02.03.01. Investigación y comunicación científica

Hablan las madres. La parte menos contada del aborto voluntario

2017-01-01T00:00:00Z

Hablan las madres. La parte menos contada del aborto voluntario Hernández-Garre, José-Manuel; Aznar-Mula, Isabel-María; Echevarría-Pérez, Paloma The aim of the study was to investigate the experiences linked to the post-abortion syndrome in mothers who have had a voluntary abortion. A phenomenological qualitative approach to collect the experiences of mothers who had voluntarily interrupted their pregnancy was used. The research technique was the semistructured interviews with women who had contacted different association's help of the Murcia region for support after experiencing symptoms consistent with post-abortion syndrome. The testimonies show feminist or utilitarian arguments to justify the decision to abort, they talk about a system, to some extent, mercantilist that has no real intention of giving real life choices. Experience shows that far from lived as an act of female freedom is experienced traumatically, developed symptoms following the sense of loss. In this context, the resource spiritual becomes the best tool to expiate guilt. The experience of abortion does not improve the lives of women; far from it is a trauma that can be avoided with proper advice to avoid the tragedy of abortion.

Utilidad de la escala de depresión de Beck para el diagnóstico de los trastornos depresivos en la esclerosis múltiple

2024-01-01T00:00:00Z

Utilidad de la escala de depresión de Beck para el diagnóstico de los trastornos depresivos en la esclerosis múltiple Aparicio-Castro, Eladio; Candeliere-Merlicco, Antonio; Santa-Yagüe, Carmen-María; Villaverde-González, Ramón INTRODUCTION: Depression is one of the most prevalent psychiatric conditions in adulthood, reaching figures of around 20%. The methodologies used to study depression are varied, and range from a self-administered test to structured psychiatric assessment. Several studies of patients with multiple sclerosis (MS) have been conducted in the last 20 years, and figures of around 35% have been found for depressive symptoms, while depressive disorders are less frequent, at approximately 21%. AIMS: The aim of this study is to evaluate the usefulness of patient self-reported scales such as the Beck depression inventory (BDI) for identifying depressive symptoms in patients with MS, and to analyse their correlation with the diagnosis of clinical depression or depressive disorder using the psychiatric clinical interview based on the criteria of the Diagnostic and statistical manual of mental disorders, fifth edition. PATIENTS AND METHODS: This is a multicentre descriptive cross-sectional study of patients with MS and depressive symptoms. The BDI and the Hamilton depression rating scale (HDRS) were used, and the patients with the highest scores underwent psychiatric assessment. RESULTS: A total of 191 patients were included; 81 of these (40.5%) had depressive symptomatology in the pathological range according to the BDI (cut-off point of 14), and 20 had a severe score (above 28). Nineteen patients with severe depressive symptoms according to both scales were selected and finally evaluated by a psychiatrist, who also assessed five patients who according to the neurologist had severe depressive symptoms despite a BDI score of almost 28, but did not reach that level. The suspected major depressive disorder was confirmed in only four (21%) cases with BDI scores indicative of severe symptoms. There is no correlation between the severity score as evidenced by the BDI and the psychiatric assessment. A major depressive disorder was diagnosed in 16 (66.6%) of the 24 patients with BDI > 26 evaluated by psychiatry. A score above 26 on the BDI enables identification of 75% of cases of depressive disorder without subtyping. The correlation between the HDRS and the BDI was statistically significant (r = 0.8; p < 0). CONCLUSIONS: The BDI is a useful screening test for identifying patients with depressive symptoms; in specific terms, a score above 26 is probably indicative of a depressive disorder that may benefit from psychiatric assessment.

Dimethyl fumarate induced Wells syndrome. A case report

2023-01-01T00:00:00Z

Dimethyl fumarate induced Wells syndrome. A case report Candeliere-Merlicco, Antonio; Villaverde-González, Ramón; Hidalgo-Pérez, Paloma-Victoria; Escobar-Arias, Fabio-Hugo; Aparicio-Castro, Eladio; Lastres-Arias, María-del-Carmen INTRODUCTION: Wells syndrome, also known as eosinophilic cellulitis, is a rare dermatosis with approximately 200 cases previously described in the literature. Here, we present a case of a patient with multiple sclerosis with Wells syndrome induced by dimethyl fumarate (DMF). CASE REPORT: A 41-year-old Caucasian woman was treated with DMF in July 2021. One week later, she experienced itching on her upper and lower right arm, followed by the appearance of erythematous plaques covered with vesicles. The complete blood count showed an increased eosinophil count of up to 2,000 µL. The histological images demonstrated dermal eosinophil infiltration concordant with Wells syndrome. The clinical course was benign, with complete resolution of the lesions and normalization of the eosinophil count within four weeks. Administration of corticosteroids was not necessary. CONCLUSIONS: Eosinophilia is rare in patients with multiple sclerosis treated with DMF and usually does not require dosage adjustments. Although clinical manifestations of eosinophilia in these patients are very rare, it is important for practitioners to recognize the symptoms. Many neuroleptic drugs can induce eosinophilia and systemic symptoms; therefore, physicians must be aware of the risks associated with DMF and neuroleptic drugs, particularly for quetiapine, which contains fumarate.

Outpatient Parenteral Antibiotic Treatment vs Hospitalization for Infective Endocarditis: Validation of the OPAT-GAMES Criteria

2022-09-02T00:00:00Z

Outpatient Parenteral Antibiotic Treatment vs Hospitalization for Infective Endocarditis: Validation of the OPAT-GAMES Criteria Pericàs, Juan-M; Llopis-Pérez, Jaume; Muñoz, Patricia; González-Ramallo, Víctor; García-Leoni, María-Eugenia; de-Alarcón, Arístides; Luque, Rafael; Fariñas, María-Carmen; Goenaga, Miguel-Ángel; Hernández-Meneses, Marta; Nicolás, David; Ramos-Martínez, Antonio; Rodríguez-Esteban, M-Ángeles; Villoslada-Gelabert, Aroa; Miró, José-M; Fernández-Sánchez, Fernando; Noureddine, Mariam; Rosas, Gabriel; de-la-Torre-Lima, Javier; Bereciartua, Elena; Blanco, Roberto; Victoria-Boado, María; Campaña-Lázaro, Marta; Crespo, Alejandro; Guio-Carrión, Laura; del-Álamo-Martínez-de-Lagos, Mikel; Euba-Ugarte, Gorane; Goikoetxea, Josune; Ibarrola-Hierro, Marta; Iruretagoyena, José-Ramón; Irurzun-Zuazabal, Josu; López-Soria, Leire; Montejo, Miguel; Nieto, Javier; Rodrigo, David; Rodríguez, Regino; Vitoria, Yolanda; Voces, Roberto; García-López, María-Victoria; Georgieva, Radka-Ivanova; Ojeda, Guillermo; Rodríguez-Bailón, Isabel; Ruiz-Morales, Josefa; Azkune-Galparsoro, Harkaitz; Berritu-Boronat, Elisa; Bustinduy-Odriozola, María-Jesús; del-Bosque-Martín, Cristina; Echeverría, Tomás; Eizaguirre-Yarza, Alberto; Fuentes, Ana; Goyeneche-del-Río, Muskilda; Granda-Bauza, Ángela; Iribarren, José-Antonio; Kortajarena-Urkola, Xabier; Pérez-Moreiras-López, José-Ignacio; Rengel-Jiménez, Ainhoa; Reviejo, Karlos; Sáez-Berbejillo, Alberto; Sánchez-Haza, Elou; Sebastián-Alda, Rosa; Solla-Ruiz, Itziar; Unamuno-Ugartemendia, Irati; Vicente-Anza, Diego; Villanueva-Benito, Iñaki; Zabalo-Arrieta, Mar; Carrasco, Rafael; Climent, Vicente; Llamas, Patricio; Merino, Esperanza; Plazas, Joaquín; Reus, Sergio; Álvarez, Nemesio; Bravo-Ferrer, José-María; Castelo, Laura; Cuenca, José; Llinares, Pedro; Miguez-Rey, Enrique; Rodríguez-Mayo, María; Sánchez, Efrén; Sousa-Regueiro, Dolores; Martínez, Francisco-Javier; del-Mar-Alonso, Ma; Castro, Beatriz; Delgado-Melian, Teresa; Fernández-Sarabia, Javier; García-Rosado, Dacil; González-González, Julia; Lacalzada, Juan; Lorenzo-de-la-Peña, Lissete; Pérez-Ramírez, Alina; Prada-Arrondo, Pablo; Rodríguez-Moreno, Fermín; Plata-Ciezar, Antonio; Reguera-Iglesias, José-Ma; Álvarez, Víctor-Asensi; Costas, Carlos; de-la-Hera, Jesús; Fernández-Suárez, Jonnathan; Iglesias-Fraile, Lisardo; León-Arguero, Víctor; López-Menéndez, José; Bajo, Pilar-Mencia; Morales, Carlos; Moreno-Torrico, Alfonso; Palomo, Carmen; Payá-Martínez, Begoña; Rodríguez-García, Raquel; Telenti-Asensio, Mauricio; Almela, Manuel; Ambrosioni, Juan; Azqueta, Manel; Brunet, Mercè; Bodro, Marta; Cartañá, Ramón; Cuervo, Guillermo; Falces, Carlos; Fita, Guillermina; Fuster, David; García-de-la-María, Cristina; García-Pares, Delia; Marco, Francesc; Moreno, Asunción; Ninot, Salvador; Quintana, Eduardo; Paré, Carlos; Pereda, Daniel; Pomar, José-L; Ramírez, José; Rovira, Irene; Sandoval, Elena; Sitges, Marta; Soy, Dolors; Téllez, Adrián; Tolosana, José-M; Vidal, Bárbara; Vila, Jordi; Adán, Iván; Alonso, Juan-Carlos; Álvarez-Uría, Ana; Bermejo, Javier; Bouza, Emilio; Cuerpo-Caballero, Gregorio; Delgado-Montero, Antonia; González-Mansilla, Ana; Gargallo, Esther; Kestler-Hernández, Martha; Hualde, Amaia-Mari; Machado, Marina; Marín, Mercedes; Martínez-Sellés, Manuel; Olmedo, María; Pedraz, Álvaro; Pinilla, Blanca; Pinto, Ángel; Rincón, Cristina; Rodríguez-Abella, Hugo; Rodríguez-Créixems, Marta; Segado, Antonio; Toledo, Neera; Valerio, Maricela; Vázquez, Pilar; Verde-Moreno, Eduardo; Antorrena, Isabel; Loeches, Belén; Moreno, Mar; Ramírez, Ulises; Rial-Baston, Verónica; Romero, María; Rosillo, Sandra; Agüero-Balbin, Jesús; Amado, Cristina; Armiñanzas-Castillo, Carlos; Arnaiz, Ana; Arnaiz-de-las-Revillas, Francisco; Cobo-Belaustegui, Manuel; Fariñas-Álvarez, Concepción; Fernández-Sampedro, Marta; García, Iván; González-Rico, Claudia; Gutierrez-Fernández, Laura; Gutiérrez-Cuadra, Manuel; Gutiérrez-Díez, José; Pajarón, Marcos; Parra, José-Antonio; Teira, Ramón; Zarauza, Jesús; Calderón-Parra, Jorge; Cobo, Marta; Domínguez, Fernando; Fortaleza, Alberto; García-Pavia, Pablo; González, Jesús; Fernández-Cruz, Ana; Múñez, Elena; Sánchez-Romero, Isabel; Centella, Tomasa; Hermida, José-Manuel; Moya, José-Luis; Martín-Dávila, Pilar; Navas, Enrique; Oliva, Enrique; del-Río, Alejandro; Rodríguez-Roda-Stuart, Jorge; Ruiz, Soledad; Hidalgo-Tenorio, Carmen; Almendro-Delia, Manuel; Araji, Omar; Barquero, José-Miguel; Calvo-Jambrina, Román; de-Cueto, Marina; Gálvez-Acebal, Juan; Méndez, Irene; Morales, Isabel; López-Cortés, Luis-Eduardo; García, Emilio; Haro, Juan-Luis; Lepe, José-Antonio; López, Francisco; Alonso, Luis-Javier; Azcárate, Pedro; Azcona-Gutiérrez, José-Manuel; Blanco, José-Ramón; Cabrera-Villegas, Antonio; García-Álvarez, Lara; García-García, Concepción; Oteo, José-Antonio; de-Benito, Natividad; Gurguí, Mercè; Pacho, Cristina; Pericas, Roser; Pons, Guillem; Álvarez, M; Fernández, AL; Martínez, Amparo; Prieto, A; Regueiro, Benito; Tijeira, E; Vega, Marino; Canut-Blasco, Andrés; Mollar, José-Cordo; Gainzarain-Arana, Juan-Carlos; García-Uriarte, Óscar; Marín-López, Alejandro; Ortiz-de-Zárate, Zuriñe; Urturi-Matos, José-Antonio; Sánchez-Porto, Antonio; Úbeda-Iglesias, Alejandro; Arribas-Leal, José-María; García-Vázquez, Elisa; Hernández-Torres, Alicia; Blázquez, Ana; de-la-Morena-Valenzuela, Gonzalo; Alonso, Ángel; Aramburu, Javier; Calvo, Felicitas-Elena; Moreno-Rodríguez, Anai; Tarabini-Castellani, Paola; Heredero-Gálvez, Eva; Maicas-Bellido, Carolina; Largo-Pau, José; Sepúlveda, María-Antonia; Toledano-Sierra, Pilar; Iqbal-Mirza, Sadaf-Zafar; Cascales-Alcolea, Eva; Keituqwa-Yañez, Iván; Navarro-Martínez, Julián; Peláez-Ballesta, Ana; Moreno-Escobar, Eduardo; Peña-Monje, Alejandro; Sánchez-Cabrera, Valme; Vinuesa-García, David; Arrizabalaga-Asenjo, María; Cifuentes-Luna, Carmen; Núñez-Morcillo, Juana; Pérez-Seco, María-Cruz; Aured-Guallar, Carmen; Fernández-Abad, Nuria; García-Mangas, Pilar; Matamala-Adell, Marta; Palacián-Ruiz, María-Pilar; Porres, Juan-Carlos; Alcaraz-Vidal, Begoña; Cobos-Trigueros, Nazaret; del-Amor-Espín, María-Jesús; Giner-Caro, José-Antonio; Jiménez-Sánchez, Roberto; Almazán, Amaya-Jimeno; Ortín-Freire, Alejandro; Viqueira-González, Monserrat; Pericás-Ramis, pere; Ribas-Blanco, María-Ángels; Ruiz-de-Gopegui-Bordes, Enrique; Vidal-Bonet, Laura; Bellón-Munera, María-Carmen; Escribano-Garaizabal, Elena; Tercero-Martínez, Antonia; Segura-Luque, Juan-Carlos; Badía, Cristina; Boix-Palop, Lucía; Xercavins, Mariona; Ibars, Sónia; Bosch, Xerach; Gómez-Nebreda, Eloy; Horcajada-Herrera, Ibalia; Menduiña-Gallego, Irene; Pulido, Imanol; Marrero-Santiago, Héctor; de-Miguel-Martínez, Isabel; Pisos-Álamo, Elena; Aguilar-Blanco, Eva-María; Catalán-González, Mercedes; Corres-Peiretti, María-Angélica; Eixerés-Esteve, Andrea; Domínguez-Pérez, Laura; de-Cossío-Tejido, Santiago; Galván-Román, Francisco; García-Robles, José-Antonio; López-Medrano, Francisco; López-Gude, María-Jesús; Orellana-Miguel, María-Ángeles; Pilkington, Patrick; Revilla-Ostalaza, Yolanda; Ruiz-Morales, Juan; Ruiz-Solis, Sebastián; Sabín-Collado, Ana; Sánchez-Fernández, Marcos; Solera-Rallo, Javier; Solís-Martín, Jorge; Escrihuela-Vidal, Francesc; Carratalà, Jordi; Grau, Inmaculada; Grillo, Sara; Ardanuy, Carmen; Berbel, Dámaris; Sánchez-Salado, José-Carlos; Alegre, Oriol; Ruiz-Majoral, Alejandro; Sbraga, Fabrizio; Blasco, Arnau; Gracia-Sánchez, Laura; Sánchez-Rodríguez, Iván; Álvarez, Beatriz; Cabello-Úbeda, Alfonso; Fernández-Roblas, Ricardo; Navas-Lobato, Miguel-Ángel; Pello, Ana-María; de-la-Peña-Triguero, Mireia; Figueroa-Cerón, Ruth-Esther; Ruiz-Gómez, Lara; Ble, Mireia; Horcajada-Gallego, Juan-Pablo; Ginel, Antonio-José; López, Inmaculada; Mas, Alexandra; Mestres, Antoni; Molina, Lluís; Serrat, Ramón; Ribas, Núria; Sánchez, Francisca; Silverio, Ana; Suárez, Marina; Sorlí, Luisa; Recasens, Lluís; Taurón, Manuel BACKGROUND: Outpatient parenteral antibiotic treatment (OPAT) programs are increasingly used to manage infective endocarditis (IE), but current criteria for indicating OPAT are markedly conservative. We aimed to investigate whether more liberal criteria for indicating OPAT in IE can be safely used. METHODS: This was a prospective multicenter nationwide cohort study (2008-2018). Rates of readmission, recurrences, and 1-year mortality were compared between hospital-based antibiotic treatment (HBAT) and OPAT. Risk factors for readmission and mortality in OPAT patients were investigated by logistic regression. Patients did not fulfill OPAT-GAMES (Grupos de Apoyo al Manejo de la Endocarditis en ESpaña) criteria if they had any of the following: cirrhosis, severe central nervous system emboli, undrained abscesses, severe conditions requiring cardiac surgery in nonoperable patients, severe postsurgical complications, highly difficult-to-treat microorganisms, or intravenous drug use. RESULTS: A total of 2279 HBAT patients and 1268 OPAT patients were included. Among OPAT patients, 307 (24.2%) did not fulfill OPAT-GAMES criteria. Overall, OPAT patients presented higher rates of readmission than HBAT patients (18.2% vs 14.4%; P = .004), but no significant differences were found in the propensity analysis. Patients not fulfilling OPAT-GAMES criteria presented significantly higher rates of readmission than HBAT and OPAT-GAMES (23.8%, 14.4%, 16.4%; P < .001), whereas no significant differences were found in mortality (5.9%, 8%, 7.4%; P = .103) or recurrences (3.9%, 3.1%, 2.5%; P = .546). Not fulfilling OPAT-GAMES criteria was associated with higher risk of readmission (odds ratio [OR], 1.43; 95% CI, 1.03-1.97; P = .03), whereas cardiac surgery was associated with lower risk (OR, 0.72; 95% CI, 0.53-0.98; P = .03). CONCLUSIONS: OPAT-GAMES criteria allow identification of IE patients at higher risk of long-term complications to whom OPAT cannot be safely administered.