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Ideación Suicida en Adolescentes: Un Análisis Psicosocial

  • Sánchez-Sosa,Juan Carlos
  • Villarreal-González,María Elena
  • Musitu,Gonzalo
  • Martínez Ferrer,Belen
Se especificó y contrastó un modelo explicativo psicosocial de ideación suicida en adolescentes, mediante un estudio explicativo de tipo transversal. Se utilizó una muestra probabilística estratificada de 1285 estudiantes mexicanos de escolaridad media y media superior. Los instrumentos utilizados tenían índices adecuados de fiabilidad. Se contrastó el modelo con la técnica de ecuaciones estructurales utilizando el paquete estadístico EQS 6.1 que explicó el 33.10 % de varianza explicada. Los resultados mostraron que el modelo obtuvo niveles adecuados de bondad de ajuste absoluto (RMSEA=.41; GFI=.953; AGFI=.939) y comparativo (CFI=.951; IFI=.958; NFI=.925; NNFI=.943). Se concluyó que el Modelo Explicativo Psicosocial de Ideación Suicida (MEPIS) se ajustaba bien a los datos y era compatible con el modelo teórico propuesto, al integrar una estructura contextual que presentaba una relación indirecta y significativa del funcionamiento familiar y los problemas de integración escolar con la variable dependiente. Además, también se observó, una relación directa y significativa de la victimización escolar, sintomatología depresiva y conducta alimentaria de riesgo con la ideación suicida.
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El Análisis Factorial Confirmatorio en el estudio de la Estructura y Estabilidad de los Instrumentos de Evaluación: Un ejemplo con el Cuestionario de Autoestima CA-14

  • Herrero,Juan
Este trabajo presenta un estudio de la estructura factorial y la estabilidad del Cuestionario de Autoestima CA-14 utilizando la técnica del Análisis Factorial Confirmatorio. El trabajo pretende ilustrar y guiar en las posibilidades que ofrece esta técnica, prestando especial atención a los requisitos que deben cumplir los datos, los métodos de estimación sugeridos en la literatura científica, los índices de ajuste más adecuados para evaluar los modelos y otras circunstancias que se deben tener en cuenta a la hora de estimar modelos de Análisis Factorial Confirmatorio. En el trabajo se presentan además diversas estrategias metodológicas en la implementación de esta técnica: correlación de errores residuales, imposición de constricciones o equivalencias en los parámetros de un modelos, modelos multigrupo, etc.
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Aceite de oliva, sistema inmune e infección

  • Puertollano,M.ª A.
  • Puertollano,E.
  • Álvarez de Cienfuegos,G.
  • Pablo,M. A. de
Los ácidos grasos de naturaleza poliinsaturada ω-3 han recibido una gran atención en los últimos años como componentes de la dieta supresores de las funciones inmunes y por ello han sido aplicados en la resolución de diferentes desórdenes de naturaleza inflamatoria. Aunque la inhibición de algunas funciones inmunes por la acción de estos ácidos grasos ejerce efectos beneficiosos en la disminución de la respuesta inflamatoria del individuo, este estado puede conducir a una reducción significativa de la protección del individuo frente a microorganismos de naturaleza infecciosa (virus, bacterias, hongos y parásitos). Sin embargo, el aceite de oliva (constituido principalmente por ácidos grasos monoinsaturados y uno de los componentes principales de la dieta Mediterránea) modula también algunas de estas funciones, sin reducir de forma tan severa la resistencia inmune del individuo frente a agentes de naturaleza infecciosa. Bajo estas premisas podemos afirmar que la administración de aceite de oliva puede contribuir a la reducción de la actividad inflamatoria observada en algunas enfermedades crónicas caracterizadas por desórdenes inmunes, sin agravar la susceptibilidad del individuo a agentes patógenos. Por lo tanto, la aplicación del aceite de oliva en emulsiones lipídicas puede tener efectos beneficiosos sobre la salud y particularmente sobre el sistema inmune de individuos inmunocomprometidos, adquiriendo una gran importancia en nutrición clínica. El presente trabajo de revisión contribuye a clarificar la interrelación existente entre la administración de dietas constituidas por aceite de oliva y el sistema inmune, así como a determinar el efecto que este componente esencial de la dieta Mediterránea juega en la inmunomodulación en los estados de infección.
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Behavioural therapy in the treatment of obesity (II): role of the Mediterranean diet

  • Garaulet,M.
  • Pérez de Heredia,F.
Objectives: Obesity is the consequence of an imbalance between energy intake and expenditure, food intake being affected by multiple factors -psychological, social, work-related, etc. This revision discusses the role of diet in the behavioural treatment (BT) of obesity, which faces multiple approaches and focuses on patients' behaviour rather than their mere energy intake. Setting: Recent literature has been revised that deals with the health benefits of Mediterranean diet in order to assess its suitability for obesity treatment based on BT. Results: BT helps patients to develop skills and techniques in order to adopt proper habits and attain their healthiest weight. Patients learn to establish realistic goals, both as regards weight and behaviour, and to evaluate their progress in modifying eating and exercising habits. The application of the Mediterranean diet in obesity treatment presents various advantages which are based on the principles of this diet -wide variety of food, high carbohydrate content, or high satiating capacity, which prevents specific hunger and ketogenesis-, and has been demonstrated to be effective in reducing body weight. Conclusions: BT based on the Mediterranean diet is a useful tool for obesity treatment. The Mediterranean diet provides the patients with a diet established on widely recognised nutritional benefits, suitable to their social and daily life, and that can be easily followed in the long term, according to the objectives of BT. For these reasons, Mediterranean diet-based BT helps to prolong both the treatment and maintenance periods and therefore contributes to a more stable weight loss.
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Use of carb counting in the dietary treatment of diabetes mellitus

  • Lopes Souto,D.
  • Lopes Rosado,E.
Currently, carb counting is a nutritional strategy that has allowed a greater adherence and dietary management of patients with diabetes mellitus, because it allows the consumption of a greater variety of foods. However, also requires greater adherence by the patient to maintain an adequate blood glucose monitoring and the ability to determine the amount of carbohydrates in the meals. Since diabetes mellitus is a chronic disease, a more flexible and varied diet will allow better monitoring, taking into account their glycemic control in long-term. The objective of this study was to examine the applicability of this method to a less restrictive diet and nutritionally adequate for the patient with diabetes mellitus, as well an individual dietary adjustment that is needed to better glycemic control, identifying nutritional advantages and disadvantages of the method.
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Protocolización de la Nutrición Artificial por vía Parenteral: Bases metodológicas y organizativas para el diseño y revisión del proceso

  • Schoenenberger Arnaiz,J. A.
  • Rodríguez Pozo,A.
En el campo de la nutrición artificial por vía parenteral (NP) se debate en torno a la aplicación de conceptos como estandarización, individualización, protocolización o normalización. Las Unidades de Nutrición Artificial (UNA) que diseñan o revisan su sistema de provisión de NP deben tener en cuenta las referencias metodológicas y normativas existentes así como los recursos de que dispone para realizar el proceso. El objetivo de este trabajo consiste en revisar y evaluar las posibilidades existentes para diseñar un proceso eficiente y seguro aplicando la metodología de la mejora continua de la calidad. Se revisan los requerimientos actuales en términos de calidad de formulación, seguridad y contención de costes así como los recursos disponibles para no mermar las posibilidades de adaptar el tratamiento a las necesidades del paciente ni comprometer su eficacia. La solución al problema de si el enfoque escogido en el sistema de provisión de NP es adecuado debe venir de la revisión de la calidad del servicio a través de la evaluación de indicadores tanto de proceso como de resultado. En esta labor el farmacéutico del hospital juega un papel relevante como agente garante del cumplimiento de las normas de buena práctica.
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G1359A polymorphism of the cannabinoid receptor gene (CNR1) and insulin resistance in patients with diabetes mellitus type 2

  • Luis,D. A. de
  • González Sagrado,M.
  • Aller,R.
  • Izaola,O.
  • Conde,R.
  • Romero,E.
Background: A silent intragenic biallelic polymorphism (1359 G/A) (rs1049353) of the CB1 gene resulting in the substitution of the G to A at nucleotide position 1359 in codon 435 (Thr), was reported as a common polymorphism in Caucasian populations. Objective: The aim of our study was to investigate the influence of the missense polymorphism (G1359A) of CB1 receptor gene on obesity anthropometric parameters, cardiovascular risk factors and adipocytokines in patients with obesity and diabetes mellitus type 2. Design: A population of 60 naïve diabetic patients was analyzed. An indirect calorimetry, tetrapolar electrical bioimpedance, blood pressure, a serial assessment of nutritional intake with 3 days written food records and biochemical analysis (lipid profile, adipocytokines, insulin, CRP and lipoprotein-a) were performed. The statistical analysis was performed for the combined G1359A and A1359A as a group and wild type G1359G as second group, with a dominant model. Results: The mean age was 57.44 ± 11.7 years and the mean BMI 37.84 ± 6.4, with 14 males and 46 females. Thirty-five patients (58.3%) had genotype G1359G (wild type group) and 25 (42.7%) patients G1359A (mutant type group). Age was similar in both groups (wild type: 56.3 ± 11.8 years vs mutant group: 58.7 ± 10 years:ns). Sex distribution was similar in both groups (wild vs mutant type groups), males (22.9% vs 24%) and females (77.1% vs 76%). No differences were detected between groups in anthropometric parameters, cardiovascular risk factors, dietary intake and adipocytokines levels. Conclusion: The finding of this study is the lack of association of G1359A polymorphism of CB receptor 1 gene with obesity, cardiovascular risk factors and adipocytokines.
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Effect of etoricoxib, a cyclooxygenase-2 selective inhibitor on aberrant crypt formation and apoptosis in 1,2 dimethyl hydrazine induced colon carcinogenesis in rat model

  • Sharma,P.
  • Kaur,J.
  • Sanyal,S. N.
Etoricoxib, a second generation selective cyclooxygenase-2 (COX-2) inhibitor had been studied for the chemopreventive response at its therapeutic anti-inflammatory dose in 1,2-dimethylhydrazine (DMH) induced colon carcinogenesis in rat model. Eight to ten weeks old male rats of Sprague-Dawley strain were divided into four groups. While group 1 served as control and received the vehicle of the drugs, group 2 and 3 were administered freshly prepared DMH in 1mM EDTA-saline (pH 7.0) (30 mg/kg body wt/week, subcutaneously). Group 3 was also given a daily treatment of etoricoxib (0.6 mg/kg body wt orally) while the group 4 received the same amount of etoricoxib only, prepared in 0.5% carboxymethyl cellulose. Animals were sacrificed at the end of 6 weeks, body weight recorded and the colons were subjected to macroscopic and histopathological studies. The maximum number of raised mucosal lesions called the multiple plaque lesions (MPL) were found in the DMH group which significantly reverted back in the DMH + etoricoxib group, while very few MPLs were recorded in the control and etoricoxib only group. Similarly, the number of aberrant crypt foci (ACF), the point of future carcinogenic growth, was recorded more in the DMH group and significantly less in the DMH + etoricoxib group. The histopathological analysis showed the presence of severe hyperplasia, occasional dysplasia and aggregates of lymphoid cells in the localized regions. Etoricoxib group showed near normal histological features with the crypt architecture and the surrounding stromal tissue remaining intact. To ascertain the molecular mechanism of such anti-carcinogenic features the colonocytes were isolated and studied in primary culture for the evidence of apoptosis by fluorescent staining and genotoxic changes by single cell gel electrophoresis assay (comet assay) which shows that the DMH treated animals produced much less apoptotic nuclei but more comet producing cell, while these features were reverted back with the etoricoxib treatment. The cytoplasmic expression of COX-2 protein was studied in paraffin sections of the colon by immunohistochemistry with COX-2 specific antibody which showed a very high presence of this inducible enzyme with the DMH group while in all other groups of animals it was not visible or weekly expressed. The anti-inflammatory effect of the drug, etoricoxib was also validated by a carrageenan-induced inflammation in rat model which showed an extremely high anti-inflammatory response within the dose range used in the present study. Also the growth profile of all the animals remained the same throughout the six week period of the investigation as there was no change in the body weight. It appears that apoptosis remains the dominant anti-proliferative end effect of this drug, mediated by an inhibition of the proinflammatory COX-2 isoform although further molecular probings are needed to arrive at a conclusive agreement in favor of the chemoprotective use of such drugs in colon cancers.
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Parenteral nutrition supplemented with glutamine in patients undergoing bone marrow transplantation

  • Alonso Pérez,L.
  • Fernández Vázquez,A.
  • Valero Zanuy,M.ª A.
  • Gomis Muñoz,P.
  • León Sanz,M.
  • Herreros de Tejada,A.
The objective of the study is to evaluate if the administration of glutamine in parenteral nutrition (PN) solution reduces the need for antibiotics, the risk of liver disease and the duration of hospital stay in bone marrow transplantation. Material and methods: Retrospective observational study in 68 adult patients undergoing a bone marrow transplantation who required PN for mucositis. Of these patients, 40 were given PN with 2,063 ± 294 kcal/day and 98.6 ± 13.9 g of amino acids/day, supplemented with Lglutamine (13.5-27 g/day), and 28 were given isocaloric (1,966 ± 307 kcal/day) and isonitrogenated (92 ± 16.3 g of amino acids/day) PN with standard glutamine-free amino acid solution. Antibiotic consumption and duration of hospital stay were analysed. Of the total cohort, hepatic profile was studied at the beginning and on day 7 of PN in 50 patients without liver disease at the start of PN. Results: There were no differences between both groups with regard to total number and duration of antibiotics prescribed or hospital stay. Of the 50 patients without hepatic alterations at the beginning of PN, 2 patients in the control group and 5 in the glutamine group developed a hepatic profile compatible with liver disease secondary to PN. Comparing both groups, there were no differences in hepatic enzyme values. Conclusions: Supplementation with PN glutamine does not improve the variables studied, but the actual clinical use of glutamine in this haematological treatment should be studied further and its potential advantages identified.
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