Kloos Syndrome (Paralysis of Time). A Psychopathological Rare Case.

A case of Kloos syndrome is presented, a rare psychopathological manifestation in psychiatry characterized by the experience of "time paralysis" related to an epileptic focus in the left temporoparietal areas. This syndrome was identified through a detailed psychopathological analysis and detected by an electroencephalographic record. The patient's symptoms disappeared after receiving antiepileptic treatment with Carbamazepine. In this case report we highlight the detailed phenomenological and clinical analysis, as well as the importance of carrying out complementary tests when we are faced with unusual or sudden-onset symptoms without any trigger, as took place in the case exposed.

Non-lethal suicidal behavior in university students of Spain during COVID-19.

Background: Suicide is the fourth external cause of death in the world, in persons between the ages of l5 and 29. The objectives of this study were to measure the prevalence of suicidal behavior in university students and analyze the relationship of suicide risk with psychological distress, resilience, and family and social support. Methods: An observational and transversal study wherein the students at the University of Malaga (Spain) completed an online questionnaire which included items from different scales, sociodemographic and academic questions, and the subjective impact of the COVID-19 pandemic. Descriptive analyses and prevalence rates of suicidal behavior were calculated, and bivariate analyses, multiple linear regression, and a mediation and moderation analyses were conducted. Results: A total of 2,212 students completed the questionnaire. The prevalence of the last 6 months was 30.4% wishing for death, 14.7% suicidal ideation, 5% self-harm injuries, and 0.5% suicide attempts. Psychological distress, family and social support were linked to the risk of suicide. Lastly, resilience and family support measure and moderate the relation between psychological stress and suicide risk. Conclusion: Psychological distress is a risk factor for suicidal behavior, while resilience and family and social support are linked to a lower risk of suicide.

La relación entre la diferenciación del self, las habilidades sociales y la asistencia a psicoterapia en una muestra de adultos españoles / The relationship between differentiation of self, social skills and psychotherapy attendance in a sample of Spanish adults

Antecedentes La diferenciación del self es la capacidad intrapsíquica de distinguir las emociones de las cogniciones, y la capacidad interpersonal de mantener vínculos significativos y ser autónomos. Objetivo Analizar la relación entre la diferenciación y las habilidades sociales, y las diferencias en la diferenciación en función de la asistencia a psicoterapia en una muestra española. Método La muestra está formada por 126 sujetos españoles, 78 mujeres y 48 hombres, de entre 18 y 65 años, que contestaron un cuestionario sociodemográfico, la Escala de Diferenciación del Self y la Escala de Habilidades Sociales. Resultados Se observaron relaciones entre la diferenciación y las habilidades sociales. Además, la fusión con los otros y el corte emocional predecían las habilidades sociales. Por otro lado, los sujetos que habían realizado una terapia anteriormente y aquellos que nunca habían acudido a terapia tenían unos niveles de diferenciación más altos que aquellos que acudían a terapia en el momento del estudio. Conclusiones Existen asociaciones entre la diferenciación del self, las habilidades sociales y la asistencia a terapia. Se discuten los resultados y se sugieren futuras líneas de investigación.

Background Differentiation of self is the intrapsychic capacity to distinguish emotions from cognitions and the interpersonal capacity to maintain significant bonds and to be autonomous. Objetive To analyze the relationship between differentiation and social skills, and the differences in differentiation according to therapy attendance in a Spanish sample. Method The sample consisted of 126 Spanish subjects, 78 women and 48 men, aged between 18 and 65 years, who answered a sociodemographic questionnaire, the Differentiation of Self Scale and the Social Skills Scale. Results Significant relationships between differentiation of self and social skills were observed. Furthermore, fusion with others and emotional cutoff predicted social skills. On the other hand, subjects who had previously undergone therapy and those who had never attended therapy had higher levels of differentiation than those who were attending therapy at the time of the study. Conclusion There are associations between differentiation of self, social skills, and therapy attendance. Results are discussed and future lines of research are suggested.

Differentiation of self and its relationship with marital satisfaction and parenting styles in a Spanish sample of adolescents' parents.

The present study aims to test some of the assumptions of Bowen's Family Systems Theory, specifically, to assess the relationships between differentiation of self (DoS), marital satisfaction and parenting styles, as well as the gender differences in these variables in a Spanish sample. The sample includes 140 Spanish non-single adults, over 30 years old, who have at least one adolescent son or daughter, aged between 12 and 19 years old. The instruments used were a sociodemographic questionnaire, the Differentiation of Self Scale, the Warmth Scale-Parents, the Rules and Demands Scale-Parents and the Satisfaction subscale of the Dyadic Adjustment Scale. The results show DoS is related to marital satisfaction, and parenting styles' dimensions. Regarding gender, women show higher emotional reactivity and warmth-communication than men do. Furthermore, marital satisfaction mediates the relationship between DoS and parental warmth-communication, criticism-rejection and inductive form. Finally, implications for clinical practice and future research are discussed.

Perceived Impact of the COVID-19 Lockdown on the Family Context of Foster and Non-Foster Families.

The COVID-19 pandemic and the resulting lockdown have had a far-reaching impact across all levels of society. In Spain, severe restrictions were placed on people's mobility, and leaving the home was only possible under special circumstances. This study analyzes the impact of lockdown on the family context of foster and non-foster families, focusing particularly on their levels of cohesion, adaptability, and perceived stress. It also examines a series of variables that may have influenced foster families' perceptions of their family context during lockdown. Data were gathered through an online survey that was completed by 347 individuals corresponding to 100 foster families and 247 non-foster families from different regions of Spain. Analyses were descriptive and exploratory in nature. The results appear to suggest that lockdown has had a greater impact on the family context of non-foster families. With respect to foster families' experiences of lockdown, variables such as loss of employment and having a child with special educational needs would seem to be important. For both types of families, lockdown has provided an opportunity to improve certain aspects of their family context. Given that further lockdowns of some degree may be necessary in the future, it is important to ensure that families have access to the psychoeducational resources they need to maintain, as far as possible, a positive family context.

Perceived stress, resources and adaptation in relation to the COVID-19 lockdown in Spanish foster and non-foster families.

The lockdown imposed as a result of the COVID-19 pandemic has placed unprecedented stress on families. The family is a key system in relation to child development, and when birth families are unable to meet their child's needs, foster carers become an important source of support in their development. The Double ABC-X Model of family stress and adaptation considers that a family's capacity to cope with stressful situations is influenced by pile-up of stressors, family resources and perception of the situation. Following this model, the study aimed to determine the impact of the COVID-19 lockdown on family stress and functioning. The sample comprised 347 Spanish adults (100 with foster families and 247 with non-foster families) who completed a survey during lockdown. The results showed that certain sociodemographic variables (gender, income, working from home, characteristics of the home and children with special educational needs) were associated with stressors during lockdown, perception of the lockdown, and family adaptation to stress during lockdown. Associations were also found between stressors, family resources, perception of lockdown, and family adaptation in foster and non-foster families, with the former having a more positive perception of the lockdown experience. The relevance of the results and their implications are discussed.

Differences Between the Psychological Symptoms of Health Workers and General Community After the First Wave of the COVID-19 Outbreak in Spain.

The coronavirus disease-2019 (COVID-19) has worsened the physical and mental health of the general population. Healthcare workers have a high risk of suffering a mental disorder after the first wave. In this way, psychologists, who deal with mental health issues and are considered as healthcare workers in many countries, are of interest in this context. The present study aimed to examine anxiety, depression, stress, and obsessions and compulsions across psychologists, healthcare professionals, and the general community. These variables were measured through the Depression, Anxiety, and Stress Scale (DASS-21), as well as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), which are related to different sociodemographic variables. The study was carried out after the first wave in Spain through an online questionnaire. Structural equation modeling and a multigroup analysis were carried out across the groups and variables under study. The results suggested that; (i) healthcare workers and general community depicted similar results in anxiety and stress, as well as obsessions; (ii) the group of psychologists depicted better scores than the other groups under study; (iii) stress and anxiety did not predict compulsions in the group of psychologists; (iv) anxiety predicted obsessions for all the professions, while the relationship of this variable with stress was different for each group; and (v) invariance reached a full metric level.

De Colegio oficial de psicólogos a Consejo general de colegios. Posicionamiento nacional y proyección internacional / From the college of psychologists to the Spanish psychological association. National positioning and international projection

La creación del COP tuvo enorme trascendencia para dotar de identidad la psicología española. Esta Corporación destinada a ordenar y representar la profesión no ha dejado de crecer, a pesar de graves problemáticas internas y externas. El artículo ofrece una revisión legislativa y documental, sobre todo desde su revista oficial, Papeles del Psicólogo. Analiza la segunda etapa del COP, la de la profesionalización, la descentralización y la reorganización como Consejo General de Colegios, atendiendo a su papel en la proyección interna e internacional de la disciplina en su conjunto. (AU)

The creation of the COP (Spanish College of Psychologists) was of enormous significance in establishing the identity of psychology in Spain. Theorganization, aimed at organizing and representing the profession, has not stopped growing, despite the serious internal and external issues it hashad. This article presents a legislative and documentary review, particularly based on its representative publication, Papeles del Psicólogo/Psychologist Papers. We analyze the second stage of the COP, that of professionalization, decentralization, and reorganization as theSpanish Psychological Association, taking into account its role in the internal and international projection of the discipline as a whole. (AU)

Psicología Y Profesión En España. Los Primeros Años Del Colegio Oficial De Psicólogos / Psychology And Profession In Spain. The Early Years Of The Spanish Psychological Association

La creación del COP tuvo enorme trascendencia para el establecimiento de la Psicología y para dotarla de identidad. Desde la Ley de creación en 1980, esta organización de carácter semipúblico destinada a ordenar y representar la profesión no ha dejado de crecer, a pesar de graves problemáticas internas y externas. El COP ha pasado por diversas etapas, que reflejan y al tiempo ayudan a caracterizar la corta historia disciplinar de la psicología, sobre todo su definición, frente a otras profesiones. El artículo ofrece una amplia revisión legislativa y documental, sobre todo desde su revista portavoz, Papeles del Psicólogo. Analiza sus complicados primeros años, hasta 1993, bajo la dirección de Carlos Camarero y de Adolfo Hernández, marcados por la configuración interna de la Organización, una grave problemática profesional, y la lucha por conseguir la Licenciatura. (AU)

The creation of the Spanish Psychological Association (Spanish acronym, COP) was of enormous significance in the establishing of psychology in Spain, and in the creation of its identity. Since the publication of the 1980 Law of Creation [of the COP], this organization-aimed at regulating and representing the psychology profession-has not stopped growing, despite the serious internal and external issues it has had. The Spanish Psychological Association has gone through different stages over the past 40 years, which reflect and help us to characterize the short history of Spanish psychology, in particular the history of its delimitation with respect to other professions. This article presents an extensive legislative and documentary review, particularly based on its representative publication, Papeles del Psicólogo/Psychologist Papers. We analyze the complicated early years, up to 1993, under the direction of Carlos Camarero and Adolfo Hernández, a phase marked by the internal configuration of the organization, a serious challenge for the profession, and the fight to approve the master’s degree. (AU)

Relationship between family functioning, differentiation of self and anxiety in Spanish young adults.

OBJECTIVES: In the present study, the relationship between family functioning, differentiation of self and trait anxiety was examined. In addition, differences in trait anxiety and differentiation of self according to sex were studied. It was also checked whether family functioning predicted the achieved degree of differentiation of self, and whether family functioning and differentiation of self predicted the level of trait anxiety. Finally, it was analyzed whether the level of differentiation of self mediated the relationship between family functioning and trait anxiety. METHODS: The study involved 185 Spanish participants, aged between 18 and 56 years and the scales used were the Family Adaptability and Cohesion Evaluation Scale-20Esp (FACES-20Esp), the Differentiation of Self Scale (EDS) and the State-Trait Anxiety Inventory (STAI). RESULTS: The results indicated that family functioning was related to differentiation of self and trait anxiety, and that differentiation of self was related to trait anxiety. In addition, according to sex, differences were found in the degree of differentiation of self and in the I Position, with a higher score for men, as well as in Emotional Reactivity and trait anxiety, with higher scores for women. It was also observed that family functioning predicted the level of differentiation of self, and that differentiation of self and family functioning predicted trait anxiety. Finally, it was found that the relationship between family functioning and trait anxiety was partially mediated by differentiation of self. CONCLUSIONS: There are relationships between family functioning, differentiation of self and trait anxiety, and there are differences in differentiation of self and trait anxiety based on sex. The relevance of the results and their implications for clinical practice are discussed.

Historia, Dificultades Y Retos De La Federación Iberoamericana De Asociaciones De Psicología / History, Difficulties, And Challenges Of The Ibero-American Federation Of Psychology Associations

El objetivo del artículo es presentar y describir los principales elementos fundacionales, así como los eventos icónicos y misionales dela Federación Iberoamericana de Asociaciones de Psicología (FIAP). Se señalan las contribuciones, las tareas de la Federación y las dificultades para construir una psicología organizada que es vulnerable a las fragilidades y la diversidad de las realidades socioeconómicas y sociopolíticas de la región, para finalmente discutir su papel dentro de la organización y representación de la profesión psicológica, así como las insuficiencias, los retos y las tareas de la misma para continuar favoreciendo el posicionamiento y la internacionalización de la ciencia psicológica y la profesión de los países de lengua española y portuguesa. (AU)

The main aim of the article is to present and describe the main foundational elements, as well as the iconic events and mission, ofthe Ibero-American Federation of Psychology Associations (FIAP). The contributions and tasks of this organization are described, as well as the difficulties of building an organized psychology, vulnerable to the fragilities and diversities of the socio-economicand socio-political realities of the region. The final purpose is to discuss the role of the FIAP within the organization and representation of the psychology profession, as well as its shortcomings, challenges, and tasks, in order to continue to promote thepositioning and internationalization of the psychological science and profession in Spanish and Portuguese speaking countries. (AU)

Profile Changes in Male Partner Abuser After an Intervention Program in Gender-Based Violence.

Gender-based violence is a phenomenon deeply rooted in social, cultural, psychological, and educational factors. To comply with social demands, Government agencies have promoted numerous development plans to reduce this kind of violence. The measures taken by the Spanish Government include preventive and educational measures as well as direct intervention with the victims and aggressors. This study is based on a Spanish psychological intervention with men convicted of gender-based violence. The study supports current evidence of male perpetrators as well as analyzing the effectiveness of these intervention programs. The results of the study indicate that the aggressors of gender-based violence present personality disorders, such as the compulsive behavior, and the results of intervention program indicate that the users obtain higher scores in social skills and empathy and lower scores in romantic jealousy and anger.

Relación entre el trastorno por déficit de atención con hiperactividad y el trastorno por consumo de sustancias (revisión) / Relation between attention-deficit/ hiperactivity disorder and substance use disorder (a review)

Introducción: Existe una elevada comorbilidad entre el trastorno por déficit de atención e hiperactividad (TDAH) y el trastorno por consumo de sustancias, asociando una mayor gravedad de las adicciones, menor edad de inicio del consumo, así como una mayor cronicidad de la drogodependencia. En los pacientes con patología dual el tratamiento resulta ser una tarea compleja, por lo que la eficacia farmacológica ha sido objeto de múltiples estudios académicos en las últimas décadas. Objetivos: El objetivo principal es realizar una revisión bibliográfica acerca de esta comorbilidad, para conocer si el TDAH se considera un factor de riesgo en el desarrollo de un Trastorno por Consumo de Sustancias (TCS) en la adolescencia y en la edad adulta. También se pretende examinar si el tratamiento farmacológico del TDAH previene el desarrollo de TCS y si es segura su prescripción en pacientes con dicha comorbilidad. Metodología: Se realizó una búsqueda bibliográfica principalmente en la base de datos PubMed, en la que se introdujeron las palabras clave y se aplicaron los criterios de inclusión y de exclusión. Resultados: Los pacientes con TDAH tienen más riesgo de desarrollar dependencia al alcohol (OR 2,31), a la nicotina (OR 2,28) y al cannabis (OR 1,73); así como de desarrollar un TCS (OR 2,49) en la edad adulta. Conclusiones: El TDAH es un factor de riesgo para padecer un TCS, siendo seguro el tratamiento en pacientes con patología dual además de mejorar la drogodependencia. (AU)

Introduction: There is a high comorbidity between attention deficit hyperactivity disorder (ADHD) and substance use disorder, with a higher severity of addictions, an earlier age on the onset of the consumption, as well as an increased chronic drug dependence. In patients with dual pathology treatment appears to be a complex task, causing the pharmacological efficacy to be object of study of multiple academic studies in the recent decades. Objectives: The main objective is to carry out a literature review on this comorbidity, in order to know if ADHD is considered a risk factor in the development of a Substance use disorders (SUD) in adolescence and adulthood. It is also intended to analyze whether the pharmacological treatment of ADHD prevents from the development of SUD and whether its prescription is safe in patients with such comorbidity. Methodology: A bibliographic research was carried out mainly in the PubMed database, in which the keywords were introduced, and the inclusion and exclusion criteria applied. Results: Patients with ADHD are at greater risk of developing dependence on alcohol (OR 2.31), nicotine (OR 2.28) and cannabis (OR 1.73); and developing a substance abuse disorder (SUD) (OR 2.49) in adulthood. Conclusions: Attention deficit hyperactivity disorder is a risk factor for developing a substance abuse disorder, being the treatment safe in patients with dual pathology as well as improving the drug dependence. (AU)

Recomendaciones para el uso de la hormona de crecimiento humana recombinante en pacientes pediátricos de talla baja en Colombia / Recommendations for treatment with recombinant human growth hormone in pediatric patients in Colombia

resumen está disponible en el texto completo

Abstract In Colombia there are no guidelines for diagnosis and management of patients with short stature and for the use of recombinant human growth hormone, mainly caused by the diversity of training centers in pediatric endocrinology. In response to this situation, the Asociación Colegio Colombiana de Endocrinología Pediátrica leds the first colombian short stature expert committee in order to standardize the use of human recombinant growth hormone. This work had the participation and endorsement of a consortium of clinical experts representing the Sociedad Colombiana de Pediatría, Secretaría Distrital de Salud de Bogotá- Subred Integrada de Servicios de Salud Suroccidente, Fundación Universitaria Sanitas, Universidad de los Andes and some public and private health institutions in the country, in addition to the participation of methodological experts from the Instituto Global de Excelencia Clínica Keralty. By reviewing the literature and with the best available evidence, we proposed to unify definitions, a diagnostic algorithm, biochemical and dynamic tests with their reference parameters, a description of the considerations about growth hormone use among the indications approved by regulatory agency for medications and food in Colombia and finally a proposal for an informed consent and a medication fact sheet available for parents and patients.

Disability and perceived stress in primary care patients with major depression / Discapacidad y estrés percibido en pacientes de atención primaria con depresión mayor

BACKGROUND: Major depressive disorder (MDD) is highly prevalent in the Spanish primary care (PC) setting and the leading cause of disability in Spain. The aim of this study was to evaluate several key psychometric properties of the Sheehan Disability Scale (SDS) in patients with or without MDD and varying degrees of symptom severity using the Patient Health Questionnaire-9 (PHQ-9). METHOD: A total of 1,704 PC patients participating in the PsicAP clinical trial completed the SDS and PHQ-9. We evaluated the factor structure, measurement invariance across gender, internal consistency, and the discriminative and predictive validity. RESULTS: Confirmatory factor analyses revealed a unifactorial model of the SDS containing 4 items (SDS-4) with the best model fit (CFI: .99; GFI: .99; TLI: 96; RMSEA: .10). This model contained the three life domain items (work, family, and social life) plus perceived stress (PS) with significant loadings. The internal consistency of the SDS-4 was acceptable in patients with or without MDD, regardless of symptom severity. The SDS-4 also showed good discriminative capacity and acceptable predictive validity in all subsamples. CONCLUSIONS: These findings support the use of the SDS-4 to assess depression-related disability in patients at Spanish primary care centres

ANTECEDENTES: el Trastorno Depresivo Mayor (TDM) es muy prevalente en la atención primaria (AP) española y es la principal causa de discapacidad en España. En este trabajo se estudiaron algunas propiedades psicométricas de la Escala de Discapacidad de Sheehan (SDS) en pacientes con o sin TDM y con varios niveles de severidad de síntomas, usando el Patient Health Questionnaire-9 (PHQ-9). MÉTODO: 1.704 pacientes de AP que participaron en el ensayo clínico PsicAP cumplimentaron la SDS y el PHQ-9. Se estudió la estructura factorial, medida de invarianza de género, consistencia interna, validez discriminativa y la validez predictiva. RESULTADOS: el análisis factorial confirmatorio mostró un modelo unifactorial con 4 ítems (SDS-4) con un buen ajuste (CFI: .99; GFI: .99; TLI: 96; RMSEA: .10). Este modelo contenía los tres ítems de esferas de la vida (trabajo, familia y vida social) más el ítem de estrés percibido con cargas significativas. La consistencia interna de la SDS-4 fue aceptable en pacientes con MDD y con diferente severidad de síntomas depresivos. También se halló una buena validez discriminativa y aceptable validez predictiva. CONCLUSIONES: nuestros hallazgos respaldan el uso de la SDS-4 cuando se evalúe la discapacidad relacionada con la depresión en centros de AP españoles

Disability and perceived stress in primary care patients with major depression.

BACKGROUND: Major depressive disorder (MDD) is highly prevalent in the Spanish primary care (PC) setting and the leading cause of disability in Spain. The aim of this study was to evaluate several key psychometric properties of the Sheehan Disability Scale (SDS) in patients with or without MDD and varying degrees of symptom severity using the Patient Health Questionnaire-9 (PHQ-9). METHOD: A total of 1,704 PC patients participating in the PsicAP clinical trial completed the SDS and PHQ-9. We evaluated the factor structure, measurement invariance across gender, internal consistency, and the discriminative and predictive validity. RESULTS: Confirmatory factor analyses revealed a unifactorial model of the SDS containing 4 items (SDS-4) with the best model fit (CFI: .99; GFI: .99; TLI: 96; RMSEA: .10). This model contained the three life domain items (work, family, and social life) plus perceived stress (PS) with significant loadings. The internal consistency of the SDS-4 was acceptable in patients with or without MDD, regardless of symptom severity. The SDS-4 also showed good discriminative capacity and acceptable predictive validity in all subsamples. CONCLUSIONS: These findings support the use of the SDS-4 to assess depression-related disability in patients at Spanish primary care centres.

El papel de la organización colegial-COP en el posicionamiento internacional de la Psicología Española (1979-2018) / The role of the Association of Psychologists-COP in the international ranking of Spanish Psychology (1979-2018)

La presencia de revistas españolas de psicología en diferentes bases de datos internacionales (JCR y SJR) es un indicador que determina el crecimiento y la madurez de esta disciplina y aporta una visión de la actividad científica en psicología y su situación en el contexto internacional. El objetivo del presente trabajo es determinar el papel del Colegio de Psicólogos como editor de revistas de psicología de impacto. Se seleccionaron 17 revistas indexadas simultáneamente en las bases JCR y SJR de 2018. Los resultados muestran como el 53% de éstas son editadas o coeditadas por un Colegio de Psicólogos, con especial relevancia del Colegio de Psicólogos de Madrid, teniendo una mayor presencia en otras bases de datos y un mayor número de revistas en los primeros cuartiles del JCR (SSCI), si bien no existen diferencias en el número de registros en los tres primeros cuartiles desde 1997 hasta la actualidad. Se puede concluir que las políticas de estado y las campañas de posicionamiento de universidades, asociaciones y colegios juegan un papel clave en la internacionalización y posicionamiento, y que en el caso español el Colegio de Psicólogos es el principal editor y promotor de una auténtica política orientada a estos fines

The presence and spread of Spanish psychology journals in different international databases (JCR and SJR) is an indicator that determines the maturity and growth of this field, apart from providing an interesting view of the scientific activity for what concerns psychology and its situation within the international context. The objective of the present work is to determine the role of the College of Psychologists as editor of psychology high-impact journals. 17 indexed journals were simultaneously selected in the JCR and SJR databases. The results show how 53% of them are edited or coedited by a College of Psychologists, with the particular relevance of the College of Psychologists from Madrid, having this a higher presence in other databases and a higher number of 1st quartile journals in JCR (SSCI); however, there are no differences in the number of first quartile registers in the time span that goes from 1997 until now. We could conclude that the state policies and the ranking campaigns of universities, associations and colleges play a key role in internationalization and ranking, since, in the case of Spain, the College of Psychologists is the main editor and promotor of a true policy focused on these objectives

¿Permiten la citología, el genotipado y la anoscopia de alta resolución establecer un protocolo para la detección precoz del carcinoma epidermoide de canal anal en población de riesgo? / Do cytology, genotyping, and high resolution anoscopy allow to establish a protocol for early detection of squamous cell carcinoma of the anal canal in risk population?

Introducción: El cáncer anal ha experimentado un aumento de incidencia en los últimos años. Está mediado por el VPH y precedido de cambios precancerosos planteando la posibilidad de dirigir los esfuerzos preventivos hacia los grupos de alto riesgo. Sigue siendo controvertida la indicación de cribado y los métodos de detección ideales. Objetivo: Validar las pruebas de cribado implementadas en la actualidad comparadas con la biopsia como "gold standard". Material y Métodos: Estudio transversal con recogida de datos prospectiva, en una cohorte de hombres VIH+ que tienen sexo con hombres, pertenecientes al Hospital Gregorio Marañón e Infanta Leonor en un periodo de 2 años. Resultados: Se seleccionaron 179 pacientes con 286 visitas a la consulta de screening en las que se llevaron a cabo 3 pruebas de cribado en paralelo (citología anal, genotipado del VPH y anoscopia de alta resolución (AAR) con toma de biopsia dirigida sobre zona sospechosa o aleatoria). La sensibilidad y especificidad para la detección de displasia de alto grado y cáncer y su grado de concordancia con la biopsia fue la siguiente: citología 3,23%/94,43% (k: 0,03), genotipado de VPH de alto riesgo 90,32%/27,45% (k: 0,05), AAR 32,26%/87,45 (k: 0, 17) siendo el rendimiento diagnóstico de las tres pruebas muy bajo. Conclusión: La citología presenta un rendimiento diagnóstico muy bajo comparado con el genotipado que representa el mayor. A la luz de nuestros resultados, los protocolos clínicos tal y como vienen desarrollándose en la actualidad deberían de ser abandonados.

Introduction: The incidence of anal cancer has increased in recent years. It is mediated by HPV and preceded by precancerous changes, raising the possibility of directing preventive efforts towards high-risk groups. The indication of screening remains controversial and which methods would be the ideal ones. Objective: To validate the screening tests established actually, comparing it with the biopsy considered as the "gold standard". Materials and Methods: A cross-sectional study was performed, with prospective data collection in a cohort of VIH+ patients, who have male homosexual anal relations, belonging to Gregorio Marañón and Infanta Leonor Hospitals in a period of 2 years. Results: A total of 179 patients were selected with 286 visits to the screening Outpatient Clinic in which 3 parallel screening tests were performed (anal cytology, HPV genotyping and high resolution anoscopy (AAR) with a biopsy directed on a suspicious or random area). The sensitivity and specificity for the detection of high-grade dysplasia and cancer and their degree of agreement with the biopsy was as follows: cytology 3.23%/94.43% (k: 0.03), high HPV genotyping. risk 90.32%/27.45% (k: 0.05), AAR 32.26%/87.45 (k: 0, 17), the diagnostic accuracy of the three tests being very low. Conclusion: Cytology shows a very low diagnostic accuracy compared to the genotype that represents the highest one. In light of our results, clinical protocols as they are currently being developed should be abandoned.

Sentencia judicial, delito sexual y pericial psicológica: enfoque transcultural / Judicial Sentence, Sexual Assaults and Psychological Expertise: A Cross-Cultural Approach

Resumen Se analiza la influencia de la pericial psicológica en las decisiones judiciales en delitos sexuales infantiles en tres departamentos de Colombia y una provincia española. El estudio transcultural compara las sentencias entre los años 2000 y 2014. Los resultados arrojaron que en el 91.7 % de sentencias de juicios celebrados, los magistrados españoles hacen referencia explícita a la pericial psicológica. En tanto que en Colombia, la proporción fue del 88.8 %. La cercanía de estos porcentajes es alentadora, porque a estos resultados se llega utilizando examen de datos distintos, desiguales códigos penales y recorridos dispares en la aplicación de la pericial psicológica. Se obtienen conclusiones similares que refrendan la importancia del psicólogo en la toma de decisiones judiciales.

Abstract It was analyze the influence of psychological evaluation in judicial decisions of child sexual abuse in three departments of Colombia and in a Spanish province. The transcultural analysis compares judgments of child sexual abuse in both countries between the year of 2000 and 2014. The 91.7% of judgments of the Spanish judges or magistrates made explicit reference to the psychological evaluation while in Colombia the proportion was 88.8%. The proximity of these percentages is encouraging because these results were reached using different test data, different criminal codes and different routes in the application of psychological expertise. Similar conclusions in both countries confirm the value of the contribution of psychologist on judicial decisions.

The Effect of Hyperoxygenated Fatty Acids in Preventing Skin Lesions Caused by Surgical Pneumatic Tourniquets.

OBJECTIVES: To determine whether hyperoxygenated fatty acids (HOFAs) provide safe and effective protection against lesions caused by surgical pneumatic tourniquets (SPTs). METHODS: This was a nonrandomized, single-blind, 2-arm, prospective, comparative study. The study was approved by the Ethics and Clinical Research Commission of the Hospital Universitario Gregorio Marañón, in Madrid, Spain. Subjects in the intervention group were treated topically with HOFAs (Linovera; B. Braun Medical Inc, Bethlehem, Pennsylvania) at the site (upper and lower limbs) where an SPT was to be applied. An elastic bandage was then set in place and finally the SPT. Control subjects were treated in the same way, but no HOFAs were applied. PARTICIPANTS: The study subjects were all patients of the Department of Orthopedic and Trauma Surgery at the Hospital Universitario Gregorio Marañón for whom the use of an SPT was indicated for 60 minutes or longer. In total, 174 patients completed the study, 83 in the HOFA-treatment arm and 91 in the control arm. All subjects gave their informed consent to be included. MAIN OUTCOME: Assessment of the lesions induced by the SPT after its removal. MAIN RESULTS: Significant correlations were found between the risk of developing lesions and age 70 years or older (P = .021), a duration of ischemia of 70 minutes or longer (P = .006), and being a member of the control group (P < .001). Some 93.4% of the intervention group experienced only a grade 0 to 1 skin lesion compared with 55.4% of the control group. Moreover, 44.6% of the control arm subjects suffered a grade 2 to 4 lesion compared with only 6% of the HOFA-treated subjects. No subject in the treatment arm suffered any important skin lesion; in the control arm, however, 2 patients suffered edema, another suffered induration, and 2 experienced abrasions. CONCLUSIONS: The use of topical HOFAs, in conjunction with the application of an elastic bandage before applying an SPT, is a safe and effective way of preventing SPT-induced skin lesions.