The patients on the liver transplant (LT) waiting list usually present with deterioration in their quality of life. Previous studies on psychological intervention have shown how the quality of life ...can be improved.
To analyze preliminary results of the influence of group psychotherapy on the quality of life of patients on the LT waiting list.
Fifteen patients on the LT waiting list who accepted receiving group psychotherapy were selected. The development of each 1 of these sessions was carried out at fortnightly periods for 6 months (12 sessions). Those patients who received a transplant and those patients who did not attend more than 6 group psychotherapy sessions were excluded. The Nottingham Health Profile was used to assess the quality of life. It consists of 38 items belonging to 6 health dimensions: energy, pain, physical mobility, emotional reaction, sleep, and social isolation. The study population was given a questionnaire before starting group psychotherapy and after it was finished.
Of the 15 patients selected from the study population, 3 patients were given a transplant before the psychotherapy had finished, and 5 patients were excluded for not having attended more than 50% of the sessions. Therefore, the study was completed on 7 patients (n = 7). Overall, a better assessment can be seen in the second questionnaire.
Group psychotherapy might favorably influence the quality of life of patients on the LT waiting list; therefore, it might be interesting to carry out studies on a larger scale in order to confirm these results.
•There is a deterioration in the quality of life in patients on the waiting list for liver transplantation. Psychological intervention could have an impact on cirrhotic patients on the transplant waiting list and could improve the quality of life in these patients.•Impact of psychological intervention in cirrhotic patients on transplant waiting list.•Improvement of quality of life with group psychotherapy in patients with cirrhosis.
It is well-known that there is a high incidence of depression in patients on the liver transplant (LT) waiting list. However, there have been few studies of psychological intervention on these ...patients.
To determine symptoms of depression in patients on the LT waiting list and the impact of group psychotherapy.
Study population: patients on the LT waiting list who received group psychotherapy (n = 15). Control group: patients who did not receive psychotherapy (n = 10). Measurement instrument: Beck's depression test, which was provided before psychotherapy was initiated and after it was completed (after 6 months). The control group was given the questionnaire at the same 2 points in time as the study group. The psychotherapeutic method consisted of discussing patients' feelings, which dealt with several matters related to transplantation. Different coping strategies were considered.
More than half of those surveyed initially had depressive symptoms. When the second survey was administered to the study population, all the patients improved in their psychopathological assessment. When the survey was administered to the control group, a worse psychopathological assessment was obtained in all cases.
Our data suggest an improvement in depressive symptoms in patients on the LT waiting list after receiving group psychotherapy.
Malnutrition among hospitalized patients has clinical implications, and interest has arisen to find screening tools able to identify subjects under risk. At present, there is no consensus about the ...most suitable nutrition screening tool for pediatric patients.
To validate STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics) pediatric screening tool in Spain.
Descriptive cross-sectional study of patients admitted to a 3rd level children's hospital with both medical and surgical specialities. During the first 24 hours of admission, STAMP screening tool was applied. For its validation, results were compared with those obtained from a nutritional assessment performed by specialist staff, which included clinical, anthropometric and body composition data.
A sample of 250 children was studied. Nutritional assessment identified 64 patients (25.6%) under risk, 40 of whom were malnourished (16%). STAMP classified 48.4% of the patients as being under nutritional risk. This tool showed 75% sensitivity and 60.8% specificity when identifying patients under risk according to nutritional assessment. It showed 90% sensitivity and 59.5% specificity when identifying malnourished patients.
Malnutrition was less frequent than that reported in other European countries, although diagnosis technique was different. STAMP is a simple and useful tool for nutritional screening, avoiding the need to assess all patients on admission in order to identify those under nutritional risk.
describir la talla final y la ganancia sobre la talla diana, en un grupo de niños diabéticos tipo 1 y analizar su relación con distintas variables.
estudio retrospectivo de 52 pacientes (27 mujeres) ...diagnosticados de diabetes tipo 1 antes de los 14 años y seguidos hasta la talla final. Variables principales: talla final, talla diana, tiempo de evolución de la diabetes, glucohemoglobina (HbA
1c) media, requerimiento insulínico, índice de masa corporal, enfermedades autoinmunes asociadas.
al inicio de la diabetes la escala de desviación estándar (EDE) de talla se encontraba ligeramente por encima de la media (0,734 en varones y 0,563 en mujeres). A lo largo de la evolución se produce un pérdida de talla generalizada, más acusada en varones en etapa prepuberal (p=0,016). La talla final alcanzada fue 173,14±5,28
cm en varones (EDE=−0,034) y 161,9±6,97
cm en mujeres (EDE=0,385). La ganancia de talla fue 1,56±3,66
cm en varones y 2,26±6,13
cm en mujeres. La única variable relevante relacionada significativamente con la ganancia de talla fue la HbA
1c media (pérdida de 2
cm por cada aumento del 1% de HbA
1c media a igualdad del resto de las variables).
nuestros resultados indican que, aunque al inicio de la diabetes los niños tienen una talla algo mayor que la de la población de referencia, se produce una pérdida de talla durante la evolución de la enfermedad, más acusada en varones en periodo prepuberal. Ello produce que la talla final de los varones se encuentre ligeramente por debajo de la media, mientras que las mujeres alcanzan una talla final similar a la de la población de referencia. Ambos sexos alcanzaron su talla diana, pero en varones la ganancia sobre ésta fue escasa. El mal control metabólico se relacionó con la menor ganancia de talla en niños diabéticos.
To describe the final height and height-gain in relation to target height, in children with type 1 diabetes mellitus, and analyse their relationship to different variables.
Retrospective analysis of the growth data of 52 children (27 girls) diagnosed with type 1 diabetes mellitus before 14 years old, and followed up until their final height was attained. Main variables: final height, target height, illness duration, glycated haemoglobin (HbA1c), insulin dose, BMI, and other autoimmune diseases.
The height SDS (standard deviation scale) at diagnosis was slightly higher (0.734 in boys and 0.563 in girls). During the development of the disease, a growth reduction was seen, which was significantly higher in boys of prepubertal age (p=0.016). The mean final height attained was 173.14±5.28
cm in boys and 161.9±6.97
cm in girls. Height gain was 1.56±3.66 in boys (SDS=−0.034) and 2.26±6.13 in girls (SDS=0.385). The only variable significantly related to height gain was mean glycated-haemoglobin (growth reduction of 2
cm for every increment of 1% in mean glycated-haemoglobin).
At onset, diabetic children were slightly taller than the general population. A growth reduction was shown as the disease developed, significantly higher in boys of prepubertal age. The final height in boys was slightly lower than the mean, but in girls was similar to the general population. Both sexes attained their target height, although the height gain was less in boys. Poorer metabolic control was associated with reduced height gain.
INTRODUCTIONIt is well known that there is a high incidence of depression in patients on the liver transplant (LT) waiting list. Moreover, these patients usually present with deterioration in their ...quality of life. However, there have been few studies about psychological intervention on patients on the transplant waiting list that have assessed both of these aspects. Objectivesto assess the impact of group psychotherapy on psychopathological symptoms and on the quality of life of these patients.
MATERIALS AND METHODSStudy populationpatients on the LT waiting list who received group psychotherapy (n=15). Patient selection was carried out randomly using the list of patients waiting for a LT. Measurement instrumentsBeckʼs depression test, which was provided before psychotherapy was initiated and after it was completed (after 6 months, with a total of 12 sessions). The Nottingham Health Profile (NHP) was used to assess the quality of life. It consists of 38 items belonging to six health dimensionsEnergy, Pain, Physical mobility, Emotional reaction, Sleep and Social isolation. The score is obtained by calculating the average of the addition of affirmative answers for each dimension, the higher the score the worse the assessment. The two tests were completed at the same point in time. The group psychotherapeutic method consisted of having a discussion about patientsʼ emotions and feelings. The role of the therapists was to facilitate the expression of emotions and to give meaning to them. Those patients who received a transplant were excluded and those patients who did not attend more than 6 group psychotherapy sessions were also excluded (>50%).
RESULTSThree patients were given a transplant before the psychotherapy had finished and five patients were excluded for not having attended more than 50% of the sessions (three attended two sessions and two attended three sessions). Therefore, the study was completed on 7 patients. The indication of LT was due to chronic alcoholic liver disease in four patients (all were Child-Pugh class B), two patients had HCC (both were Child A), and one patient had chronic hepatitis C virus (Child B). Initially 5 patients had depression-related symptoms; one patient had moderate depression, and four patients had intermittent states of depression. When the second survey was administered, all the patients improved in their psychopathological assessment (Table 1). Table 2 shows the average assessment for the six dimensions of quality of life before and after therapy. Overall, a better assessment can be seen in the second questionnaire.(Table is included in full-text article.)(Table is included in full-text article.)
CONCLUSIONOur data suggest an improvement in depressive symptoms and quality of life in patients on the LT waiting list after receiving group psychotherapy. Assuming that these results were confirmed in a larger number of patients, it would be interesting to implement group psychotherapy in the largest number of LT units possible.
The aim of this study was to determine the predictive capacity of response at treatment week (TW) 4 for the achievement of sustained virological response 12 weeks after the scheduled end of therapy ...date (SVR12) to treatment against hepatitis C virus (HCV) genotype 3 (GT3) infection with all-oral direct-acting antiviral (DAA) -based regimens.
From a prospective multicohort study, HCV GT3-infected patients who completed a course of currently recommended DAA-based therapy at 33 Spanish hospitals and who had reached the SVR12 evaluation time-point were selected. TW4 HCV-RNA levels were categorized as target-not-detected (TND), below the lower limit of quantification (LLOQTD) and ≥LLOQ.
A total of 123 patients were included, 86 (70%) received sofosbuvir/ daclatasvir±ribavirin, 27 (22%) received sofosbuvir/ ledipasvir/ ribavirin and 10 (8.1%) received sofosbuvir/ ribavirin, respectively. In all, 114 (92.7%) of the 123 patients presented SVR12 in an on-treatment approach, but nine (7.3%) patients relapsed, all of them had presented cirrhosis at baseline. In those who achieved TND, LLOQTD and ≥LLOQ, SVR12 was observed in 81/83 (98%; 95% CI 91.5%–99.7%), 24/28 (85.7%; 95% CI 67.3%–96%) and 9/12 (75%; 95% CI 42.8%–94.5%), respectively; p(linear association) 0.001. Corresponding numbers for subjects with cirrhosis were: 52/54 (96.3%; 95% CI 87.3%–95.5%), 14/18 (77.8%; 95% CI 52.4%–93.6%) and 7/10 (70%; 95% CI 34.8%–93.3%); p 0.004.
TW4-response indicates the probability of achieving SVR12 to currently used DAA-based therapy in HCV genotype 3-infected individuals with cirrhosis. This finding may be useful to tailor treatment strategy in this setting.
Introducción: La malnutrición en los pacientes hospitalizados tiene implicaciones clínicas y evolutivas, por lo que existe interés en desarrollar métodos de cribado que identifiquen los individuos de ...riesgo. En la actualidad no existe consenso acerca de la herramienta de cribado nutricional más apropiada para aplicar en población pediátrica. Objetivo: Validar en España la herramienta de cribado nutricional pediátrico STAMP (Screening Tool for the Assessment of Malnutrition in Pediatrics). Métodos: Estudio descriptivo transversal en pacientes ingresados en un hospital pediátrico de tercer nivel con diferentes especialidades médicas y quirúrgicas. En las primeras 24 horas de ingreso se aplicó el método de cribado nutricional STAMP. Para la validación de sus resultados se llevó a cabo una valoración del estado nutricional que incluyó datos clínicos, antropométricos y de composición corporal realizada por personal especializado en nutrición. Resultados: Fueron estudiados 250 niños. La valoración nutricional detectó 64 pacientes (25,6%) considerados de riesgo, de los cuales 40 (16%) estaban ya malnutridos. STAMP clasificó un 48,4% de la muestra como de riesgo nutricional elevado. Dicho método mostró una sensibilidad del 75% y una especificidad del 60,8% para identificar los pacientes considerados de riesgo en la valoración nutricional, y una sensibilidad del 90% y especificidad del 59,5% para detectar los malnutridos. Comentarios: La frecuencia de malnutrición fue algo inferior a la de otros países de nuestro entorno, aunque el método diagnóstico fue diferente. El método STAMP es una herramienta sencilla y útil para el cribado nutricional, que evitaría la necesidad de valorar a todos los pacientes al ingreso para detectar los sujetos de riesgo.
The formation of multidomain epitaxial graphene on Rh(111) under ultra-high vacuum (UHV) conditions has been characterized by scanning tunnelling microscopy (STM) measurements and density functional ...theory (DFT) calculations. At variance with the accepted view for strongly interacting graphene-metal systems, we clearly demonstrate the formation of different rotational domains leading to multiple moiré structures with a wide distribution of surface periodicities. Experiments reveal a correlation between the STM apparent corrugation and the lattice parameter of the moiré unit cell, with corrugations of just 30-40 pm for the smallest moirés. DFT calculations for a relevant selection of these moiré patterns show much larger height differences and a non-monotonic behaviour with the moiré size. Simulations based on non-equilibrium Green's function (NEGF) methods reproduce quantitatively the experimental trend and provide a detailed understanding of the interplay between electronic and geometric contributions in the STM contrast of graphene systems. Our study sheds light on the subtle energy balance among strain, corrugation and binding that drives the formation of the moiré patterns in all graphene/metal systems and suggests an explanation for the success of an effective model only based on the lattice mismatch. Although low values of the strain energy are a necessary condition, it is the ability of graphene to corrugate in order to maximize the areas of favourable graphene-metal interactions that finally selects the stable configurations.
•Multiresidue method for edible vegetable oils using GC–MS/MS.•Evaluation of different sorbents for the clean-up step using QuEChERS methodology.•Comparison of the novel EMR-Lipid sorbent with Z-Sep ...and PSA.•Procedural Standard Calibration to correct recovery losses.•Several pesticides are detected in most of the olive oil samples.
The aim of this research was to adapt the QuEChERS method for routine pesticide multiresidue analysis in edible vegetable oil samples using gas chromatography coupled to tandem mass spectrometry (GC–MS/MS). Several clean-up approaches were tested: (a) D-SPE with Enhanced Matrix Removal-Lipid (EMR-Lipid™); (b) D-SPE with PSA; (c) D-SPE with Z-Sep; (d) SPE with Z-Sep. Clean-up methods were evaluated in terms of fat removal from the extracts, recoveries and extraction precision for 213 pesticides in different matrices (soybean, sunflower and extra-virgin olive oil). The QuEChERS protocol with EMR-Lipid d-SPE provided the best reduction of co-extracted matrix compounds with the highest number of pesticides exhibiting mean recoveries in the 70–120% range, and the lowest relative standard deviations values (4% on average). A simple and rapid (only 5min) freeze-out step with dry ice (CO2 at −76°C) prior to d-SPE clean-up ensured much better removal of co-extracted matrix compounds in compliance of the necessity in routine analysis. Procedural Standard Calibration was established in order to compensate for recovery losses of certain pesticides and possible matrix effects. Limits of quantification were 10μgkg−1 for the majority of the pesticides. The modified methodology was applied for the analysis of different 17 oil samples. Fourteen pesticides were detected with values lower than MRLs and their concentration ranged between 10.2 and 156.0μgkg−1.
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