Nonimmediate allergic reactions (NIR) to aminopenicillin include several entities, the most common of which are urticaria-like and maculopapular exanthemas. To evaluate a group of children who ...developed one or more episodes of skin reactions suggestive of NIR after aminopenicillin administration. The inclusion criteria required negative immediate skin tests and absence of specific IgE antibodies to different penicillins. Intradermal and patch tests were carried out with delayed readings and, if negative, a drug-provocation test including a full therapeutic course of the drug was given. Two different groups were compared: A) children with positive skin testing or a positive drug-provocation test and B) children with negative skin testing and good tolerance after a drug-provocation test. Group A was composed of 20 patients. Positive intradermal/patch tests were found in one patient and in the remaining 19, a positive response to a drug-provocation test confirmed the diagnosis. Group B (the control group) consisted of 19 patients with similar symptoms after aminopenicillin intake but good tolerance. No differences in age, dose or number of previous treatments were observed between the groups. The clinical entities were also similar in both groups. Reproducible nonimmediate skin reactions to aminopenicillins may occur in children in spite of negative skin testing. The value of this diagnostic procedure seems to be limited in this type of reaction, with drug-provocation tests (DPT) being a reasonable and safe alternative if the diagnosis has to be confirmed.
Antecedentes/Objetivo: El ciberacoso es uno de los problemas sociales de mayor preocupación en los ámbitos educativos, especialmente en la adolescencia, en la que las experiencias de victimización se ...han asociado a episodios de ansiedad y depresión. Se diseñó un estudio con el objetivo de analizar la relación entre cibervictimización, ansiedad y depresión en la adolescencia mediante un meta-análisis e identificar las variables moderadoras que podrían ayudar a explicar las distintas correlaciones. Método: Se realizó una búsqueda de estudios transversales en las bases de datos Web of Science, Scopus y PsyclNFO. De los 156 estudios identificados, finalmente 13, con un total de 7,348 participantes, cumplieron con los criterios de inclusión. Resultados: Los resultados sugieren correlaciones estadísticamente significativas entre cibervictimización y ansiedad (r = .31) y cibervictimización y depresión (r = .28). El análisis de meta-regresión mostró que el porcentaje de mujeres y continente son variables moderadoras en la relación de cibervictimización con depresión y ansiedad. Conclusiones: En conclusión, el mal uso de las nuevas tecnologías de la información y la comunicación puede provocar un desajuste psicológico y social de las personas, con repercusiones negativas en su desarrollo.
Antecedentes: El ciberbullying es una problemática con una alta prevalencia en nuestra sociedad y que tiene importantes implicaciones para el bienestar psicológico de los adolescentes. El objetivo ...del trabajo fue examinar la estructura de red de la Escala de Depresión, Ansiedad y Estrés en una muestra de jóvenes, así como comprobar las relaciones que se establecen entre diferentes tipos de cibervictimización y la presencia de estados emocionales negativos. Método: Se realizó un estudio descrip tivo transversal. La muestra estuvo formada por 2,171 estudiantes de Educación Secundaria, con una media de edad de 13.84 años (donde el 50.53% fueron hombres y el 49.47% mujeres). Se aplicó el Cuestionario de Cibervictimización (CYVIC) y la versión española de Depression, Anxiety and Stress Scale (DASS-21). Resultados: Se encontraron correlaciones positivas entre todas las dimensiones del DASS-21 y los tipos de cibervictimización. Atendiendo a la estructura de redes, se halló que los diferentes nodos de los tres estados emocionales se relacionaban positivamente entre sí (aunque algunas relaciones eran más fuertes que otras). Por otro lado, en relación al sexo, las mujeres mostraron medias significativamente más elevadas en depresión, ansiedad y estrés. Al analizar la red, las asociaciones más estrechas se dieron entre la ansiedad y la cibervictimización de tipo escrita-verbal y la exclusión en ambos sexos. Conclusiones: Los estados emocionales negativos y los tipos de cibervictimización se relacionaban en una compleja red donde los esfuerzos por abordar la reducción de los síntomas emocionales asociados a la cibervictimización podrían producir beneficios duraderos en el bienestar emocional de los jóvenes.
Transition-metal-containing rotaxanes can behave as linear motors at the molecular level. The molecules are set into motion either by an electrochemical reaction or using a chemical signal. In a ...first example, a simple rotaxane is described that consists of a ring threaded by a two-coordination-site axle. The ring contains a bidentate ligand, coordinated to a copper center. The axle incorporates both a bidentate and a terdentate ligand. By oxidizing or reducing the copper center to Cu(II) or Cu(I) respectively, the ring glides from a given position on the axle to another position and vice versa. By generalizing the concept to a rotaxane dimer, whose synthesis involves a quantitative double-threading reaction triggered by copper(I) complexation, a molecular assembly reminiscent of a muscle is constructed. By exchanging the two metal centers of the complex (copper(I)/zinc(II)), a large-amplitude movement is generated, which corresponds to a contraction/stretching process. The copper(I)-containing rotaxane dimer is in a stretched situation (overall length ∼8 nm), whereas the zinc(II) complexed compound is contracted (length ∼6.5 nm). The stretching/contraction process is reversible and it is hoped that, in the future, other types of signals can be used (electrochemical or light pulse) to trigger the motion.
The SLC39A14, SLC30A10 and SLC39A8 are considered to be key genes involved in manganese (Mn) homeostasis in humans. Mn levels in plasma and urine are useful tools for early recognition of these ...disorders. We aimed to explore further biomarkers of Mn deposition in the central nervous system in two siblings presenting with acute dystonia and hypermanganesemia due to mutations in SLC39A14. These biomarkers may help clinicians to establish faster and accurate diagnosis and to monitor disease progression after chelation therapy is administered.
A customized gene panel for movement disorders revealed a novel missense variant (c.311G > T; p.Ser104Ile) in SLC39A14 gene in two siblings presenting at the age of 10 months with acute dystonia and motor regression. Mn concentrations were analyzed using inductively coupled mass spectrometry in plasma and cerebrospinal fluid, disclosing elevated Mn levels in the index case compared to control patients. Surprisingly, Mn values were 3-fold higher in CSF than in plasma. We quantified the pallidal index, defined as the ratio between the signal intensity in the globus pallidus and the subcortical frontal white matter in axial T1-weighted MRI, and found significantly higher values in the SLC39A14 patient than in controls. These values increased over a period of 10 years, suggesting the relentless pallidal accumulation of Mn. Following genetic confirmation, a trial with the Mn chelator Na
CaEDTA led to a reduction in plasma Mn, zinc and selenium levels. However, parents reported worsening of cervical dystonia, irritability and sleep difficulties and chelation therapy was discontinued.
Our study expands the very few descriptions of patients with SLC39A14 mutations. We report for the first time the elevation of Mn in CSF of SLC39A14 mutated patients, supporting the hypothesis that brain is an important organ of Mn deposition in SLC39A14-related disease. The pallidal index is an indirect and non-invasive method that can be used to rate disease progression on follow-up MRIs. Finally, we propose that patients with inherited defects of manganese transport should be initially treated with low doses of Na
CaEDTA followed by gradual dose escalation, together with a close monitoring of blood trace elements in order to avoid side effects.
Antecedentes: El objetivo del trabajo fue explorar la relación entre humanización, capacidad de adaptación al cambio y salud mental en docentes europeos (españoles, portugueses e italianos) y la ...relación entre humanización y salud mental en docentes mediante el análisis del rol mediador de la capacidad de adaptación al cambio. Método: Se realizó un estudio descriptivo transversal con docentes de tres países europeos (España, n = 263, Portugal, n = 344 e Italia, n = 287). Se administró la Healthcare Professional Humanization Scale (HUMAS), el General Health Questionnaire (GHQ-28) y el Cuestionario de Adaptación al Cambio (ADAPTA-10). Resultados: En los tres países se obervó una asociación negativa entre humanización y la presencia de sintomatología problemática. Con los factores de adaptación al cambio la humanización presentó una asociación negativa con el factor emocional y positiva con el cognitivo-conductual. Del análisis comparativo de medias se obtuvieron diferencias en humanización, el factor emocional de adaptación al cambio y la presencia de sintomatología problemática. Finalmente, los modelos de mediación mostraron la ausencia de un efecto directo en la relación entre humanización y la presencia de sintomatología GHQ-28 cuando esta se encontraba mediada por el factor emocional (muestra española y portuguesa). En la muestra italiana fue significativo el efecto directo de la humanización-sintomatología GHQ-28, con menor proporción del efecto indirecto del factor emocional actuando este como mediador. Por otro lado, tomando como mediador el factor cognitivo-conductual, se obtuvo el mismo resultado para los tres países: un efecto directo negativo entre la humanización y la sintomatología GHQ-28, no estando este mediado por el factor cognitivo-conductual. Conclusiones: La necesidad de mejorar la formación en competencias de humanización reside en la potencial función protectora que pueden ejercer sobre la salud mental de los docentes.
This work studies the use of ultrasonic imaging as an evaluation tool in concrete subjected to freeze–thaw (F–T) cycles. To evaluate the damage in this deterioration process, ultrasonic velocity and ...attenuation images have been generated from concrete specimens with and without air-entraining agents. Two parameters have been proposed from these ultrasonic images according to our experimental setup: the non-assessable area proportion (NAAP) and a weighted average velocity in terms of the NAAP. The proposed parameters have been compared with the recommended failure criteria of the ASTM and Rilem standards, which employ ultrasonic contact measurements. The principal advantage of the use of ultrasonic images and the proposed methodology in comparison with the ultrasonic velocity measurements by contact is the possibility of detection of incipient damage caused by accelerated freeze–thaw cycles.
Fibromyalgia syndrome (FMS) is a complex psychosomatic pain condition. In addition to generalized pain and various cognitive difficulties, new FMS diagnostic criteria acknowledge fatigue and sleep ...problems as core aspects of this condition. Indeed, poor sleep quality has been found to be a significant predictor of pain, fatigue, and maladaptive social functioning in this patient group. While there is promising evidence supporting the role of mindfulness as a treatment for FMS, to date, mindfulness intervention studies have principally focused on dimensions of pain as the primary outcome with sleep problems either not being assessed or included as a secondary consideration. Given the role of sleep problems in the pathogenesis of FMS, and given that mindfulness has been shown to improve sleep problems in other clinical conditions, the present study explored the effects of a mindfulness-based intervention known as
(
) on a range of sleep-related outcomes (subjective insomnia, sleep quality, sleepiness, and sleep impairment) in individuals with FMS. Adult women with FMS (
= 39) were randomly assigned to the 7 weeks mindfulness treatment or a waiting list control group. Results showed that compared to the control group, individuals in the mindfulness group demonstrated significant improvements across all outcome measures and that the intervention effects were maintained at a 3 month follow-up assessment. The
program shows promise for alleviating sleep problems relating to FMS and may thus have a role in the treatment of FMS as well as other pain disorders in which sleep impairment is a central feature of the condition.
Abstract Introduction This study was aimed at assessing general practitioners’ (GP) reliance on patient history, examination findings and the influence of the utilisation of point-of-care tests ...(POCT) in antibiotic prescribing for sore throat and lower respiratory tract infections (LRTI). Methods Audit-based study carried out in 2015. A group of GPs received an intervention six years earlier with provision of POCTs and another group of GPs acted as controls. Odds ratios for clinical variables predicting antibiotic prescribing were calculated by logistic regression analyses. Results A total of 238 GPs included 1906 patients with sore throat and 1970 LRTIs. A negative POCT result was negatively associated with antibiotic prescribing, with odds ratios ranging from 0.09 to 0.23. GPs using POCTs attached less weight to clinical criteria. Conclusion GPs using rapid tests are mainly influenced by POCT results in the decision to prescribe antibiotics. However, antibiotic prescribing is still observed with negative POCT results.
PDF
