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La Terapia Dialectico Conductual “Radically Open” (RO TDC) es una terapia transdiagnótica desarrollada  para abordar el exceso de control (overcontrol) presente en trastornos graves como la Anorexia Nerviosa. El exceso de control es un modo afrontamiento desadaptativo que emerge de factores temperamentales y factores sociales y que se asocia con aislamiento social, déficit relacional, hiperperfeccionismo, rigidez, evitación del riesgo e inhibición emocional. La RO TDC tiene como objetivos la apertura a la  experiencia y al feedback negativo como oportunidad de aprendizaje, la flexibilidad para adaptarse a un entorno en permanente cambio, y el establecimiento de vínculos sociales. En el tratamiento se prioriza el placer, la relajación y la unión,  tomando como diana principal los déficit en señalización social que perpetuán el aislamiento. El objetivo de este trabajo es presentar una visión general de los principios teóricos y las estrategias terapéuticas de la RO TDC, haciendo hincapié en su aplicación y utilidad en la Anorexia Nerviosa.

La variabilidad en la práctica clínica en psicología clínica en España es ha sido escasamente estudiado. Este estudio describe la variabilidad en las respuestas asistenciales de Psicología Clínica en los Centros y consultas externas de Salud Mental de la Comunidad de Madrid, a través de una encuesta informada por 120 psicólogos/as clínicos/as del Servicio Madrileño de Salud, y analizar factores que puedan relacionarse con ella. El riesgo de mala salud mental del área de salud se relaciona con una lista de espera más larga y realización de grupos de psicoterapia. La renta media del área de salud y los años de experiencia se asociaron a una mayor probabilidad de realizar grupos. La gestión privada de los dispositivos se asoció con una menor duración de las primeras consultas y sucesivas y con una demora temporal entre consultas mayor. Se discuten las implicaciones de estos resultados.

Variations in clinical practice in clinical psychology may involve, among other aspects, the type of treatment, the waiting time to receive it, and its duration. There have been few studies that have examined the variability in mental health care in Spain. The objective of this study has been to describe the variability in the assistance responses of Clinical Psychologist in Mental Health Center and hospital outpatient consultations in the Community of Madrid, through a survey reported by clinical psychologists, and to analyze factors that may be related to this variability. 120 responses were obtained, 36% of SERMAS clinical psychologists. The risk of poor mental health in the health area was related to a longer waiting list for clinical psychology and with the completion of therapy groups. The mean income of the health area and the professional's years of experience were also associated with a greater probability of carrying out groups of psychotherapy. The private management of the public devices was associated with a shorter time for first consultation and subsequent appointments and a longer time delay between appointments. The factors related to the organizational offer are the ones that most influence the healthcare variables examined. The implications of these results are discussed. La variabilidad en la práctica clínica en psicología clínica en España es ha sido escasamente estudiado. Este estudio describe la variabilidad en las respuestas asistenciales de Psicología Clínica en los Centros y consultas externas de Salud Mental de la Comunidad de Madrid, a través de una encuesta informada por 120 psicólogos/as clínicos/as del Servicio Madrileño de Salud, y analizar factores que puedan relacionarse con ella. El riesgo de mala salud mental del área de salud se relaciona con una lista de espera más larga y realización de grupos de psicoterapia. La renta media del área de salud y los años de experiencia se asociaron a una mayor probabilidad de realizar grupos. La gestión privada de los dispositivos se asoció con una menor duración de las primeras consultas y sucesivas y con una demora temporal entre consultas mayor. Se discuten las implicaciones de estos resultados.

La variabilidad en la práctica clínica en psicología clínica en España es ha sido escasamente estudiado. Este estudio describe la variabilidad en las respuestas asistenciales de Psicología Clínica en los Centros y consultas externas de Salud Mental de la Comunidad de Madrid, a través de una encuesta informada por 120 psicólogos/as clínicos/as del Servicio Madrileño de Salud, y analizar factores que puedan relacionarse con ella. El riesgo de mala salud mental del área de salud se relaciona con una lista de espera más larga y realización de grupos de psicoterapia. La renta media del área de salud y los años de experiencia se asociaron a una mayor probabilidad de realizar grupos. La gestión privada de los dispositivos se asoció con una menor duración de las primeras consultas y sucesivas y con una demora temporal entre consultas mayor. Se discuten las implicaciones de estos resultados.

Frontal cortex is involved in important memory processes but its role is different from that associated with structures in the medial temporal lobe and diencephalon. While damage in the latter structures produces profound and global anterograde amnesia, damage to the frontal cortex is manifested by an specific group of memory impairments and distortions like confabulations, source amnesia, prospective memory and metamemory deficit, or impaired free recall. Frontal lobes is less involved in memory acquisition per se than it is in leading the strategic processes that support memory encoding, retrieval and monitoring.

To date, no immunological data on COVID-19 heterologous vaccination schedules in humans have been reported. We assessed the immunogenicity and reactogenicity of BNT162b2 (Comirnaty, BioNTech, Mainz, Germany) administered as second dose in participants primed with ChAdOx1-S (Vaxzevria, AstraZeneca, Oxford, UK). We did a phase 2, open-label, randomised, controlled trial on adults aged 18–60 years, vaccinated with a single dose of ChAdOx1-S 8–12 weeks before screening, and no history of SARS-CoV-2 infection. Participants were randomly assigned (2:1) to receive either BNT162b2 (0·3 mL) via a single intramuscular injection (intervention group) or continue observation (control group). The primary outcome was 14-day immunogenicity, measured by immunoassays for SARS-CoV-2 trimeric spike protein and receptor binding domain (RBD). Antibody functionality was assessed using a pseudovirus neutralisation assay, and cellular immune response using an interferon-γ immunoassay. The safety outcome was 7-day reactogenicity, measured as solicited local and systemic adverse events. The primary analysis included all participants who received at least one dose of BNT162b2 and who had at least one efficacy evaluation after baseline. The safety analysis included all participants who received BNT162b2. This study is registered with EudraCT (2021-001978-37) and ClinicalTrials.gov (NCT04860739), and is ongoing. Between April 24 and 30, 2021, 676 individuals were enrolled and randomly assigned to either the intervention group (n=450) or control group (n=226) at five university hospitals in Spain (mean age 44 years [SD 9]; 382 [57%] women and 294 [43%] men). 663 (98%) participants (n=441 intervention, n=222 control) completed the study up to day 14. In the intervention group, geometric mean titres of RBD antibodies increased from 71·46 BAU/mL (95% CI 59·84–85·33) at baseline to 7756·68 BAU/mL (7371·53–8161·96) at day 14 (p<0·0001). IgG against trimeric spike protein increased from 98·40 BAU/mL (95% CI 85·69–112·99) to 3684·87 BAU/mL (3429·87–3958·83). The interventional:control ratio was 77·69 (95% CI 59·57–101·32) for RBD protein and 36·41 (29·31–45·23) for trimeric spike protein IgG. Reactions were mild (n=1210 [68%]) or moderate (n=530 [30%]), with injection site pain (n=395 [88%]), induration (n=159 [35%]), headache (n=199 [44%]), and myalgia (n=194 [43%]) the most commonly reported adverse events. No serious adverse events were reported. BNT162b2 given as a second dose in individuals prime vaccinated with ChAdOx1-S induced a robust immune response, with an acceptable and manageable reactogenicity profile. Instituto de Salud Carlos III. For the French and Spanish translations of the abstract see Supplementary Materials section.

Solid organ transplant (SOT) recipients are especially at risk of developing infections by multidrug resistant bacteria (MDR). In this study, the biofilm-forming capability of 209 MDR strains ( Escherichia coli n = 106, Klebsiella pneumoniae n = 78, and Enterobacter spp. n = 25) isolated from rectal swabs in the first 48 hours before or after kidney (93 patients), liver (60 patients) or kidney/pancreas transplants (5 patients) were evaluated by using a microplate assay. Thirty-nine strains were isolated before transplant and 170 strains were isolated post-transplant. Overall, 16% of E. coli strains, 73% of K. pneumoniae strains and 4% Enterobacter strains showed moderate or strong biofilm production. Nine strains isolated from infection sites after transplantation were responsible of infections in the first month. Of these, 4 K. pneumoniae , 1 E. coli and 1 Enterobacter spp. strains isolated pre-transplant or post-transplant as colonizers caused infections in the post-transplant period. Our results suggest that in vitro biofilm formation could be an important factor for adhesion to intestine and colonization in MDR K. pneumoniae strains in SOT recipients, but this factor appears to be less important for MDR E. coli and Enterobacter spp.

BackgroundThe microbiota is emerging as a key factor in the predisposition to insulin resistance and obesity.ObjectiveTo understand the interplay among gut microbiota and insulin sensitivity in multiple tissues.DesignIntegrative multiomics and multitissue approach across six studies, combining euglycaemic clamp measurements (used in four of the six studies) with other measurements of glucose metabolism and insulin resistance (glycated haemoglobin (HbA1c) and fasting glucose).ResultsSeveral genera and species from the Proteobacteria phylum were consistently negatively associated with insulin sensitivity in four studies (ADIPOINST, n=15; IRONMET, n=121, FLORINASH, n=67 and FLOROMIDIA, n=24). Transcriptomic analysis of the jejunum, ileum and colon revealed T cell-related signatures positively linked to insulin sensitivity. Proteobacteria in the ileum and colon were positively associated with HbA1c but negatively with the number of T cells. Jejunal deoxycholic acid was negatively associated with insulin sensitivity. Transcriptomics of subcutaneous adipose tissue (ADIPOMIT, n=740) and visceral adipose tissue (VAT) (ADIPOINST, n=29) revealed T cell-related signatures linked to HbA1c and insulin sensitivity, respectively. VAT Proteobacteria were negatively associated with insulin sensitivity. Multiomics and multitissue integration in the ADIPOINST and FLORINASH studies linked faecal Proteobacteria with jejunal and liver deoxycholic acid, as well as jejunal, VAT and liver transcriptomic signatures involved in the actin cytoskeleton, insulin and T cell signalling. Fasting glucose was consistently linked to interferon-induced genes and antiviral responses in the intestine and VAT. Studies in Drosophila melanogaster validated these human insulin sensitivity-associated changes.ConclusionThese data provide comprehensive insights into the microbiome-gut-adipose-liver axis and its impact on systemic insulin action, suggesting potential therapeutic targets.Cite Now

This work was partially funded by Instituto de Salud Carlos III (ISCIII, Madrid, Spain) through the project PI15/01934 to J.M.F.-R. and the projects PI20/01090 and PI23/00575 (co-funded by the European Union under the European Regional Development Fund (FEDER) ‘A way to make Europe’) to J.M.-P. (HR22-00737). The Aging Imageomics Study was funded by Pla estratègic de recerca i innovació en salut 2016–2020 from Generalitat de Catalunya (reference no. SLT002/16/00250). Health Imageomics was funded by Health LivingLab operation of the Girona Healthy Region Program, which was granted by the Projectes d’Especialització i Competitivitat Territorial of the RIS3Cat and the Operative Programme of the European Regional Development Fund of Catalonia 2014–2020. This work was also supported by the Spanish ‘Ministerio de Ciencia e Innovación (MICIN), Agencia Estatal de Investigación’ (PID2020-120029GB-I00/MICIN/AEI/10.13039/501100011033, RD21/0009/0019, to R.M.; the ‘Generalitat de Catalunya, AGAUR’ (2017 SGR-669, to R.M.; the ‘ICREA-Acadèmia’ (2020, to R.M.); the ‘European Commission-DG Research’ (PainFact, H2020-SC1-2019-2-RTD-848099, QSPain Relief, H2020-SC1-2019-2-RTD-848068, to R.M.); the Spanish ‘la Caixa’ Foundation under project code LCF/PR/HR22/52420017 to R.M. and J.M.F.-R.; the Spanish ‘Instituto de Salud Carlos III, RETICS-RTA’ (RD16/0017/0020, to R.M.); the Spanish ‘Ministerio de Sanidad, Servicios Sociales e Igualdad, Plan Nacional Sobre Drogas’ (PNSD-2021I076, to R.M.; PNSD-2023I040, to E.M.G.; and Ministerio de Ciencia e Innovación (ERA-NET) PCI2021-122073-2A to E.M.G. This study has been co-financed by FEDER funds from the European Union (‘A way to build Europe’) and the Generalitat of Catalonia: Agency for Management of University and Research Grants (2021SGR00990) and Department of Health (SLT002/16/00250) to R.P. IDIBGI is a CERCA Programme/Generalitat de Catalunya. J.M.-P. and A.C.N. are funded by Instituto de Salud Carlos III (Madrid, Spain) through the Miguel Servet Program CP18/00009 and Sara Borrell Program CD20/00051 (co-funded by the European Union under the European Social Fund ‘Investing in Your Future’), respectively. L.V.-C. is funded by the Program for the Promotion of Talent and Employability (Generalitat de Catalunya) SLT017_20_000164. This study was conducted using samples and/or data from the Aging Imageomics Study, supported by the Generalitat de Catalunya through the Strategic Plan for Health Research and Innovation 2016–2020 (SLT002/16/00250). We particularly acknowledge the participants of the IDIBGI Horizontal Aging Program and the IDIBGI Biobank (Biobanc IDIBGI, B.0000872), integrated in the Platform ISCIII Biomodels and Biobanks, for their collaboration. This study was conducted using samples and/or data from the Healthy Imageomics Study, supported by the Specialization and Territorial Competitiveness Projects within the RIS3Cat and the Catalonia European Regional Development Fund (ERDF) Operational Programme 2014–2020. It was co-financed by the ERDF of the European Union under the Catalonia ERDF Operational Programme 2014–2020 and by the Diputació de Girona. Illustrations were created with Biorender.com.