Significant dose reduction is feasible in FDG PET/CT protocols without compromising diagnostic quality.

PURPOSE: To reduce the radiation dose to patients by optimizing oncological FDG PET/CT protocols. METHODS: The baseline PET/CT protocol in our institution for oncological PET/CT examinations consisted of the administration of 5.18 MBq/kg of FDG and a CT acquisition with a reference current-time product of 120 mAs. In 2016, FDG activity was reduced to 4.44 and 3.70 MBq/kg and reference CT current-time-product was reduced to 100 and 80 mAs. 322 patients scanned with different protocols were retrospectively evaluated. For each patient, effective dose was calculated. The overall image quality was subjectively rated by the referring physician on a 4-point scale (IQ score: 1 excellent, 2 good, 3 poor but interpretable, 4 poor not interpretable). Image quality was quantitatively evaluated measuring noise in the liver. RESULTS: CT Results: Effective dose was progressively reduced from 9.5 ±â€¯2.8 to 8.0 ±â€¯2.3 and 6.2 ±â€¯1.5 mSv (p < 0.001). A mean dose reduction of 34.9% was achieved. There was a significant degradation of IQ score (p < 0.05) and noise (p < 0.001). Nevertheless, the number of poor quality studies (IQ score >2) did not increase. PET Results: Effective dose was gradually reduced from 6.5 ±â€¯1.4 to 5.7 ±â€¯1.3 and 5.0 ±â€¯1.0 mSv (p < 0.001). Average dose reduction was 23.4%. IQ score (p < 0.05) and noise (p < 0.001) significantly degraded for lower activity protocols. However, all images with reduced activity were scored as interpretable (IQ score ≤ 3). CONCLUSIONS: A significant radiation dose reduction of 28.7% was reached. Despite a slight reduction in image quality, the new regime was successfully implemented with readers reporting unchanged clinical confidence.

Trastorno de síntomas somáticos: de la sospecha de simulación al tratamiento cognitivo-conductual / Somatic symptom disorder: From suspicion of malingering to cognitive-behavioral treatment

Se considera dolor crónico a aquel que persiste por más de tres meses destacando en patologías como lumbalgia, migraña, fibromialgia o artrosis, entre otras. En su génesis, desarrollo y mantenimiento están implicados factores psicológicos como una gran frecuencia e intensidad de emociones negativas, un estilo desadaptativo de afrontamiento, un patrón atencional desajustado y una respuesta excesiva de preocupación. El tratamiento del dolor se complica cuando al profesional sanitario le asalta la duda de una posible simulación o intento deliberado de engañar sobre la enfermedad o discapacidad, exagerando la sintomatología, con el objetivo de conseguir un beneficio. Se describe el caso de un paciente tratado de dolor crónico en una unidad de dolor, del que se sospecha simulación para obtener una prestación económica por incapacidad permanente. Tras la evaluación, se descarta un proceso de simulación y se comienza un tratamiento cognitivo-conductual. Se describe la evaluación que permite descartar la sospecha de simulación, el tratamiento cognitivo-conductual con la elección de técnicas avaladas científicamente para el tratamiento del dolor crónico y los resultados obtenidos

Chronic pain is considered one that persists for more than three months. The treatment of pain is complicated even more when the health professional has a second thought about a possible malingering. This is a deliberate attempt to simulate a disease or disability, exaggerating the symptomatology, with the aim of obtaining a benefit, which is usually of an economic type. This paper depicts the case of a patient treated for chronic pain in a pain unit, which is suspected of obtaining an economic benefit due to permanent disability. After the evaluation, a malingering process is ruled out and a cognitive-behavioral treatment is started. We describe the evaluation that allows to rule out the suspicion of malingering, the cognitive-behavioral treatment with the choice of scientifically endorsed techniques for the treatment of chronic pain, and the results obtained

Cerium oxide nanoparticles alter the antioxidant capacity but do not impact tuber ionome in Raphanus sativus (L).

The effects of nCeO2 on food quality are not well known yet. This research was performed to determine the impact of nCeO2 on radish (Raphanus sativus L.). Plants were cultivated to full maturity in potting soil treated with nCeO2 at concentrations of 0, 62.5, 125, 250, and 500 mg/kg. Germination, growth, photosynthesis, ionome, and antioxidants were evaluated at different growth stages. Results showed that at 500 mg/kg, nCeO2 significantly retarded seed germination but did not reduce the number of germinated seeds. None of the treatments affected gas exchange, photosynthesis, growth, phenols, flavonoids, and nutrients' accumulation in tubers and leaves of adult plants. However, tubers' antioxidant capacity, expressed as FRAP, ABTS(•-) and DPPH, increased by 30%, 32%, and 85%, respectively, in plants treated with 250 mg nCeO2kg(-1) soil. In addition, cerium accumulation in tubers of plants treated with 250 and 500 mg/kg reached 72 and 142 mg/kg d wt, respectively. This suggests that nCeO2 could improve the radical scavenging potency of radish but it might introduce nCeO2 into the food chain with unknown consequences.

Cognitive processes in evaluation anxiety: An experimental study based on memory bias

The present article presents the data from an experimental research with the primary goal of exploring the presence of memory bias in participants with high levels of evaluation anxiety in comparison with a group with low evaluation anxiety, as measured by the F1 factor of the Anxiety Situations and Responses Inventory (Miguel-Tobal & Cano-Vindel, 2002). For this purpose, an experimental task based on the conception of explicit memory was carried out, specifically a free recall test, cuing the beginning of words, using words with evaluation anxiety content versus neutral words. The results and their clinical implications, as well as the limitations in the experimental study concerning the processing of threatening information, are discussed

En el presente artículo se presentan los datos de una investigación experimental cuyo objetivo fundamental fue explorar la presencia del sesgo de memoria en participantes con niveles elevados de ansiedad de evaluación en comparación con un grupo con baja ansiedad evaluativa medidos mediante el factor F1 del Inventario de Situaciones y Respuestas de Ansiedad (Miguel- Tobal y Cano-Vindel, 2002). Para ello se llevó a cabo una tarea experimental basada en la concepción de memoria explícita, en concreto una prueba de recuerdo libre con clave de inicio de palabras, mediante el uso de palabras con contenido de ansiedad de evaluación vs palabras neutras. Se discuten los resultados encontrados, sus implicaciones a nivel clínico y las limitaciones que se dan en el estudio experimental del procesamiento de la información amenazante

Effect of cerium oxide nanoparticles on the quality of rice ( Oryza sativa L.) grains.

Despite the remarkable number of publications on the interaction of engineered nanoparticles (ENPs) with plants, knowledge of the implications of ENPs in the nutritional value of food crops is still limited. This research was performed to study the quality of rice grains harvested from plants grown in soil treated with cerium oxide nanoparticles (nCeO2). Three rice varieties (high, medium, and low amylose) were cultivated to full maturity in soil amended with nCeO2 at 0 and 500 mg kg(-1) soil. Ce accumulation, nutrient content, antioxidant property, and nutritional quality of the rice grains were evaluated. Results showed that rice grains from nCeO2-treated plants had less Fe, S, prolamin, glutelin, lauric and valeric acids, and starch. Moreover, the nCeO2 reduced in grains all antioxidant values, except flavonoids. Medium- and low-amylose varieties accumulated more Ce in grains than the high-amylose variety, but the grain quality of the medium-amylose variety showed higher sensitivity to the nCeO2 treatment. These results indicate that nCeO2 could compromise the quality of rice. To the authors' knowledge, this is the first report on the effects nCeO2 on rice grain quality.

Fibromialgia: ¿exageración o simulación? / Fibromyalgia: Exaggeration or malingering?

Se presenta un estudio multidimensional de la exageración de síntomas en pacientes con fibromialgia. El objetivo principal es detectar patrones discriminantes de simulación de discapacidad relacionada con el dolor con el fin de desarrollar un protocolo detallado para la evaluación de sospecha de simulación en los casos con síntomas físicos o psicológicos falsos o exagerados motivados por incentivos externos. La muestra total (N = 113) estuvo compuesta por cuatro grupos: pacientes con fibromialgia no litigantes (n = 36), pacientes con fibromialgia en situación de litigancia (n = 26), participantes análogos (n = 21) y grupo control (n = 30). Se administraron diferentes pruebas médicas y psicológicas a los participantes, incluyendo pruebas médicas complementarias, la adaptación española de la Escala de Auto–Eficacia (Baessler y Schwarzer, 1996), la Escala de Satisfacción Personal Vital (González Ordi, Santamaría y Casado Morales, 2012), la adaptación española del Cuestionario de Impacto de Fibromialgia (FIQ, Monterde, Salvat, Montull y Fernández-Ballart, 2004), la versión española de la Encuesta de Salud SF-36 (Alonso, Prieto y Antó, 1995), la adaptación española del Inventario Estructurado de Simulación de Síntomas (SIMS, González Ordi y Santamaría, 2009) y la adaptación española del Inventario de Personalidad de Minnesota- 2- Formulario Reestructurado (MMPI-2-RF, Ben-Porath y Tellegen, 2008a). Se presentan datos sobre las diferencias entre grupos y la precisión de predicción de los instrumentos utilizados. También se aborda un protocolo para la detección de la simulación en base a los resultados del perfil diferencial entre la fibromialgia no litigante y litigantes (AU)

A multidimensional study on symptom exaggeration in fibromyalgia patients is presented. The main aim is to detect discriminant patterns of malingered pain-related disability in order to develop a detailed protocol for the assessment of suspected malingering in cases of false or grossly exaggerated physical or psychological symptoms motivated by external incentives. Overall sample (N = 113) consisted of four groups: fibromyalgia patients not involved in litigation (n = 36), fibromyalgia patients involved in litigation (n = 26), analogue fibromyalgia-instructed participants (n = 21), and control group (n = 30). Several medical and psychological tests were administered to participants, including medical complementary tests, the Spanish adaptation of the General Self-Efficacy Scale (Baessler & Schwarzer, 1996), the Life Personal Self-Report Scale (González-Ordi, Santamaría, & Casado-Morales, 2012), the Spanish adaptation of the Fibromyalgia Impact Questionnarie (FIQ, Monterde, Salvat, Montull, & Fernández-Ballart, 2004), the Spanish version of the SF-36 Health Survey (Alonso, Prieto, & Antó, 1995), the Spanish adaptation of the Structured Inventory of Malingered Symptomatology (SIMS, González-Ordi & Santamaría, 2009), and the Spanish adaptation of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF, Ben-Porath & Tellegen, 2008a). Data on mean group differences and predictive accuracy of the instruments used are presented. A protocol for the detection of malingering based on the differential profile scores between fibromyalgia non-litigants and litigants are also addressed (AU)

Synchrotron verification of TiO2 accumulation in cucumber fruit: a possible pathway of TiO2 nanoparticle transfer from soil into the food chain.

The transfer of nanoparticles (NPs) into the food chain through edible plants is of great concern. Cucumis sativus L. is a freshly consumed garden vegetable that could be in contact with NPs through biosolids and direct agrichemical application. In this research, cucumber plants were cultivated for 150 days in sandy loam soil treated with 0 to 750 mg TiO2 NPs kg(-1). Fruits were analyzed using synchrotron µ-XRF and µ-XANES, ICP-OES, and biochemical assays. Results showed that catalase in leaves increased (U mg(-1) protein) from 58.8 in control to 78.8 in 750 mg kg(-1) treatment; while ascorbate peroxidase decreased from 21.9 to 14.1 in 500 mg kg(-1) treatment. Moreover, total chlorophyll content in leaves increased in the 750 mg kg(-1) treatment. Compared to control, FTIR spectra of fruit from TiO2 NP treated plants showed significant differences (p ≤ 0.05) in band areas of amide, lignin, and carbohydrates, suggesting macromolecule modification of cucumber fruit. In addition, compared with control, plants treated with 500 mg kg(-1) had 35% more potassium and 34% more phosphorus. For the first time, µ-XRF and µ-XANES showed root-to-fruit translocation of TiO2 in cucumber without biotransformation. This suggests TiO2 could be introduced into the food chain with unknown consequences.

Toxicity assessment of cerium oxide nanoparticles in cilantro (Coriandrum sativum L.) plants grown in organic soil.

Studies have shown that CeO2 nanoparticles (NPs) can be accumulated in plants without modification, which could pose a threat for human health. In this research, cilantro (Coriandrum sativum L.) plants were germinated and grown for 30 days in soil amended with 0 to 500 mg kg⁻¹ CeO2 NPs and analyzed by spectroscopic techniques and biochemical assays. At 125 mg kg⁻¹, plants produced longer roots (p ≤ 0.05), and at 500 mg kg⁻¹, there was higher Ce accumulation in tissues (p ≤ 0.05). At 125 mg, catalase activity significantly increased in shoots and ascorbate peroxidase in roots (p ≤ 0.05). The FTIR analyses revealed that at 125 mg kg⁻¹ the CeO2 NPs changed the chemical environment of carbohydrates in cilantro shoots, for which changes in the area of the stretching frequencies were observed. This suggests that the CeO2 NPs could change the nutritional properties of cilantro.

Guías para el entrenamiento en ultrasonido de emergencias / Guidelines for emergency ultrasound training

Guías diseñadas y aprobadas por un grupo de especialistas designados por ACEM, la Asociación Colombiana de Medicina de Urgencias y Emergencias. Se describen los distintos tópicos de entrenamientos seleccionados, correspondientes a los niveles básico, intermedio, o avanzado. (AU)

Guías para el entrenamiento en ultrasonido de emergencias / Guidelines for emergency ultrasound training

Guías diseñadas y aprobadas por un grupo de especialistas designados por ACEM, la Asociación Colombiana de Medicina de Urgencias y Emergencias. Se describen los distintos tópicos de entrenamientos seleccionados, correspondientes a los niveles básico, intermedio, o avanzado.

Effect of cerium oxide nanoparticles on rice: a study involving the antioxidant defense system and in vivo fluorescence imaging.

Previous studies have reported the uptake of cerium oxide nanoparticles (nCeO2) by plants, but their physiological impacts are not yet well understood. This research was aimed to study the impact of nCeO2 on the oxidative stress and antioxidant defense system in germinating rice seeds. The seeds were germinated for 10 days in nCeO2 suspension at 62.5, 125, 250, and 500 mg L(-1) concentrations. The Ce uptake, growth performance, stress levels, membrane damage, and antioxidant responses in seedlings were analyzed. Ce in tissues increased with increased nCeO2 concentrations, but the seedlings showed no visible signs of toxicity. Biochemical assays and in vivo imaging of H2O2 revealed that, relative to the control, the 62.5 and 125 mg nCeO2 L(-1) treatments significantly reduced the H2O2 generation in both shoots and roots. Enhanced electrolyte leakage and lipid peroxidation were found in the shoots of seedlings grown at 500 mg nCeO2 L(-1). Altered enzyme activities and levels of ascorbate and free thiols resulting in enhanced membrane damage and photosynthetic stress in the shoots were observed at 500 mg nCeO2 L(-1). These findings demonstrate a nCeO2 concentration-dependent modification of oxidative stress and antioxidant defense system in rice seedlings.

Inteligencia emocional y rendimiento escolar: estado actual de la cuestión / Emotional intelligence and school performance: an updated overview

Una de las líneas de investigación que más interés ha generado en los últimos años, dentro del campo de la Inteligencia Emocional (IE), ha sido el análisis del papel que juegan las emociones en el contexto educativo y, sobretodo, profundizar en la influencia de la variable inteligencia emocional a la hora de determinar tanto el éxito académico de los estudiantes como su adaptación escolar. En los últimos años, se han realizado numerosos estudios con el propósito de analizar la relación existente entre inteligencia emocional y rendimiento académico. Sin embargo, los resultados se muestran inconsistentes debido a la falta de consenso en cuanto a la definición, operacionalización del constructo y la metodología tan diversa que presentan los estudios. En este trabajo, analizaremos la relación entre IE y el rendimiento académico así como los objetivos y beneficios de la implementación de programas de alfabetización emocional en los centros educativos.

A research line that has generated a lot of interest in the last years, within the field of Emotional Intelligence (EI), is the analysis of the role that emotions play in the educational context, and, moreover, to deepen in the influence that the emotional intelligence variable has to determining both the academic success of the students and their scholastic adaptation. In the last years, a widecorpus of studies have been carried out to analyze the existing relationship between emotional intelligence and academic performance. Nevertheless, results are inconsistent due to the lack of consensus not only at the definition but in the so diverse methodology that these studies present. In our work, we analyze the relationship between EI and the academic performance as well as the objectives and benefits of the implementation of programs of emotional alphabetization at educational centres.

Dissection as a modulator of emotional attitudes and reactions of future health professionals.

CONTEXT: There is ongoing discussion within the medical education community about dissection as an educational strategy and as a professional training tool in technical and emotional skills training. OBJECTIVES: This study aimed to discover the emotional reactions, attitudes and beliefs of new students faced with human cadaver dissection; to evaluate the changes produced in these variables by the exhibition and practice of dissection; to analyse the level of anxiety students feel when faced with death, and to elucidate the possible relationships between these items. METHODS: The study used a sample of 425 students who were first-time enrolees in a human anatomy course. Three new instruments were designed, with items covering emotional reactions (cognitive, physiological and motor reactions), beliefs and attitudes related to what the student expects to experience or has experienced in dissection. Death anxiety was measured using the Death Anxiety Inventory. RESULTS: As students gained more experience of dissection, their emotional reactions were reduced and their attitudes and beliefs changed. Statistically significant differences in the level of death anxiety emerged, depending on the perceptions students had of their degree of preparation for dissection, and emotional control and deeper thoughts about life and death during dissection. DISCUSSION: The practice of anatomy allows the student to learn how to face up to and adapt his or her emotional reactions and attitudes; this gives human cadaver dissection great importance as an educational strategy and as a professional training tool in technical and emotional skills training.

Prevención de trastornos de alimentación. Un primer programa de prevención en dos fases / Eating disorders. A two step prevention program

Se presenta la elaboración y puesta en marcha de un programa de prevención de trastornos de alimentación. El programa se desarrolla en dos partes, en un primer momento se interviene con un grupo de adolescentes de riesgo y se complementa posteriormente con una intervención con padres. Se trabaja en el marco de la prevención primaria indirecta, siendo éste un elemento a destacar por su importancia en esta área ya que sabemos que estos trastornos son de difícil detección y que por su naturaleza conllevan ocultamiento y rechazo de la ayuda, por lo que resulta mucho más eficaz la prevención que se desarrolla a partir del trabajo con los factores de riesgo asociados a los mismos. Así, el énfasis de este trabajo tanto con adolescentes como con padres, no recae directamente en modificar conductas de riesgo, sino principalmente en proporcionar estrategias personales que minimicen la influencia de los factores de riesgo asociados a los trastornos de alimentación (AU)

A program for the prevention of eating disorders was developed and implemented.The program is implemented in two stages, first there is a work with a group of high risk teenagers and then it is complemented with parent involvement. The work develops within the framework of indirect primary prevention–a key issue in this area since it is well known that these disorders are difficult to identify and that their nature entails concealment and refusal of help. Hence, prevention is very effective since it addresses the risk factors associated to eating disorders. Therefore, the emphasis of this work with adolescents and parents does not lie directly on modifying the risk behaviour but rather on providing personal strategies to minimize the effect of risk factors associated with eating disorders (AU)