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Esmeyer E.M.,Radboud University Nijmegen | Magallon-Botaya R.,Aragon Health science Institute IACS | Lagro-Janssen A.L.M.,Radboud University Nijmegen
Journal of Immigrant and Minority Health

Knowledge of depression among immigrants within Spanish primary care is limited. This database study investigates the incidence of depressive disorders among immigrants and natives within primary care in Aragón (Spain). Participants were patients registered in an electronic record register, aged above 20 years diagnosed with depression. Incidence of depression was calculated and compared per continent of origin, gender and age with the Mann-Whitney U test and the Kruskal–Wallis test. The population consisted of 11,088 patients with depression of whom 93.0 % natives and 7.0 % immigrants. Incidence of depression amongst male immigrants was lower than amongst male natives (OR 0.80). Eastern European males showed the lowest incidence 4.1 (3.5–5.3). The gender difference in incidence was larger in immigrants than in natives (OR 3.4 vs. 2.7). Due to male immigrants the incidence of depression within primary care is lower among immigrants. Equal care should be provided to patients of both genders and all origin. © 2016 The Author(s) Source

Escolano C.,Aragon Institute of Engineering Research | Navarro-Gil M.,BitBrain Technologies S.L. | Garcia-Campayo J.,Aragon Health science Institute IACS | Congedo M.,CNRS GIPSA Laboratory | And 2 more authors.
Applied Psychophysiology Biofeedback

Standardized neurofeedback (NF) protocols have been extensively evaluated in attention-deficit/hyperactivity disorder (ADHD). However, such protocols do not account for the large EEG heterogeneity in ADHD. Thus, individualized approaches have been suggested to improve the clinical outcome. In this direction, an open-label pilot study was designed to evaluate a NF protocol of relative upper alpha power enhancement in fronto-central sites. Upper alpha band was individually determined using the alpha peak frequency as an anchor point. 20 ADHD children underwent 18 training sessions. Clinical and neurophysiological variables were measured pre- and post-training. EEG was recorded pre- and post-training, and pre- and post-training trials within each session, in both eyes closed resting state and eyes open task-related activity. A power EEG analysis assessed long-term and within-session effects, in the trained parameter and in all the sensors in the (1–30) Hz spectral range. Learning curves over sessions were assessed as well. Parents rated a clinical improvement in children regarding inattention and hyperactivity/impulsivity. Neurophysiological tests showed an improvement in working memory, concentration and impulsivity (decreased number of commission errors in a continuous performance test). Relative and absolute upper alpha power showed long-term enhancement in task-related activity, and a positive learning curve over sessions. The analysis of within-session effects showed a power decrease (“rebound” effect) in task-related activity, with no significant effects during training trials. We conclude that the enhancement of the individual upper alpha power is effective in improving several measures of clinical outcome and cognitive performance in ADHD. This is the first NF study evaluating such a protocol in ADHD. A controlled evaluation seems warranted due to the positive results obtained in the current study. © 2014, Springer Science+Business Media New York. Source

Escolano C.,Aragon Institute of Engineering Research | Navarro-Gil M.,BitBrain Technologies S.L. | Garcia-Campayo J.,Aragon Health science Institute IACS | Minguez J.,Aragon Institute of Engineering Research | Minguez J.,BitBrain Technologies S.L.
Applied Psychophysiology Biofeedback

The minimization of the non-specific factors of neurofeedback (NF) is an important aspect to further advance in the understanding of the effects of these types of procedures. This paper investigates the NF effects of a single session (25 min) of individual upper alpha enhancement following a sham-controlled experimental design (19 healthy participants). We measured immediate effects after the training and 1-day lasting EEG effects (eyes closed resting state and task-related activity), as well as the event-locked EEG effects during the execution of a mental rotation task. These metrics were computed in trained (upper alpha) and non-trained EEG parameters (lower alpha and lower beta). Several cognitive functions were assessed such as working memory and mental rotation abilities. The NF group showed increased upper alpha power after training in task-related activity (not significantly sustained 1 day after) and higher pre-stimulus power during the mental rotation task. Both groups improved cognitive performance, with a more prominent improvement for the NF group, however a single session seems to be insufficient to yield significant differences between groups. A higher number of training sessions seems necessary to achieve long-lasting effects on the electrophysiology and to enhance the behavioral effects. © 2014, Springer Science+Business Media New York. Source

Caralt M.,Autonomous University of Barcelona | Velasco E.,Gregorio Maranon University Hospital | Lanas A.,University of Zaragoza | Lanas A.,CIBER ISCIII | And 4 more authors.

Liver bioengineering has been a field of intense research and popular excitement in the past decades. It experiences great interest since the introduction of whole liver acellular scaffolds generated by perfusion decellularization1-3. Nevertheless, the different strategies developed so far have failed to generate hepatic tissue in vitro bioequivalent to native liver tissue. Even notable novel strategies that rely on iPSC-derived liver progenitor cells potential to self-organize in association with endothelial cells in hepatic organoids are lacking critical components of the native tissue (e.g., bile ducts, functional vascular network, hepatic microarchitecture, etc)4. Hence, it is vital to understand the strengths and short comes of our current strategies in this quest to re-create liver organogenesis in vitro. To shed some light into these issues, this review describes the different actors that play crucial roles in liver organogenesis and highlights the steps still missing to successfully generate whole livers and hepatic organoids in vitro for multiple applications. © 2014 Landes Bioscience. Source

Calderon-Larranaga A.,University of Zaragoza | Poblador-Plou B.,University of Zaragoza | Gonzalez-Rubio F.,Aragon Health science Institute IACS | Gimeno-Feliu L.A.,University of Zaragoza | And 2 more authors.
British Journal of General Practice

Background: The consequences of multimorbidity include polypharmacy and repeated referrals for specialised care, which may increase the risk of adverse drug events (ADEs). Aim: The objective of this study was to analyse the influence of multimorbidity, polypharmacy, and multiple referrals on the frequency of ADEs, as an indicator of therapeutic safety, in the context of a national healthcare system. Design and setting: This was a multicentre, retrospective, observational study of 79 089 adult patients treated during 2008 in primary care centres. Method: The explanatory patient variables sex, age, level of multimorbidity, polypharmacy, number of primary care physician visits, and number of different specialties attended were analysed. The response variable was the occurrence of ADEs. Logistic regression models were used to identify associations among the analysed variables. Results: The prevalence of individuals with at least one ADE was 0.88%. Multivariate analysis identified the following variables as risk factors for the occurrence of ADE in descending order of effect size: multimorbidity level (odds ratio [OR] Veryhigh/Low = 45.26; ORHigh/Low = 17.58; ORModerate/Low = 4.25), polypharmacy (OR = 1.34), female sex (OR = 1.31), number of different specialties (OR = 1.20), and number of primary care physician visits (OR = 1.01). Age, however, did not show statistical significance (OR = 1.00; 95% confidence interval = 0.996 to 1.005). Conclusion: The results of this study demonstrate that multimorbidity is strongly related to the occurrence of ADEs, insofar as it requires the intervention of multiple specialties and the prescription of multiple medications. Further research should shed light on the causal pathway between multimorbidity and increased risk of adverse events. ©British Journal of General Practice. Source

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