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BACKGROUND: Developing effective vaccines against SARS-CoV-2 that consider manufacturing limitations, equitable access, and acceptance is necessary for developing platforms to produce antigens that can be efficiently presented for generating neutralizing antibodies and as a model for new vaccines. RESULTS: This work presents the development of an applicable technology through the oral administration of the SARS-CoV-2 RBD antigen fused with a peptide to improve its antigenic presentation. We focused on the development and production of the recombinant receptor binding domain (RBD) produced in E. coli modified with the addition of amino acids extension designed to improve antigen presentation. The production was carried out in shake flask and bioreactor cultures, obtaining around 200 mg/L of the antigen. The peptide-fused RBD and peptide-free RBD proteins were characterized and compared using SDS-PAGE gel, high-performance chromatography, and circular dichroism. The peptide-fused RBD was formulated in an oil-in-water emulsion for oral mice immunization. The peptide-fused RBD, compared to RBD, induced robust IgG production in mice, capable of recognizing the recombinant RBD in Enzyme-linked immunosorbent assays. In addition, the peptide-fused RBD generated neutralizing antibodies in the sera of the dosed mice. The formulation showed no reactive episodes and no changes in temperature or vomiting. CONCLUSIONS: Our study demonstrated the effectiveness of the designed peptide added to the RBD to improve antigen immunostimulation by oral administration.
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COVID-19 , SARS-CoV-2 , Animales , Humanos , Ratones , Adyuvantes Inmunológicos , Vacunas contra la COVID-19 , Escherichia coli , Administración Oral , Antígenos Virales , Anticuerpos Neutralizantes , Péptidos , Anticuerpos AntiviralesRESUMEN
Several artificial intelligence algorithms have been developed for COVID-19-related topics. One that has been common is the COVID-19 diagnosis using chest X-rays, where the eagerness to obtain early results has triggered the construction of a series of datasets where bias management has not been thorough from the point of view of patient information, capture conditions, class imbalance, and careless mixtures of multiple datasets. This paper analyses 19 datasets of COVID-19 chest X-ray images, identifying potential biases. Moreover, computational experiments were conducted using one of the most popular datasets in this domain, which obtains a 96.19% of classification accuracy on the complete dataset. Nevertheless, when evaluated with the ethical tool Aequitas, it fails on all the metrics. Ethical tools enhanced with some distribution and image quality considerations are the keys to developing or choosing a dataset with fewer bias issues. We aim to provide broad research on dataset problems, tools, and suggestions for future dataset developments and COVID-19 applications using chest X-ray images.
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Inteligencia Artificial , COVID-19 , Humanos , Prueba de COVID-19 , Rayos X , SesgoRESUMEN
The emergence of COVID-19 as a global pandemic forced researchers worldwide in various disciplines to investigate and propose efficient strategies and/or technologies to prevent COVID-19 from further spreading. One of the main challenges to be overcome is the fast and efficient detection of COVID-19 using deep learning approaches and medical images such as Chest Computed Tomography (CT) and Chest X-ray images. In order to contribute to this challenge, a new dataset was collected in collaboration with "S.E.S Hospital Universitario de Caldas" ( https://hospitaldecaldas.com/ ) from Colombia and organized following the Medical Imaging Data Structure (MIDS) format. The dataset contains 7,307 chest X-ray images divided into 3,077 and 4,230 COVID-19 positive and negative images. Images were subjected to a selection and anonymization process to allow the scientific community to use them freely. Finally, different convolutional neural networks were used to perform technical validation. This dataset contributes to the scientific community by tackling significant limitations regarding data quality and availability for the detection of COVID-19.
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COVID-19 , Humanos , COVID-19/diagnóstico por imagen , Rayos X , ColombiaRESUMEN
The rapid spread of COVID-19 on all continents and the mortality induced by SARS-CoV-2 virus, the cause of the pandemic coronavirus disease 2019 (COVID-19) has motivated an unprecedented effort for vaccine development. Inactivated viruses as well as vaccines focused on the partial or total sequence of the Spike protein using different novel platforms such us RNA, DNA, proteins, and non-replicating viral vectors have been developed. The high global need for vaccines, now and in the future, and the emergence of new variants of concern still requires development of accessible vaccines that can be adapted according to the most prevalent variants in the respective regions. Here, we describe the immunogenic properties of a group of theoretically predicted RBD peptides to be used as the first step towards the development of an effective, safe and low-cost epitope-focused vaccine. One of the tested peptides named P5, proved to be safe and immunogenic. Subcutaneous administration of the peptide, formulated with alumina, induced high levels of specific IgG antibodies in mice and hamsters, as well as an increase of IFN-γ expression by CD8+ T cells in C57 and BALB/c mice upon in vitro stimulation with P5. Neutralizing titers of anti-P5 antibodies, however, were disappointingly low, a deficiency that we will attempt to resolve by the inclusion of additional immunogenic epitopes to P5. The safety and immunogenicity data reported in this study support the use of this peptide as a starting point for the design of an epitope restricted vaccine.
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COVID-19 , Vacunas Virales , Cricetinae , Humanos , Ratones , Animales , SARS-CoV-2 , Epítopos , Glicoproteína de la Espiga del Coronavirus/genética , Vacunas contra la COVID-19 , COVID-19/prevención & control , Anticuerpos Antivirales , Inmunoglobulina G , Péptidos , ARN , Óxido de Aluminio , Anticuerpos NeutralizantesRESUMEN
The bioinformatic pipeline previously developed in our research laboratory is used to identify potential general and specific deregulated tumor genes and transcription factors related to the establishment and progression of tumoral diseases, now comparing lung cancer with other two types of cancer. Twenty microarray datasets were selected and analyzed separately to identify hub differentiated expressed genes and compared to identify all the deregulated genes and transcription factors in common between the three types of cancer and those unique to lung cancer. The winning DEGs analysis allowed to identify an important number of TFs deregulated in the majority of microarray datasets, which can become key biomarkers of general tumors and specific to lung cancer. A coexpression network was constructed for every dataset with all deregulated genes associated with lung cancer, according to DAVID's tool enrichment analysis, and transcription factors capable of regulating them, according to oPOSSUM´s tool. Several genes and transcription factors are coexpressed in the networks, suggesting that they could be related to the establishment or progression of the tumoral pathology in any tissue and specifically in the lung. The comparison of the coexpression networks of lung cancer and other types of cancer allowed the identification of common connectivity patterns with deregulated genes and transcription factors correlated to important tumoral processes and signaling pathways that have not been studied yet to experimentally validate their role in lung cancer. The Kaplan-Meier estimator determined the association of thirteen deregulated top winning transcription factors with the survival of lung cancer patients. The coregulatory analysis identified two top winning transcription factors networks related to the regulatory control of gene expression in lung and breast cancer. Our transcriptomic analysis suggests that cancer has an important coregulatory network of transcription factors related to the acquisition of the hallmarks of cancer. Moreover, lung cancer has a group of genes and transcription factors unique to pulmonary tissue that are coexpressed during tumorigenesis and must be studied experimentally to fully understand their role in the pathogenesis within its very complex transcriptomic scenario. Therefore, the downstream bioinformatic analysis developed was able to identify a coregulatory metafirm of cancer in general and specific to lung cancer taking into account the great heterogeneity of the tumoral process at cellular and population levels.
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COVID-19 global pandemic affects health care and lifestyle worldwide, and its early detection is critical to control cases' spreading and mortality. The actual leader diagnosis test is the Reverse transcription Polymerase chain reaction (RT-PCR), result times and cost of these tests are high, so other fast and accessible diagnostic tools are needed. Inspired by recent research that correlates the presence of COVID-19 to findings in Chest X-ray images, this papers' approach uses existing deep learning models (VGG19 and U-Net) to process these images and classify them as positive or negative for COVID-19. The proposed system involves a preprocessing stage with lung segmentation, removing the surroundings which does not offer relevant information for the task and may produce biased results; after this initial stage comes the classification model trained under the transfer learning scheme; and finally, results analysis and interpretation via heat maps visualization. The best models achieved a detection accuracy of COVID-19 around 97%.
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In recent years, the traditional approach to spatial image steganalysis has shifted to deep learning (DL) techniques, which have improved the detection accuracy while combining feature extraction and classification in a single model, usually a convolutional neural network (CNN). The main contribution from researchers in this area is new architectures that further improve detection accuracy. Nevertheless, the preprocessing and partition of the database influence the overall performance of the CNN. This paper presents the results achieved by novel steganalysis networks (Xu-Net, Ye-Net, Yedroudj-Net, SR-Net, Zhu-Net, and GBRAS-Net) using different combinations of image and filter normalization ranges, various database splits, different activation functions for the preprocessing stage, as well as an analysis on the activation maps and how to report accuracy. These results demonstrate how sensible steganalysis systems are to changes in any stage of the process, and how important it is for researchers in this field to register and report their work thoroughly. We also propose a set of recommendations for the design of experiments in steganalysis with DL.
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In recent years, Deep Learning techniques applied to steganalysis have surpassed the traditional two-stage approach by unifying feature extraction and classification in a single model, the Convolutional Neural Network (CNN). Several CNN architectures have been proposed to solve this task, improving steganographic images' detection accuracy, but it is unclear which computational elements are relevant. Here we present a strategy to improve accuracy, convergence, and stability during training. The strategy involves a preprocessing stage with Spatial Rich Models filters, Spatial Dropout, Absolute Value layer, and Batch Normalization. Using the strategy improves the performance of three steganalysis CNNs and two image classification CNNs by enhancing the accuracy from 2% up to 10% while reducing the training time to less than 6 h and improving the networks' stability.
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INTRODUCTION: The 2015 National Mental Health Survey aimed to expand our knowledge about the real mental state of children in Colombia, taking into account the fact that most mental disorders in adults begin during childhood or adolescence. It is essential to have an improved knowledge of the magnitude of this issue and to design timely interventions that reduce long term complications. OBJECTIVE: The aim of the study was to determine the prevalence of the disorders in the last 12 months and 30 days according to the DSM-IV, as well as to collect data about social and demographic variables. METHODS: The structured Diagnostic Interview Schedule for Children (DISC-P), which provides DSM-IV diagnoses, was applied to carers of non-institutionalised children between 7 and 11 years old. The disorders evaluated included: major depressive disorder, dysthymia, generalised anxiety disorder, separation anxiety disorder, attention deficit hyperactivity disorder in its three kinds (mixed, inattentive, and hyperactive), oppositional defiant disorder, and conduct disorder. The instrumentation was computer-assisted. RESULTS: Prevalences of the disorders are present both in the last 30 days and in the last 12 months. In general, there is a prevalence of any of the disorders of 3% (95% CI, 2.2-4.0) in the last 30 days, and 4.7% (95% CI, 3.6-6.2) in the last 12 months. When evaluated individually, attention deficit hyperactivity disorder is the most frequent disorder, with a prevalence of 2.3% and 3.0% in the last 30 days and the last 12 months, respectively. In addition, the disorders that are known to frequently begin during childhood are the most common disorders in the age group studied, with a prevalence of 2.5% in the last 30 days and 3.2% in the last year. CONCLUSIONS: The 2015 National Mental Health Survey provides precise information about the real mental situation in children between the ages of 7 and 11 years in Colombia, compared with past epidemiological studies in the country, which were restricted to specific populations. By improving the reliability on knowledge about mental disorders in children, it will be possible to design more appropriate and precise strategies for prevention, diagnosis, and treatment.
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Trastornos Mentales/epidemiología , Trastornos del Neurodesarrollo/epidemiología , Niño , Colombia/epidemiología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Trastornos Mentales/fisiopatología , Trastornos del Neurodesarrollo/fisiopatología , Prevalencia , Reproducibilidad de los Resultados , Factores de TiempoRESUMEN
Resumen Introducción: La Encuesta Nacional de Salud Mental (ENSM) de 2015 busca profundizar en la realidad de la situación mental de los menores de edad de Colombia, teniendo en cuenta la carga de enfermedad que representan y que algunos trastornos mentales del adulto tienen su origen en la niñez o en la adolescencia, lo cual exige un mayor conocimiento del problema para diseñar intervenciones oportunas y disminuir las complicaciones a largo plazo. Objetivo: Determinar la prevalencia y los factores asociados de los trastornos en los últimos 30 días y los últimos 12 meses. Métodos: Se aplicó la entrevista estructurada Diagnostic Interview Schedule for Children (DISCP), que provee diagnósticos del DSM-IV a los cuidadores de niños no institucionalizados de 7-11 años. Se evaluaron los siguientes trastornos: depresión mayor, distimia, ansiedad generalizada, ansiedad de separación, déficit de atención e hiperactividad en sus tres presentaciones (mixto, inatento e hiperactivo), negativista desafiante y de conducta. El instrumento fue asistido por computador. Resultados: Se presentan las prevalencias de los trastornos tanto en los últimos 30 días como en los últimos 12 meses. En general se observa una prevalencia de cualquiera de los trastornos medidos del 3% (intervalo de confianza del 95% [IC95%], 2,2%-4,0%) en los últimos 30 días y del 4,7% (IC95%, 3,6%-6,2%) en los últimos 12 meses. Son más frecuentes en las mujeres. El trastorno por déficit de atención e hiperactividad es el más frecuente (el 2,3 y el 3,0%). Además, los trastornos de la conducta de inicio habitual en la infancia son los más frecuentes en este grupo etario, con prevalencias del 2,5% en los últimos 30 días y el 3,2% en el último año. Se presentan factores de riesgo asociados. Conclusiones: La ENSM de 2015 provee una información sobre la realidad de la situación mental de los niños de Colombia que permitirá diseños de 7-11 añar estrategias de prevención, diagnóstico y tratamiento más apropiados y precisos.
Abstract Introduction: The 2015 National Mental Health Survey aimed to expand our knowledge about the real mental state of children in Colombia, taking into account the fact that most mental disorders in adults begin during childhood or adolescence. It is essential to have an improved knowledge of the magnitude of this issue and to design timely interventions that reduce long term complications. Objective: The aim of the study was to determine the prevalence of the disorders in the last 12 months and 30 days according to the DSM-IV, as well as to collect data about social and demographic variables. Methods: The structured Diagnostic Interview Schedule for Children (DISC-P), which provides DSM-IV diagnoses,was applied to carers of non-institutionalised children between 7 and 11 years old. The disorders evaluated included: major depressive disorder, dysthymia, generalised anxiety disorder, separation anxiety disorder, attention deficit hyperactivity disorder in its three kinds (mixed, inattentive, and hyperactive), oppositional defiant disorder, and conduct disorder. The instrumentation was computer-assisted. Results: Prevalences of the disorders are present both in the last 30 days and in the last 12 months. In general, there is a prevalence of any of the disorders of 3% (95% CI, 2.2-4.0) in the last 30 days, and 4.7% (95% CI, 3.6-6.2) in the last 12 months. When evaluated individually, attention deficit hyperactivity disorder is the most frequent disorder, with a prevalence of 2.3% and 3.0% in the last 30 days and the last 12 months, respectively. In addition, the disorders that are known to frequently begin during childhood are the most common disorders in the age group studied, with a prevalence of 2.5% in the last 30 days and 3.2% in the last year. Conclusions: The 2015 National Mental Health Survey provides precise information about the real mental situation in children between the ages of 7 and 11 years in Colombia, compared with past epidemiological studies in the country, which were restricted to specific populations. By improving the reliability on knowledge about mental disorders in children, it will be possible to design more appropriate and precise strategies for prevention, diagnosis, and treatment.
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Humanos , Masculino , Femenino , Niño , Adolescente , Encuestas y Cuestionarios , Trastornos Mentales , Trastornos de Ansiedad , Estudios Epidemiológicos , Psiquiatría Infantil , Salud Mental , Colombia , DepresiónRESUMEN
Astrocytes are important for normal brain functioning. Astrocytes are metabolic regulators of the brain that exert many functions such as the preservation of blood-brain barrier (BBB) function, clearance of toxic substances, and generation of antioxidant molecules and growth factors. These functions are fundamental to sustain the function and survival of neurons and other brain cells. For these reasons, the protection of astrocytes has become relevant for the prevention of neuronal death during brain pathologies such as Parkinson's disease, Alzheimer's disease, stroke, and other neurodegenerative conditions. Currently, different strategies are being used to protect the main astrocytic functions during neurological diseases, including the use of growth factors, steroid derivatives, mesenchymal stem cell paracrine factors, nicotine derivatives, and computational biology tools. Moreover, the combined use of experimental approaches with bioinformatics tools such as the ones obtained through system biology has allowed a broader knowledge in astrocytic protection both in normal and pathological conditions. In the present review, we highlight some of these recent paradigms in assessing astrocyte protection using experimental and computational approaches and discuss how they could be used for the study of restorative therapies for the brain in pathological conditions.
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Astrocitos/metabolismo , Biología Computacional/métodos , Enfermedades Neurodegenerativas/tratamiento farmacológico , Fármacos Neuroprotectores/farmacología , Animales , Astrocitos/efectos de los fármacos , Humanos , Terapia Molecular Dirigida/métodos , Enfermedades Neurodegenerativas/metabolismo , Fármacos Neuroprotectores/uso terapéuticoRESUMEN
INTRODUCTION: Historical trauma (HT) is a collective trauma inflicted on a group of people who share an identity or affiliation, and is often characterized by the transgenerational legacy of traumatic experiences, and expressed through various psychological and social responses. This construct is proposed in contrast to post-traumatic stress disorder (PTSD) due to limitations identified with the latter diagnostic category when addressing collective trauma, especially in situations of political and social violence. The purpose of this article is to review the literature published so far on HT. METHODS: A search was performed using the terms "historical trauma" and "mental health" or "trauma histórico" and "salud mental" in the scientific databases, EMBASE, Ebscohost, JSTOR, ProQuest, LILACS, SciELO, PsycARTICLES, ISI Web of Science and PubMed. RESULTS: The authors reviewed HT definition, paramount characteristics of its traumatic experience, and several theories of on the transgenerational succession if these experiences occur, as well as possible consequences of traumatic events at individual, family and social level. Common characteristics of different therapeutic models are highlighted, in addition to some recommendations for their application. CONCLUSIONS: PTSD has clear limitations in addressing community and cumulative traumatic experiences related to specific social and historical contexts. The authors discuss the potential utility of HT in this task. Finally, several gaps in current knowledge regarding this construct are mentioned, and some recommendations for future research are indicated.
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Conflictos Armados/psicología , Procesos de Grupo , Relaciones Intergeneracionales , Salud Mental , Trastornos de Estrés Traumático/psicología , Relaciones Familiares/psicología , Humanos , Características de la Residencia , Trastornos por Estrés Postraumático/diagnóstico , Trastornos de Estrés Traumático/terapia , Violencia/psicologíaRESUMEN
Introducción: El trauma histórico (TH) es un trauma colectivo infligido a un grupo de personas que comparte una identidad o afiliación, que se caracteriza por el legado transgeneracional de los eventos traumáticos experimentados, y se expresa a través de diversas respuestas psicológicas y sociales. Este constructo se propuso en contraposición al trastorno de estrés postraumático (TEPT), debido a las limitaciones identificadas para abordar desde esta categoría diagnóstica traumas colectivos en situaciones de violencia política y social. El objetivo del presente artículo es revisar la literatura sobre TH publicada hasta el momento. Métodos: Se llevó a cabo una búsqueda en las bases de datos EMBASE, Ebscohost, JSTOR, Pro-Quest, LILACS, SciELO, Psycarticles, ISI Web of Science y PubMed con los términos "historical trauma" y "mental health" o "trauma histórico" y "salud mental". Resultados: Se revisan elementos del constructo de TH como su definición, las características de la experiencia traumáticas que lo caracterizan y la forma en que se da una sucesión transgeneracional. Se describen las consecuencias de los eventos traumáticos individuales, familiares y sociales en comunidades que han sufrido TH. Finalmente, se revisan las características comunes de distintos modelos de intervención terapéutica y algunas recomendaciones de los creadores para su aplicación. Conclusiones: Existen claras limitaciones del TEPT en el abordaje de experiencias traumáticas comunitarias y acumuladas relacionadas con contextos sociales e históricos específicos, por lo que mencionamos las posibles ventajas que puede ofrecer el TH en esta tarea. Por último, se señalan vacíos actuales en el conocimiento sobre este tema y se esbozan algunas recomendaciones para investigaciones futuras.
Introduction: Historical trauma (HT) is a collective trauma inflicted on a group of people who share an identity or affiliation, and is often characterized by the transgenerational legacy of traumatic experiences, and expressed through various psychological and social responses. This construct is proposed in contrast to post-traumatic stress disorder (PTSD) due to limitations identified with the latter diagnostic category when addressing collective trauma, especially in situations of political and social violence. The purpose of this article is to review the literature published so far on HT. Methods: A search was performed using the terms "historical trauma" and "mental health" or "trauma histórico" and "salud mental" in the scientific databases, EMBASE, Ebscohost, JSTOR, ProQuest, LILACS, SciELO, PsycARTICLES, ISI Web of Science and PubMed. Results: The authors reviewed HT definition, paramount characteristics of its traumatic experience, and several theories of on the transgenerational succession if these experiences occur, as well as possible consequences of traumatic events at individual, family and social level. Common characteristics of different therapeutic models are highlighted, in addition to some recommendations for their application. Conclusions: PTSD has clear limitations in addressing community and cumulative traumatic experiences related to specific social and historical contexts. The authors discuss the potential utility of HT in this task. Finally, several gaps in current knowledge regarding this construct are mentioned, and some recommendations for future research are indicated.
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Humanos , Masculino , Femenino , Conflictos Armados , Trauma Histórico , Trastornos por Estrés Postraumático , Violencia , Heridas y Lesiones , Salud MentalRESUMEN
OBJECTIVE: To evaluate the academic performance in, and adherence to, a postgraduate course focused on promotion, prevention, identification, and early intervention with regard to the different mental problems and pathologies affecting children and adolescents. MATERIALS AND METHODS: This was a before-and-after intervention study involving a postgraduate course. The population of school counselors from the Colombian regions of Boyacá and Cundinamarca were invited to participate in a postgraduate course that addressed mental health. Their knowledge was evaluated before and after having received it. RESULTS: The school counselors performed well on the academic test, with 48.5 % of the population obtaining a score of 4.0/5.0 before the intervention. After the course, 61.2 % achieved the same score. It was thus considered that the course functioned as a tool for improving knowledge about promotion, prevention, recognition, and early intervention with regard to mental health in educational institutions. There was a 90.6 % adherence to the 120-hour-long postgraduate course. CONCLUSION: The postgraduate course seemed to have a positive impact in terms of the knowledge acquired about mental health, and there was good adherence to the course.
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Consejo/educación , Educación Continua , Trastornos Mentales/prevención & control , Salud Mental/educación , Adolescente , Adulto , Niño , Colombia , Asesoramiento a Distancia , Diagnóstico Precoz , Intervención Médica Temprana , Escolaridad , Femenino , Humanos , Masculino , Trastornos Mentales/diagnóstico , Persona de Mediana Edad , Psicología del Adolescente , Psicología Infantil , Servicios de Salud EscolarRESUMEN
El intento de suicidio (IS) y los comportamientos de autolesión no suicida (CALNS) se han descrito en pacientes con trastornos del comportamiento alimentario (TCA) y se relacionan con una mayor morbilidad y peor pronóstico. Objetivos: Explorar la presentación de IS y CALNS en pacientes consultantes a un programa de tratamiento ambulatorio para TCA, evaluar las variables asociadas y explorar la correlación entre ambos tipos de comportamientos. Materiales y métodos: Se estudiaron 908 pacientes de ambos sexos que consultaron el Programa Equilibrio, de Bogotá. El antecedente de IS y CALNS fue explorado sistemática-mente en la elaboración de la historia clínica mediante preguntas estructuradas directas y corroboradas durante las entrevistas con la familia. Además, se estudiaron variables sociodemográficas y clínicas, y antecedentes de experiencias traumáticas. Se calcularon frecuencias simples, se realizó un análisis bivariado entre el IS y el CALNS, y las otras variables de estudio. Finalmente, para el análisis multivariado se construyeron 2 modelos de asociación con las variables de importancia clínica y significación estadística. Resultados: El 13% de los pacientes reportaron IS en algún momento de su vida y el 26%, CALNS. Las variables asociadas con IS fueron trastorno bipolar (OR: 3,86; IC 95% 2,4-6,1), personalidad limítrofe, subtipo purgativo del TCA y autolesiones. Con los CALNS se encontró asociado abuso sexual (OR: 3,48; IC 95% 2,2-5,4), trastorno bipolar, tricotilomanía e intento de suicidio. Conclusión: El IS y los CALNS son frecuentes en pacientes con TCA con múltiples comorbilidades, mayor impulsividad y desregulación emocional, y deben ser explorados y tratados.
Suicide attempt (SA) and non-suicidal self-injurious behaviors (NSSI) have been described in patients with eating disorders (ED), and they have been associated with increased morbidity and poor prognosis. Objectives: To explore the presence of SA and NSSI in patients attending an outpatient ED program, as well as to evaluate the associated variables and the correlation between both types of behaviors. Materials and methods: A total of 908 patients of both sexes attending the Equilibrio outpatient program in Bogotá were studied. The histories of SA and NSSI were systematically examined in the development of medical history by direct and structured questions to the patient, and then validated during interviews with the family. Sociodemographic and clinical variables, as well as history of traumatic experiences, were also studied. Simple frequencies were calculated, and a bivariate analysis was performed between SA, NSSI, and the other variables of the study. Finally, two models of association were designed for the multivariate analysis, using variables of clinical importance and statistical significance. Results: SA sometime in their lives was reported by 13% of the patients, and 26% of them reported NSSI. The variables associated with SA were bipolar disorder (OR: 3.86, 95% CI; 2.4-6.1), borderline personality, purgative subtype of ED, and self-injury. Sexual abuse was associated with NSSI (OR: 3.48, 95%CI; 2.2-5.4), as well as bipolar disorder, trichotillomania, and suicide attempt. Conclusion: SA and NSSI are frequent in patients with eating disorders with multiple comorbidities, increased impulsivity and emotional dysregulation, and they should be explored and treated.
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Humanos , Masculino , Femenino , Adulto , Suicidio , Registros Médicos , Bulimia Nerviosa , Trastornos MentalesRESUMEN
UNLABELLED: Suicide attempt (SA) and non-suicidal self-injurious behaviors (NSSI) have been described in patients with eating disorders (ED), and they have been associated with increased morbidity and poor prognosis. OBJECTIVES: To explore the presence of SA and NSSI in patients attending an outpatient ED program, as well as to evaluate the associated variables and the correlation between both types of behaviors. MATERIALS AND METHODS: A total of 908 patients of both sexes attending the Equilibrio outpatient program in Bogotá were studied. The histories of SA and NSSI were systematically examined in the development of medical history by direct and structured questions to the patient, and then validated during interviews with the family. Sociodemographic and clinical variables, as well as history of traumatic experiences, were also studied. Simple frequencies were calculated, and a bivariate analysis was performed between SA, NSSI, and the other variables of the study. Finally, two models of association were designed for the multivariate analysis, using variables of clinical importance and statistical significance. RESULTS: SA sometime in their lives was reported by 13% of the patients, and 26% of them reported NSSI. The variables associated with SA were bipolar disorder (OR: 3.86, 95% CI; 2.4-6.1), borderline personality, purgative subtype of ED, and self-injury. Sexual abuse was associated with NSSI (OR: 3.48, 95%CI; 2.2-5.4), as well as bipolar disorder, trichotillomania, and suicide attempt. CONCLUSION: SA and NSSI are frequent in patients with eating disorders with multiple comorbidities, increased impulsivity and emotional dysregulation, and they should be explored and treated.
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Con el objeto de estimar los cambios funcionales en patologia del Sistema Nervioso Central, se estudio la perfusion encefalica con el isomero "d,I" del Hexametilpropilenaminooxima (HM-PAO), usando un tomografo por emision de foton unico (SPECT). La sintesis del radiofarmaco fue realizada mediante la tecnica de Schneider R.F. Se describe el metodo de preparacion y los controles correspondientes. La eficacia de la marcacion excedio el 85%en todos los casos. Cinco milimetros del complejo 99mTcHM-PAO (0.75 mg d.I HM-PAO, 25ug de Cl2Sn.2h2oy 25mCi de 99mTc) fueron inyectados en la vena antecubital. La adquisicion de datos se realiza antes de las 2 h de administrado el compuesto. La poblacion estudiada consiste en 28 controles normales y 140 pacientes con patologia neurologica (enfermedad cerebro-vascular isquemica o hemorragica 37, epilepsia 20, demencia vascular 22 y tipo Alzheimer 19, tumores 15 y miscelaneas 27), definidos por metodos clinicos, electrofisiologicos y radiologicos. Mediante el analisis semicuantitativo de los tomogramas transaxiales con 99mTc-HM-PAO, se descubrieron areas fotopenicas en el 90%de los pacientes con enfermedad cerebro-vascular, en el 65%de las demencias tipo Alzheimer, en el 80%de los epilepticos y en el 10%de los controles normales. El estudio de perfusion encefalica con 99mTc-HM-PAO y SPECT, permite diagnosticar la isquemia cerebral de diversa forma y etiologia, antes que la tomografia computada por Rxe, incluso, resulta mas util que la RMN para el diagnostico diferencial de las demencias
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Animales , Ratones , Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Estudio Comparativo , Cerebro/irrigación sanguínea , Circulación Cerebrovascular/efectos de la radiación , Tomografía Computarizada de Emisión de Fotón Único/métodos , Marcaje Isotópico/métodos , Encefalopatías/diagnóstico , Azufre Coloidal Tecnecio Tc 99m/diagnóstico , Flujo Sanguíneo Regional/efectos de la radiación , Cerebro/diagnóstico por imagen , Tomografía Computarizada de Emisión de Fotón Único/diagnóstico , Técnicas de Diagnóstico Neurológico/métodos , Isquemia Encefálica/métodos , Hemorragia Cerebral/diagnóstico , Enfermedad de Alzheimer/diagnóstico , Demencia/diagnóstico , Espectroscopía de Resonancia Magnética/diagnóstico , InvestigaciónRESUMEN
Con el objeto de estimar los cambios funcionales en patologia del Sistema Nervioso Central, se estudio la perfusion encefalica con el isomero "d,I" del Hexametilpropilenaminooxima (HM-PAO), usando un tomografo por emision de foton unico (SPECT). La sintesis del radiofarmaco fue realizada mediante la tecnica de Schneider R.F. Se describe el metodo de preparacion y los controles correspondientes. La eficacia de la marcacion excedio el 85%en todos los casos. Cinco milimetros del complejo 99mTcHM-PAO (0.75 mg d.I HM-PAO, 25ug de Cl2Sn.2h2oy 25mCi de 99mTc) fueron inyectados en la vena antecubital. La adquisicion de datos se realiza antes de las 2 h de administrado el compuesto. La poblacion estudiada consiste en 28 controles normales y 140 pacientes con patologia neurologica (enfermedad cerebro-vascular isquemica o hemorragica 37, epilepsia 20, demencia vascular 22 y tipo Alzheimer 19, tumores 15 y miscelaneas 27), definidos por metodos clinicos, electrofisiologicos y radiologicos. Mediante el analisis semicuantitativo de los tomogramas transaxiales con 99mTc-HM-PAO, se descubrieron areas fotopenicas en el 90%de los pacientes con enfermedad cerebro-vascular, en el 65%de las demencias tipo Alzheimer, en el 80%de los epilepticos y en el 10%de los controles normales. El estudio de perfusion encefalica con 99mTc-HM-PAO y SPECT, permite diagnosticar la isquemia cerebral de diversa forma y etiologia, antes que la tomografia computada por Rxe, incluso, resulta mas util que la RMN para el diagnostico diferencial de las demencias