Presence of Legionella spp. in human dental plaque.

AIMS: The aim of this research is to verify the presence of Legionella in human dental plaque. METHODS: 65 adult patients not treated with systemic or local antibiotics at least 2 months before the time of sample collection were enrolled for plaque collection between September 2015 and December 2016. A brief questionnaire about lifestyle and health risks was administered. Legionella spp. detection has been executed by semi- nested PCR. RESULTS: 8 out of 65 plaque samples (12.3%) were positive for Legionella spp. As regards health risks and lifestyle aspects, no relevant difference was observed between patients involved in our study, except for two positive patients who have reported a COPD ongoing and a pneumonia in the past. CONCLUSIONS: This study represents a step forward in the knowledge of reservoirs of the microorganism and richness of oral microbiota.

Diferencias clínicas en la depresión según la clase social / Clinical differences in depression according to social class

Los objetivos del estudio fueron: a) determinar si había diferencias en la semiología depresiva según la clase social (CS); b) averiguar si estas diferencias, en caso de existir, se debían fundamentalmente a la CS o más bien a otras variables clínicas o sociodemográficas. Se estudiaron 140 pacientes ambulatorios de Galicia con el CET-DE, el 61 por ciento rurales, diagnosticados de depresión según criterios DSM-III-R. Se elaboró una escala de CS a partir de la ocupación del cabeza de familia, los ingresos familiares y los estudios del paciente. Los pacientes de los niveles inferiores de CS referían con mayor frecuencia síntomas físicos y ansiedad; y los de las superiores, deterioro cognitivo y culpa. En el análisis logístico se observó que las variables socioeconómicas y la residencia eran las que en mayor medida explicaban estas diferencias (AU)

Propuesta de una escala de clase social destinada a pacientes con depresión / Proposal of a social class scale destined to depresive patients

Se elaboró una escala de cinco niveles de clase social con la ocupación del cabeza de familia, el nivel de estudios del paciente y los ingresos familiares. Los objetivos del estudio fueron determinar si la clase social elaborada es representativa de los factores socioeconómicos y útil para el estudio de las diferencias clínicas en pacientes con depresión en Galicia.Se estudiaron 140 pacientes diagnosticados de depresión (DSM-III-R), 60,7 por ciento del medio rural. La escala de clase social se asoció de forma significativa con todas las variables e indicadores socioeconómicos (p <0,001), excepto con la proporción entre dormitorios y personas.La clase social elaborada y los estudios, fueron las variables con las que mayores diferencias clínicas se apreciaron.La escala de clase social elaborada cumplió los objetivos para los que fue diseñada. Al estudiar la clase social en pacientes con depresión es preferible utilizar una escala multidimensional (AU)

School-based behavioral treatment for social anxiety disorder in adolescents: results of a pilot study.

OBJECTIVE: To provide preliminary estimates of feasibility and effectiveness for school-based behavioral treatment in adolescents with social anxiety disorder. METHOD: Six adolescents with social anxiety disorder were treated in a 14-session group treatment program conducted at their school. Assessments were conducted at baseline and after treatment. RESULTS: All participants were classified as treatment responders (markedly or moderately improved). Half of the participants did not meet diagnostic criteria for social phobia after treatment. Clinician severity ratings, as measured by the Anxiety Disorders Interview Schedule for Children for DSM-IV: Child Version and the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA), decreased significantly after intervention, with effect sizes of 2.5 and 1.8, respectively. All LSAS-CA scale scores decreased significantly after treatment. Self-reported social phobia symptoms on the Social Phobia and Anxiety Inventory for Children were not significantly reduced. Fear and avoidance ratings of the 10 most feared situations significantly decreased after treatment, with effect sizes of 1.5 for anxiety and 2.1 for avoidance. CONCLUSIONS: This study provides preliminary support for the promise of school-based behavioral intervention for treating social phobia in adolescents. The school environment may be a rich and innovative setting for implementation of behavioral treatment because this is the setting where adolescents with social phobia endure the most distress.

[Clinical perspective in the folie à trois: a case report]. / Aspectos clínicos de la folie à trois: a propósito de un caso.

Induced psychotic disorder is infrequent. We report a case in which three members of the same family were affected. We analyzed certain etiological factors, family relationship and social and environmental conditions.

Aspectos clínicos de la folie à trois: a propósito de un caso / Clinical perspective in the folie à trois: a case report

El trastorno psicótico inducido es un cuadro clínico poco frecuente. Describimos un caso en el que están implicados tres miembros de una misma familia. Se analizan los factores etiológicos, la dinámica familiar y el entorno social en las psicosis inducidas (AU)

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Multimodal comparisons of social phobia subtypes and avoidant personality disorder.

The purpose of the present study was to further clarify the behavioral, physiological, and verbal response of patients with circumscribed social (speech) phobia, generalized social phobia without avoidant personality disorder, and generalized social phobia with avoidant personality disorder. Patients completed a battery of verbal report instruments and participated in two behavioral assessment tests. Measures of avoidance/escape behavior, cardiac response, level of behavioral skill, state anxiety, and positive and negative self-statements during performance were collected. Significant differences across response domains were found between the circumscribed social phobia and the generalized groups. Most of the distinctions were between individuals with circumscribed social phobia and those with both generalized social phobia and avoidant personality disorder, with the former group having less overall psychopathology. In addition, there was substantial overlap of problems between generalized social phobia individuals with and without avoidant personality disorder. Implications for the conceptualization of social phobia are discussed in terms of the differences among social phobia subtypes.

Psychosocial treatments for social phobia.

Increasing recognition of the prevalence and impairment associated with social phobia has spurred the development of effective psychosocial treatments for this disorder. Exposure-based interventions have the most empirical support. This article applies the tripartite model of anxiety to social phobia, describes state-of-the-art psychosocial treatments, and highlights studies on the comparative and combined efficacy of psychological and pharmacologic treatments. Clinical issues related to treatment implementation, limitations of extant psychosocial interventions, and suggestions for future research are also discussed.

Psychometric evaluation of the social phobia and anxiety inventory for children: concurrent validity and normative data.

Examined the relation of the Social Phobia and Anxiety Inventory for Children (SPAI-C) to the Social Anxiety Scale for Children-Revised (SASC-R). The association between the SPAI-C and the SASC-R was moderate, suggesting that the measures assess overlapping, although not identical, constructs. Initial normative data are reported on the SPAI-C for a community sample of 277 4th-through 6th-grade children. Girls reported higher social anxiety on both measures than did boys. Notably, a substantial proportion of children were found to exceed suggested cut-off scores on both measures for identifying children with high levels of social anxiety, which suggests the importance of screening elementary-age children for social fears.

Factors affecting hemopoietic recovery after high-dose therapy and autologous peripheral blood progenitor cell transplantation: a single center experience.

BACKGROUND AND OBJECTIVE: While the minimum number of CD34+ cells required for complete and long-lasting engraftment is quite well established, there is not general agreement about the optimal number of CD34+ per kg needed in order to obtain engraftment as rapidly as possible. In the present study we assess factors affecting hemopoietic recovery and the optimal peripheral blood progenitor cell (PBPC) number for rapid engraftment in patients treated with high-dose therapy. DESIGN AND METHODS: We enrolled 80 consecutive patients affected by hematologic and non-hematologic malignancies treated with a median of 10 chemotherapy courses (range 3-38). PBPC collection was performed after mobilization with high-dose chemotherapy and G-CSF 5 micrograms/kg/day. The circulating and harvested CD34+ cells were recognized in the cytofluorimetric CD45+/CD14- lymphocyte gate. After myeloablative therapy, PBPC infusion was followed by G-CSF 5 micrograms/kg/day from day +5 until WBC > or = 5.0 x 10(9)/L. Univariate and multivariate Cox analyses were performed to investigate factors affecting hemopoietic recovery. The Kaplan-Meier probabilities of hemopoietic reconstitution were compared by log-rank test to assess the optimal CD34+ cell number for rapid engraftment. RESULTS: We performed a median of two apheresis (range 1-4) per patient and we infused a median of 6.1 x 10(6) CD34+ cells/kg (range 0.5-30.5). Absolute neutrophil count (ANC) > 0.5 x 10(9)/L was reached after 11 days (range 8-15). The only factor affecting granulocyte recovery proved to be the CD34+ cell number; 5.0 to 7.8 x 10(6) CD34+ cells/kg allowed a significantly faster granulocyte recovery than < 2.5 x 10(6) CD34+ cells/kg (p = 0.0312). Platelet transfusion independence (> 20 x 10(9)/L) and 50 x 10(9)/L platelets were reached after 12 (range 8-24) and 15 days (range 9-40), respectively. The CD34+ cell number was also the only factor affecting platelet recovery; the number of 5.0 to 7.8 CD34+ cells/kg allowed a significantly faster platelet recovery than the lower dose, whereas a higher number did not. No late graft failures were observed. Patients receiving 5.0 to 7.8 x 10(9) CD34+ cells/kg had a significantly shorter duration of neutropenia, fewer platelet transfusions and less time spent in hospital than those receiving lower number did, whereas patients transplanted with a higher number had no advantage. INTERPRETATION AND CONCLUSIONS: When G-CSF is employed both for PBPC mobilization and after PBPC transplantation, the CD34+ cell number is the only factor that affects hemopoietic recovery. Moreover, > 5.0 x 10(6) CD34+ cells/kg is the optimal number for obtaining rapid platelet recovery and reducing the costs of HDT but there is no advantage exceeding the threshold of 7.8 x 10(6) CD34+ cells/kg.

[Guirod's hebephrenic syndrome: a case report]. / El Síndrome Hebefrénico de Guirod: a propósito de un caso.

Schizophrenia, a psychiatric disease that is highly prevalent among the general population, has polymorphic clinical manifestations at onset and during its evolution. The most frequent manifestations are an abrupt onset with positive symptoms, perception and thought disorders, which were included by Kurt Schneider in the first range symptoms. However, on other occasions the onset is insidious and the so-called negative symptoms are present, resulting in clinical manifestations that are similar to the state of absence and a less favorable patient prognosis. Since the last century when Kraepelin defined early dementia, various authors have tried to explain the nature of this disease, resulting in Bleauler's definition of the fundamental symptoms. A clinical case of hebephrenic schizophrenia is presented in which disorders in thought, affect and volition predominated. We discuss the psychopathological views of less well-known, but not for that reason less important, authors, such as Guirod and Dice, and the similarities and differences between their views and current classifications.

Vicarious learning revisited: a contemporary behavior analytic interpretation.

Beginning in the 1960s, social learning theorists argued that behavioral learning principles could not account for behavior acquired through observation. Such a viewpoint is still widely held today. This rejection of behavioral principles in explaining vicarious learning was based on three phenomena: (1) imitation that occurred without direct reinforcement of the observer's behavior; (2) imitation that occurred after a long delay following modeling; and (3) a greater probability of imitation of the model's reinforced behavior than of the model's nonreinforced or punished behavior. These observations convinced social learning theorists that cognitive variables were required to explain behavior. Such a viewpoint has progressed aggressively, as evidenced by the change in name from social learning theory to social cognitive theory, and has been accompanied by the inclusion of information-processing theory. Many criticisms of operant theory, however, have ignored the full range of behavioral concepts and principles that have been derived to account for complex behavior. This paper will discuss some problems with the social learning theory explanation of vicarious learning and provide an interpretation of vicarious learning from a contemporary behavior analytic viewpoint.

[Tardive dyskinesia: a review]. / Discinesia tardía: una revisión.

Tardive Dyskinesia (TD) is a iatrogenic syndrome of involuntary movement that occur in association with chronic neuroleptic use. The diagnosis and ongoing assessment of TD severity is complicated by a host of methodological problems. Orofacial movements are most frequent, although other body areas, limbs, neck and trunk, may be involved. The prevalence for TD varies widely from study to study, the estimated average prevalence is a 20%. The pathophysiology of TD remains poorly understood despite the numerous theories have been proposed. One of the most consistently identified TD risk factors is age. This factor is independent of drug exposure although both are often confounded. Currently no consistency effective treatment has yet been found and the most important treatment consist of gradual neuroleptic drug-dose reduction and, where possible, complete withdrawal.

Systematic assessment of social phobia in clinical practice.

The purpose of this review is to propose a systematic approach to the assessment of social phobia for monitoring treatment outcome in clinical settings. A selection of measures is available, including questionnaires and structured interviews varying in length, complexity, and content. To design an assessment protocol for a particular patient or patient population, the clinician needs to be familiar with the characteristics of these available measures. The measures selected for detailed description and discussion here: (a) are specifically designed to assess social anxiety and social phobia, (b) have been demonstrated to have acceptable psychometric characteristics, and (c) have been utilized in treatment outcome research. Five questionnaire measures will be reviewed: (1) the Social Phobia and Anxiety Inventory (SPAI) (Turner et al., 1989a: Psychol Assessment 1:35-40), (2) the Social Interaction and Anxiety Scale (SIAS) (Mattick and Clarke, 1989 in Heimberg et al., 1992), (3) the Social Phobia Scale (SPS) (Mattick and Clarke, 1989 in Heimberg et al., 1992: Behav Therapy 23:53-73), (4) the Fear of Negative Evaluation Scale (FNES) (Watson and Friend, 1969: J Consult Clin Psychol 33:448-457), and (5) The Social Anxiety and Distress Scale (SADS) (Watson and Friend, 1969: J Consult Clin Psychol 33:448-457). Two interview measures will be reviewed, the Liebowitz Social Anxiety Scale (LSAS) (Liebowitz, 1987: Modern Problems Pharmacopsych 22:141-173) and Brief Social Phobia Scale (BSPS) (Davidson et al., 1991: J Clin Psychiatry 52:48-51). Measures developed for specific subgroups, including patients with speech anxiety and musical performance anxiety, as well as the application of other evaluation methods, such as the Behavioral Assessment Test, will also be discussed. Guidelines for selecting appropriate social phobia measures for varying clinical and research situations will be proposed that take into consideration the strengths and weaknesses of these methods.

[Family factors in adolescent suicide attempts]. / Factores familiares en las tentativas de suicidio de adolescentes.

The aim of the present study is the analysis of the family characteristics associated with suicide attempts among adolescents. Subjects were 54 adolescents aged 13-18 referred to hospital after a suicide attempt and 108 normal comparison adolescents. A case-control study design has been used and they have been matched by age, sex and socioeconomic status. Differences between groups are reported as Odds Ratio (OR) with a 95% confidence interval. The results in Odds Ratio are as follows: parental losses (OR = 19.00), mental illness in father (OR = 8.67), mental illness in mother (OR = 6.79), mental illness among brothers and sisters (OR = 3.28), poor membership relations (OR = 3.00), not living with both biological parents (OR = 8.06) and unsatisfactory familial adaptation (OR = 7.50). In conclusion, our findings highlight the importance of the familial risk factors and its implications to develop preventive programs for youngs at risk.

[Neuroleptic malignant syndrome: a review of literature]. / Síndrome neuroléptico maligno: una revisión bibliográfica.

Neuroleptic malignant syndrome is characterized by altered consciousness, fever, extrapyramidal signs and autonomic instability. Although originally described in patients receiving neuroleptic drugs, this syndrome may also occur in patients who were taking a wide variety of medications. It is a rare and potentially lethal idiosyncratic reaction that occurs after therapeutic rather than toxic doses of neuroleptics drugs and is unrelated to the duration of therapy. The implications of dopaminergic disturbances underlying the mental illnesses involved are considered. Treatment of the neuroleptic malignant syndrome involves, first of all, supportive measures and withdrawal of the neuroleptic drugs therapy.

[A study of the locus of control in patients with renal transplants]. / Estudio del locus de control en pacientes trasplantados de riñón.

The locus of control (using I-E Rotter' Scale) maximum psychosocial adjustment level (according to Axis V of DSM-III) and other sociodemographic data were assessed in 31 patients with renal transplantation. 51.5% of the patient were not psychosocially adapted, and externality was the predominant locus of control. As far as psychosocial adjustment is concerned, no variation in the absolute as found in terms of Internality-Externality. Finally, there was a statistically significant correlation between some items of the Rotter' scale and psychosocial adjustment.

[Treatment of catatonia with lorazepam]. / Tratamiento de la catatonía con loracepan.

The most recent medical literature has emphasized the notion that catatonia is a syndrome rather than a disease and, on this basis it is associated with a wide variety of medical, neurological and psychiatric conditions. The authors report on five cases of catatonic patients with a favorable response to Lorazepam and analyze the possible mechanisms of action of this Benzodiazepine in catatonic syndrome.

[The development of the index of probability of psychosocial adaptation of chronic kidney patients]. / Desarrollo de un indice de probabilidad de adaptación psicosocial de los enfermos renales crónicos (I.P.A.P.E.R.C).

Variables obtained from statistical techniques of multivarying analysis, related to psychosocial adaptation of chronic renal patients on treatment were applies in order to construct an index for the probability of the psychosocial adaptation of chronic renal patients (I.P.P.A.C.R.P.). The probability of 1% adaptation determines correctly to 97% of the cases with high sensibility and specificness thus is convenient to wait for the crossed validation of other investigators.

[Variables associated with psychosocial adaptation of chronic renal patients undergoing treatment]. / Variables asociadas a la adaptación psicosocial de los enfermos renales crónicos en tratamiento.

101 patients being treated for end-stage renal failure were studied in order to get the variables that are involved with psychosocial adaptation. Stepwise logistic regression analysis was made using the psychosocial adaptation as a dependent variable, determined by the Axis V of the D.S.M-III. 40 patients were found socially-adapted and 61 were not. Nine variables were related with the psychosocial adaptation: marital status, religious belief, education level, occupation, means of transportation to get to the treatment center, self-image before the sickness, C factor of 16 PF, the age and the evaluation of treatment by the patient. From the statistical analysis and from the interpretation of sings and values of the related variables, the influence of them on the psychosocial adaptation was demonstrated.