versión española del instrumento de VG contra las mujeres de la OMS,justifican su uso en España.(AU)

Intraoperative haemodynamic optimisation using the Hypotension Prediction Index and its impact on tissular perfusion: a protocol for a randomised controlled trial.

INTRODUCTION: Intraoperative arterial hypotension is associated with poor postoperative outcomes. The Hypotension Prediction Index (HPI) developed using machine learning techniques, allows the prediction of arterial hypotension analysing the arterial pressure waveform. The use of this index may reduce the duration and severity of intraoperative hypotension in adults undergoing non-cardiac surgery. This study aims to determine whether a treatment protocol based on the prevention of arterial hypotension using the HPI algorithm reduces the duration and severity of intraoperative hypotension compared with the recommended goal-directed fluid therapy strategy and may improve tissue oxygenation and organ perfusion. METHODS AND ANALYSIS: We will conduct a multicentre, randomised, controlled trial (N=80) in high-risk surgical patients scheduled for elective major abdominal surgery. All participants will be randomly assigned to a control or intervention group. Haemodynamic management in the control group will be based on standard haemodynamic parameters. Haemodynamic management of patients in the intervention group will be based on functional haemodynamic parameters provided by the HemoSphere platform (Edwards Lifesciences), including dynamic arterial elastance, dP/dtmax and the HPI. Tissue oxygen saturation will be recorded non-invasively and continuously by using near-infrared spectroscopy technology. Biomarkers of acute kidney stress (cTIMP2 and IGFBP7) will be obtained before and after surgery. The primary outcome will be the intraoperative time-weighted average of a mean arterial pressure <65 mm Hg. ETHICS AND DISSEMINATION: Ethics committee approval was obtained from the Ethics Committee of Hospital Gregorio Marañón (Meeting of 27 July 2020, minutes 18/2020, Madrid, Spain). Findings will be widely disseminated through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER: NCT04301102.

Self-Care and Health-Related Quality of Life in Patients with Drainage Enterostomy: A Multicenter, Cross Sectional Study.

The current article examined stoma self-care and health-related quality of life in patients with drainage enterostomy, described clinical and sociodemographic variables and analyzed the relationship between all of them. Trained interviewers collected data using a standardized form that queried sociodemographic and clinical variables. In addition, Self-Care (SC) was measured through a specific questionnaire for Ostomized Patients (CAESPO) and Health-Related Quality of Life (HRQoL) through the Stoma Quality of Life questionnaire (S-QoL), which are not included in the electronic medical record. This was a multicenter, cross sectional study conducted in four hospitals of the province of Castellon (Spain), where 139 participants were studied. As novel findings, it was found that the level of SC of the stoma was high and was positively correlated with health-related quality of life. In relation to SC and sociodemographic variables studied in the research, women, married patients and active workers presented significantly higher scores than the rest. In relation to the clinical variables, we highlight the highest scores of the autonomous patients in the care of their stoma and those who used irrigations regularly. The lowest scores were the patients with complications in their stoma. We can highlight the validity and reliability of the CAESPO scale for biomedical and social research, and the importance of skills related to self-care of ostomy patients for a good level of HRQoL.

Longitudinal Effects of Distress and Its Management During COVID-19 Lockdown in Spain.

Introduction: The COVID-19 pandemic that hit Spain during March 2020 forced the strict confinement of the population for 2 months. The objectives of this study were (a) to assess the magnitude and duration of the influence of confinement on people's Distress, (b) to study the temporal sequence of stress, and (c) to show how different day-to-day activities and personal variables influence perceived Distress levels. Method: A daily registration was completed by 123 people, with ages ranging from 21 to 75 years old ( X ¯ = 43, SD = 10 years), of which there were 40 men (32%) and 83 females (68%). During 45 days of lockdown, from March 19th to May 3rd, participants were asked to respond to a socio-demographic survey and make daily records comprising the MASQ-D30 and some day-to-day behaviors. Pooled time series was applied to establish what effect time had on the dependent variable. Results: Distress has a 14-day autoregressive function and gender, physical activity, sexual activity, listening to music, and teleworking also influence Distress. It has been hypothesized that the intercept presents variability at level 2 (individual), but it has not been significant. Interactions between Gender-Telecommuting, and Gender-Physical Activity were observed. Approximately 66% of the variance of Distress was explained (R 2 = 0.663). Discussion: At the beginning of the lockdown, the average levels of Distress were well above the levels of the end (z = 3.301). The individuals in the sample have followed a very similar process in the development of Distress. During the lockdown, the "memory" of Distress was 2 weeks. Our results indicate that levels of Distress depend on activities during lockdown. Interactions exist between gender and some behavioral variables that barely influence Distress in men but decrease Distress in women. The importance of routine maintenance and gender differences must be considered to propose future interventions during confinement.

The Acoustic Dimension of Reading: Does Musical Aptitude Affect Silent Reading Fluency?

Fluent reading in a foreign language includes a complex coordination process of visual and auditory nature as the reading brain transforms written symbols into speaking auditory patterns through subvocalization (inner voice). The auditory information activated for reading involves the projection of speech prosody and allows, beyond letters and words decoding, the recognition of word boundaries and the construction of the melodic contours of the phrase. On the one hand, phonological awareness and auditory working memory have been identified in the literature as relevant factors in the reading process as skilled readers keep the acoustic information in their auditory working memory to predict the construction of larger lexical units. On the other hand, we observed that the inclusion of musical aptitude as an element belonging to the acoustic dimension of the silent reading aptitude of adults learning a foreign language remains understudied. Therefore, this study examines the silent reading fluency of 117 Italian adult students of Spanish as a foreign language. Our main aim was to find a model that could show if linguistic, cognitive and musical skills influence adults' silent reading fluency. We hypothesized that learners' contextual word recognition ability in L1 and FL in addition to, phonological awareness, auditory working memory and musical aptitude, elements related to the acoustic dimension of reading, would influence adults' silent reading fluency. Our structural modeling allows us to describe how these different variables interact to determine the silent reading fluency construct. In fact, the effect of musical aptitude on fluent silent reading in our model reveals to be stronger than phonological awareness or auditory working memory.

Pooled Time Series Modeling Reveals Smoking Habit Memory Pattern.

Smoking is a habit that is hard to break because nicotine is highly addictive and smoking behavior is strongly linked to multiple daily activities and routines. Here, we explored the effect of gender, age, day of the week, and previous smoking on the number of cigarettes smoked on any given day. Data consisted of daily records of the number of cigarettes participants smoked over an average period of 84 days. The sample included smokers (36 men and 26 women), aged between 18 and 26 years, who smoked at least five cigarettes a day and had smoked for at least 2 years. A panel data analysis was performed by way of multilevel pooled time series modeling. Smoking on any given day was a function of the number of cigarettes smoked on the previous day, and 2, 7, 14, 21, 28, 35, 42, 49, and 56 days previously, and the day of the week. Neither gender nor age influenced this pattern, with no multilevel effects being detected, thus the behavior of all participants fitted the same smoking model. These novel findings show empirically that smoking behavior is governed by firmly established temporal dependence patterns and inform temporal parameters for the rational design of smoking cessation programs.

Correction: Intensive longitudinal modelling predicts diurnal activity of salivary alpha-amylase.

[This corrects the article DOI: 10.1371/journal.pone.0209475.].

Clinical recurrence of submucosal myoma after a mechanical hysteroscopic myomectomy: Review after 5 years follow up.

OBJECTIVE: Evaluation of five years follow up of the clinical recurrence after hysteroscopic myomectomies with MyoSure® morcellator in our district. STUDY DESIGN: Premenopausal patients from April 2013 to October 2018, with symptoms of abnormal uterine bleeding, and/or infertility, and sonographic suspicion of submucosal myoma, confirmed by diagnostic hysteroscopy prior to myomectomy were included in the prospective, not randomized cohort study (N = 320). All patients had a follow up visit between three to six months post procedure. Further follow up was established by chart review. The information was extracted from the medical records. Patient characteristics were expressed as mean ±â€¯SD or median (interquartile range) for continuous data (assumption of normality assessed using the Kolmogorov-Smirnov test). Dependence relationship between presence of corporal myomas and the performance of a major long-term surgery, and between the amount of submucosal myomas and clinical recurrence throughout the 5 years of follow-up were studied were studied by χ2. RESULTS: After one year follow up, no recurrence or symptoms were noted. 53 (16.6%) re-morcellations were performed due to incomplete resection. At the second year, three women who were discharged previously were classified as recurrence (0.9%). There were 99 women remaining to be evaluated (30.90%) in the second year. A percentage estimation of 5-6 recurrences with the 100% of women evaluated. In the third year, only one woman was classified as recurrence (0.3%), with 176 (55%) women not evaluated. At the fourth and fifth year of follow-up, 75% are still awaiting complete of the study five years. No relationship was observed in the presence of corporal myomas and recurrence throughout the 5 years of follow-up (χ2 = 0.000, p = 0.994). Dependence relationship was observed between the presence of corporal myomas and the performance of a major long-term surgery (χ2 = 11.757, p = .001, OR = 3.528). CONCLUSION: In office hysteroscopic mechanical myomectomy with MyoSure® morcellator of submucosal fibromas was a highly effective therapy for women, at three years of follow-up. It appears to give satisfactory long-term results with a low recurrence rate and without significant complications.

A Music-Mediated Language Learning Experience: Students' Awareness of Their Socio-Emotional Skills.

In a society where mobility, globalization and contact with people from other cultures have become its distinctive traits, the enhancement of plurilingualism and intercultural understanding should be of the utmost concern. From a positive psychology perspective, agency is the human capacity to affect other people positively or negatively through one's actions. This agentic vision can be related to mediation, a concept rooted in socio-cultural learning theory, where social interaction is considered a fundamental cornerstone in the development of cognition. These social interactions in the language learning setting may be facilitated through musical activities due to their social bonding effect. This paper tries to offer insights into how a music-mediated experience in language learning may develop students' interpersonal and collaborative competences to become active members of a more inclusive society. Mediation, considered to be a paradigm shift in the foreign language classroom and for different out-of-class language learning possibilities, could also provide an environment where learners maximize their emotional intelligence. Our paper focuses on this paradigm shift spearheaded by the Common European Framework for Languages Companion Volume (CEFR/CV) and the considerable repercussions it is bound to have for foreign language didactics, as cooperative tasks become central to foreign language learning. We hypothesize that mediated language learning experiences (MeLLEs) imply a socio-emotional change in learners, focusing on the others, on their needs and interests, by trying to help them understand texts, concepts or facilitating communication with their peers. An intervention with a music-MeLLE was designed and implemented in an L2 classroom of adult learners with divergent backgrounds. A self-assessment scale with mediation descriptors and the socio-emotional expertise scale (SEE) were administered. Results show that students become more mindful of their strengths, and of their capacity for collaboration and teamwork. This leads to more awareness of their mediation skills. Students' mediation skills correlate significantly with their socio-emotional skills - specifically with their expressivity. The implementation of a music-mediated experience also promoted tolerance and enhanced learners' intrinsic motivations for language learning at the same time as acknowledging their diversity.

Intensive longitudinal modelling predicts diurnal activity of salivary alpha-amylase.

Salivary alpha-amylase (sAA) activity has been widely used in psychological and medical research as a surrogate marker of sympathetic nervous system activation, though its utility remains controversial. The aim of this work was to compare alternative intensive longitudinal models of sAA data: (a) a traditional model, where sAA is a function of hour (hr) and hr squared (sAAj,t = f(hr, hr2), and (b) an autoregressive model, where values of sAA are a function of previous values (sAAj,t = f(sAA j,t-1, sAA j,t-2, …, sAA j,t-p). Nineteen normal subjects (9 males and 10 females) participated in the experiments and measurements were performed every hr between 9:00 and 21:00 hr. Thus, a total of 13 measurements were obtained per participant. The Napierian logarithm of the enzymatic activity of sAA was analysed. Data showed that a second-order autoregressive (AR(2)) model was more parsimonious and fitted better than the traditional multilevel quadratic model. Therefore, sAA follows a process whereby, to forecast its value at any given time, sAA values one and two hr prior to that time (sAA j,t = f(SAAj,t-1, SAAj,t-2) are most predictive, thus indicating that sAA has its own inertia, with a "memory" of the two previous hr. These novel findings highlight the relevance of intensive longitudinal models in physiological data analysis and have considerable implications for physiological and biobehavioural research involving sAA measurements and other stress-related biomarkers.

Effect of moderate and regular consumption of Cinco Jotas acorn-fed 100% Iberian ham on overall cardiovascular risk: A cohort study.

OBJECTIVE: To evaluate the impact that the moderate and regular consumption of Cinco Jotas acorn-fed 100% Iberian ham has on overall cardiovascular risk, lipid parameters, blood pressure, and weight. METHODS: A longitudinal, analytical, and quasi-experimental clinical study with repeated measures was carried out with 100 randomly selected individuals in primary care. The sample population included men and women (64%) between the ages of 25 and 55 (42.08, SD 9.6) who were not diagnosed with any cardiovascular illness or diabetes, were not undergoing antihypertensive treatment, nor taking lipid-lowering drugs. There were four visits during a 2-week washout period for the first of three phases. Phases 2 and 3 included an 8-week habitual diet phase followed by an 8-week intervention phase when participants consumed 40 g daily of acorn-fed 100% Cinco Jotas Iberian ham. Measurements of cardiovascular risk factors were taken following the SCORE table. These included total cholesterol, high-density lipoproteins cholesterol (HDL-c), low-density lipoproteins cholesterol (LDL-c), triglycerides (TG), and weight. RESULTS: The average vascular risk (SCORE) was 0.20 (SD 0.49) before the consumption phase and 0.18 (SD 0.48) at the end of the study (p > 0.05). An increase in HDL-c of 5 mg/dl was observed while there was a decrease in LDL-c and TG of 10 mg/dl (p < 0.05). There were no differences in total cholesterol levels, blood pressure, or weight; nor were differences observed in average consumption of calories, protein, lipids, carbohydrates, or alcohol (p > 0.05). CONCLUSIONS: The daily consumption of 40 g of Cinco Jotas acorn-fed 100% Iberian ham does not increase the risk of cardiovascular disease and has a favorable impact on lipid levels without affecting blood pressure or weight.

Development and Validation of an Instrument Measuring Self-Care in Persons With a Fecal Ostomy.

PURPOSE: The purpose of this study was to describe development of the Specific Self-Care for Ostomized Patients Questionnaire (CAESPO) instrument and evaluate its construct validity, internal reliability, and test-retest reliability (temporal stability). DESIGN: Prospective evaluation of psychometric properties of the instrument. SUBJECTS AND SETTING: The study sample comprised 125 persons (n = 89, 71.2% men) with a temporary (n = 42, 33.6%) and permanent (n = 83, 66.4%) colostomy (n = 102, 81.6%) and ileostomy (n = 23, 18.4%). Their mean age was 66.72 years; all had undergone ostomy surgery at least 3 months prior to study participation. Participants were drawn from 4 acute care facilities in the province of Castellon, Spain. INSTRUMENT: The CAESPO Questionnaire is completed by a nurse or health care provider. It comprises 3 sections: the first queries sociodemographic data, the second queries pertinent clinical data, and the third contains 58 scored items with 4 ordinal responses. Possible cumulative scores ranged from 58 to 232 points; scores are reported based on a derived percentage score that varies from 0 to 100, where a score of 0 indicates lower self-care and 100 indicates a high level of self-care. METHODS: Data were collected at baseline and retesting was completed 6 months later. Internal consistency of the CAESPO was evaluated using the Cronbach α coefficient; temporal stability (test-retest reliability) was evaluated using the test-retest procedure; confirmatory factor analysis based on conceptually hypothesized factor structure was performed to evaluate construct validity. RESULTS: Initial assessment of the construct validity of the CAESPO using confirmatory factory analysis revealed a poor fit, resulting in removal of multiple items from each of the subscales owing to low-factor loading values. The final model comprised 58 scored items; it was found to have a good fit based on standard indices (χ= 43.132, P < .001; root mean square error of approximation = 0.155 [0.107-0.204]; Bentler-Bonett normed fit index = 0.957; comparative fit index = 0.967; incremental fit index = 0.968), indicating adequate construct validity. The internal consistency of the CAESPO total score was acceptable at α = 0.889. Test-retest reliability (temporal stability) was deemed excellent (α = 0.987). CONCLUSIONS: Psychometric tests indicate that the CAESPO is a valid and reliable instrument for measuring self-care in persons living with a fecal ostomy.

Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohn’s disease with fecal calprotectin

Background: Fecal biomarkers, especially fecal calprotectin, are useful for predicting endoscopic activity in Crohn’s disease; however, the cut-off point remains unclear. The aim of this paper was to analyze whether faecal calprotectin and M2 pyruvate kinase are good tools for generating highly accurate scores for the prediction of the state of endoscopic activity and mucosal healing. Methods: The simple endoscopic score for Crohn’s disease and the Crohn’s disease activity index was calculated for 71 patients diagnosed with Crohn’s. Fecal calprotectin and M2-PK were measured by the enzyme-linked immunosorbent assay test. Results: A fecal calprotectin cut-off concentration of ≥ 170 μg/g (sensitivity 77.6%, specificity 95.5% and likelihood ratio +17.06) predicts a high probability of endoscopic activity, and a fecal calprotectin cut-off of ≤ 71 μg/g (sensitivity 95.9%, specificity 52.3% and likelihood ratio -0.08) predicts a high probability of mucosal healing. Three clinical groups were identified according to the data obtained: endoscopic activity (calprotectin ≥ 170), mucosal healing (calprotectin ≤ 71) and uncertainty (71 > calprotectin < 170), with significant differences in endoscopic values (F = 26.407, p < 0.01). Clinical activity or remission modified the probabilities of presenting endoscopic activity (100% vs 89%) or mucosal healing (75% vs 87%) in the diagnostic scores generated. M2-PK was insufficiently accurate to determine scores. Conclusions: The highly accurate scores for fecal calprotectin provide a useful tool for interpreting the probabilities of presenting endoscopic activity or mucosal healing, and are valuable in the specific clinical context (AU)

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Accurate cut-offs for predicting endoscopic activity and mucosal healing in Crohn's disease with fecal calprotectin.

BACKGROUND: Fecal biomarkers, especially fecal calprotectin, are useful for predicting endoscopic activity in Crohn's disease; however, the cut-off point remains unclear. The aim of this paper was to analyze whether faecal calprotectin and M2 pyruvate kinase are good tools for generating highly accurate scores for the prediction of the state of endoscopic activity and mucosal healing. METHODS: The simple endoscopic score for Crohn's disease and the Crohn's disease activity index was calculated for 71 patients diagnosed with Crohn's. Fecal calprotectin and M2-PK were measured by the enzyme-linked immunosorbent assay test. RESULTS: A fecal calprotectin cut-off concentration of ≥ 170 µg/g (sensitivity 77.6%, specificity 95.5% and likelihood ratio +17.06) predicts a high probability of endoscopic activity, and a fecal calprotectin cut-off of ≤ 71 µg/g (sensitivity 95.9%, specificity 52.3% and likelihood ratio -0.08) predicts a high probability of mucosal healing. Three clinical groups were identified according to the data obtained: endoscopic activity (calprotectin ≥ 170), mucosal healing (calprotectin ≤ 71) and uncertainty (71 > calprotectin < 170), with significant differences in endoscopic values (F = 26.407, p < 0.01). Clinical activity or remission modified the probabilities of presenting endoscopic activity (100% vs 89%) or mucosal healing (75% vs 87%) in the diagnostic scores generated. M2-PK was insufficiently accurate to determine scores. CONCLUSIONS: The highly accurate scores for fecal calprotectin provide a useful tool for interpreting the probabilities of presenting endoscopic activity or mucosal healing, and are valuable in the specific clinical context.

Vasculitis tras la monitorización de presión arterial / Vasculitis after blood pressure monitoring

Fundamento. Descripción de aparición de una equimosis en brazo simultáneamente con vasculitis de origen leucocitoclástica, propuesta de usos alternativos a la toma de presión arterial, y el estudio de efectos secundarios a dicha medida. Paciente. Varón de 80 años acude a urgencias con disnea, insuficiencia cardíaca, insuficiencia renal prediálisis con hiperpotasemia e inestabilidad hemodinámica. Durante su estancia desarrolló una lesión cutánea con aspecto de púrpura palpable, desde el límite inferior del manguito de presión arterial hasta la zona distal de la mano y que no desaparecía a la vitropresión, y prurito. Durante su ingreso, la lesión del brazo se extendió a todos los miembros, tanto superiores como inferiores. Resultados. El estudio de la lesión concluyó con diagnóstico de vasculitis leucocitoclástica por presencia de eosinófilos, lo que sugiere probable etiología medicamentosa a la toma de antibiótico desde 7 días antes de la entrada a urgencias. Discusión. Se plantea la necesidad de monitorización seriada de la presión arterial y la duración de dicha monitorización en pacientes inestables frente a los efectos secundarios de esta técnica. También el estudio de otras utilidades de la toma de presión arterial (AU)

Introduction. Description of appearance of ecchymosis on an arm, simultaneously with a classical Leukocytoclastic Vasculitis, the proposal of alternative utilities of measuring blood pressure, and the study of side effects to that measure. Patient. Case 80-year-old male came to ER with dyspnea, heart failure, predialysis renal failure with hyperkalemia and hemodynamic instability. During his stay he developed a skin lesion that looks like palpable purpura, from the lower limit of the blood pressure cuff to the distal area of the hand that not disappeared with vitropression, and pruritus. During admission the arm injury was extended to all members, both upper and lower. Results. The study concluded with diagnosis of Leukocytoclastic Vasculitis given the presence of eosinophils, that which suggested probable drug etiology to an antibiotic that had been taken since seven days prior to admission to ER. Discusion. The need for serial monitoring of blood pressure, and the duration of such monitoring in unstable patients considering the side effects of those techniques was questioned. In addition, the study of other utilities of measuring blood pressure (AU)

Vasculitis after blood pressure monitoring. / Vasculitis tras la monitorización de presión arterial.

INTRODUCTION: Description of appearance of ecchymosis on an arm, simultaneously with a classical Leukocytoclastic Vasculitis, the proposal of alternative utilities of measuring blood pressure, and the study of side effects to that measure. PATIENT: Case 80-year-old male came to ER with dyspnea, heart failure, predialysis renal failure with hyperkalemia and hemodynamic instability. During his stay he developed a skin lesion that looks like palpable purpura, from the lower limit of the blood pressure cuff to the distal area of the hand that not disappeared with vitropression, and pruritus. During admission the arm injury was extended to all members, both upper and lower. RESULTS: The study concluded with diagnosis of Leukocytoclastic Vasculitis given the presence of eosinophils, that which suggested probable drug etiology to an antibiotic that had been taken since seven days prior to admission to ER. DISCUSION: The need for serial monitoring of blood pressure, and the duration of such monitoring in unstable patients considering the side effects of those techniques was questioned. In addition, the study of other utilities of measuring blood pressure.

Antropología e historia de las drogas caseras o cotidianas: desde la búsqueda del efecto analgésico, anestésico y ansiolítico hasta la búsqueda de efectos psicosociales / No disponible

El consumo de sustancias con el fin de producir algún tipo de alteración de la percepción y de la conducta es inherente a la especie humana, tal y como podemos comprobar en los distintos periodos temporales de la historia humana. Desde la recolección de miel y la elaboración de hidromiel, el consumo de adormidera o de plantas antiálgicas en la prehistoria; pasando por el vino, la cerveza, el opio, el beleño y la mandrágora en la antigüedad; los destilados del vino y el café en la edad media; el láudano, el aguardiente, las colas y el tabaco en el renacimiento; hasta la cocaína en el s. XIX, parece que el ser humano siempre ha tenido cerca la ayuda de sustancias estimulantes, sedantes, anestésicas o alucinógenas, con usos que van desde fines ritualísticos hasta fines sociales, y que eran consumidos tanto de forma institucionalizada como de forma casera, observando que es habitual el inicio del consumo con cierto control hasta que deviene a un consumo casero o lúdico. El objetivo de este trabajo es presentar cómo estas sustancias caseras o cotidianas se han venido presentando en los principales periodos históricos y que, aunque pudieran considerarse alimentos, producían otros efectos muy oportunos en ocasiones (AU)

Substance use in order to produce some kind of alteration of perception and behaviour is inherent in the human species, as we can see in the different periods in human history. From honey collection and hydromel making, consumption of poppy or antalgic plants in prehistory, through wine, beer, opium, henbane and mandrake in ancient times, wine distillates and coffee in the Middle Ages, laudanum, spirits, cola nuts and tobacco in the Renaissance, to cocaine in the XIX century, it seems that humans have always had at hand the aid of stimulants, sedatives, anaesthetic or hallucinogenic substances, with uses ranging from ritualistic to social purposes, and that they were consumed on both an institutionalized basis or at home, noting that the usual pattern is initiation with some control until this turns into domestic or recreational use. The aim of this paper is to present how these commonplace or household substances have come forward in the main historical periods and, although they could be considered foodstuffs, to show how they occasionally produced other very opportune effects (AU)