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Gutierrez-Garcia A.,Complejo Asistencial Universitario Of Burgos | Fernandez-Martin A.,University of La Laguna
Ansiedad y Estres | Year: 2012

In this article we review the studies investigating the effects of anxiety on interpretive bias, i.e., the proneness to generate, prioritize or select a threatening interpretation over a neutral interpretation of an ambiguous stimulus. The article is organized in three sections: Conceptualization, Research, and Application. First, we motivate theoretically the relationship between anxiety and interpretive bias, with particular emphasis on the functional role of such a bias in the alarm mechanism of the defensive system. Second, we examine the existing experimental evidence on the issue under investigation in several specific areas. And, third, we address the possibility that the experimental findings on anxiety and interpretive bias can be applied to therapeutical treatments aimed to control and reduce vulnerability to anxiety.

Molina J.,University of Seville | Penuela I.,University of Seville | Penuela I.,Complejo Asistencial Universitario Of Burgos | Lepe J.A.,University of Seville | And 6 more authors.
Journal of Infection | Year: 2013

Objectives: To describe the morbidity and mortality related to coagulase-negative Staphylococci (CNS) bacteremia in non-critical patients. Methods: Prospective, matched case-control study nested in a cohort. Patients with CNS bacteremia and no other isolate in blood cultures during their admission were defined as cases. Each case was matched by age, sex and area of hospitalization to one control. A 30-day follow-up was performed. Mortality and hospital stay were defined as endpoints. Results: 105 cases and 105 controls were included. All cases carried intravascular catheters at the time of inclusion. Cases presented higher mortality compared to controls (14.3% vs. 4.8%), although this association was not independent in a multivariate analysis (p = 0.11). CNS bacteremia was independently associated with longer hospital stay (mean 12 vs. 8.5 days, p = 0.008). Moreover, when patients with CNS bacteremia were specifically analyzed, the persistence of fever (p = 0.005) and inappropriate empirical treatment (p = 0.04) were independently related to mortality. Conclusion: We did not observe increased mortality attributable to CNS bacteremia, although it was associated with longer hospitalizations. Early appropriate empirical antibiotic therapy pending blood culture results might improve the outcome of patients with CNS bacteremia. Close follow-up is recommended if fever persists beyond 72 h. © 2012 The British Infection Association.

Lastra-Aras E.,Complejo Asistencial Universitario Of Burgos | Robles-Diaz L.,Hospital Universitario Doce Of Octubre | Guillen-Ponce C.,Hospital Universitario Ramon y Cajal | Alba E.,Hospital Clinico Universitario Virgen Of La Victoria | Cruz J.-J.,Hospital Universitario Of Salamanca
Clinical and Translational Oncology | Year: 2013

Introduction: Approximately 5 % of all cancer cases are hereditary. Cancer genetic counseling assesses individual and family risks of cancer, conducts genetic studies, interprets results, and advises patients regarding strategies for prevention and risk reduction. Currently, many networks of hereditary cancer genetic counseling units (HCGCUs) are integrated in the medical oncology services of most Spanish hospitals, which are comprised of multidisciplinary teams and offer high-quality care for the treatment of hereditary cancer. Materials and methods: The Spanish Society of Medical Oncology (SEOM) analyzed key issues involving the integration of HCGCUs into the National Health Service. These included basic compliance issues by these units regarding their operation and organization, as well as prerequisites in quality control thereof. Results: This document describes the specific roles and clinical processes performed in HCGCUs in addition to basic services provided by molecular diagnostic laboratories. It also provides a summary on the coordination of care across different levels for patients and families with hereditary cancers. Finally, this document describes the human and material resources needed for the organization of HCGCUs. Conclusions: SEOM has been a pioneer in the creation and development of HCGCUs. This paper seeks to ensure high-quality care to individuals and families with inherited susceptibility to cancer in Spain. © 2012 Federación de Sociedades Españolas de Oncología (FESEO).

Ferrero-Arias J.,Clinica La Milagrosa | Goni-Imizcoz M.,Complejo Asistencial Universitario Of Burgos | Gonzalez-Bernal J.,University of Burgos | Lara-Ortega F.,University of Burgos | And 2 more authors.
Alzheimer Disease and Associated Disorders | Year: 2011

Objective: To determine the usefulness of a formal, structured, nonpharmacological treatment for apathetic dementia patients. PATIENTS AND Methods: A controlled, cross-over, randomized, simple-blind, multicentre clinical trial. A total of 146 institutionalized or day care dementia patients with a stage 1 or 2 Clinical Dementia Rating, with no significant motor or sensory problems, or with rapidly evolving dementia and in a clinically stable state were recruited. A cognitive mini examination, and functional, depression, and potential toxicity scales, Neuropsychiatric Inventory Questionnaire (NPI-Q), and Dementia Apathy Interview and Rating (DAIR) scales were applied at baseline. Patients were randomized to initial intervention (music and art therapy and psychomotor activity) or initial control (free activities in the day room) and changed over at 4 weeks. NPI-Q and DAIR scales were administered at the end of weeks 4 and 8. Results: A significant difference between intervention and control periods, as measured using the DAIR scale, was observed, with a difference of 0.21 (95% confidence interval: 0.07-0.34, P<0.005). The difference was very important in the patients with moderated apathy. However, differences were not so important in the patients with severe apathy and there were no differences at all in the non-apathetic patients. No significant differences were found with the NPI-Q scale, although there was a clear improvement trend in the "apathy" question on this scale. This effect seems to extend beyond the therapeutic intervention period. Conclusions: A structured, nonpharmacological, short-term occupational therapy intervention is more useful than activities of the patients' own choice for improving apathy in patients with mild or moderate dementia. Copyright © 2011 by Lippincott Williams & Wilkins.

Serrano M.,San Pedro Hospital | Bartulos M.,San Pedro Hospital | Bartulos M.,Complejo Asistencial Universitario Of Burgos | Matute B.,Los Manzanos Hospital
Neuroepidemiology | Year: 2013

Background: Hospital administrative data have been suggested as a valuable cost-effective tool for providing information about the stroke burden. Nevertheless, the choice of the diagnosis codes has been a critical issue in the development of case ascertainment algorithms. Methods: In this study, the Minimum Basic Data Set administrative database was used to analyze the accuracy of different ICD-9-CM algorithms based on the neurologist's clinical judgement as the 'gold standard'. Results: The most accurate algorithm observed in our study involved the selection of ICD-9-CM codes 430-438 in the primary diagnosis. It yielded a sensitivity of 96.1%, a specificity of 87.5% and a positive predictive value of 82.5%. Conclusions: The Minimum Basic Data Set is a valuable source to evaluate stroke frequency when using an accurate algorithm to select events. © 2013 S. Karger AG, Basel.

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