Evaluation of phosphatase and tensin homologue (PTEN) expression in gastric cancer and its relationship with histopathological findings

INTRODUCTION

Phosphatase and tensin homologue (PTEN) is an important tumour suppressor in multi-step tumorigenesis. To establish the role of PTEN in gastric cancer progression, we examined the PTEN expression degree in gastric cancer tissues. We also explained the connection between PTEN expression and histopathological findings.

MATERIALS AND METHODS

Our study was cross-sectional and made up of 50 patients with known gastric cancer. Immunohistochemical staining for PTEN was done on gastric cancer tissues. Tumour behaviour was estimated by histopathological assessments.

RESULTS

Twenty-seven (54%) of the 50 patients had PTEN staining. The evaluation of the connection between PTEN expression and demographic data and tumour behaviours revealed no meaningful relationship between PTEN expression and patients' age, gender, tumour site and size, tumour type, tumour grade and stage, neural, and lymphovascular invasion (P-value>0.05).

CONCLUSION

PTEN expression level is expected to be a significant molecular event in the progression of gastric cancer and may be a predictive marker for gastric cancer behaviours dependent on society.

Effectiveness of a transdisciplinary approach on hyperphagia management among patients with Prader Willi syndrome

BACKGROUND

One of the main characteristics of Prader Willi syndrome (PWS) is hyperphagia and obesity. This study sought to evaluate behaviours related to hyperphagia in individuals with PWS under a non-pharmacological transdisciplinary approach.

METHODS

This observational study included PWS patients under a traditional non-pharmacological nutritional approach immersed within a regular transdisciplinary treatment (RTT) and a control group of PWS individuals without RTT. All individuals were evaluated using the Hyperphagia Questionnaire for Clinical Trials (HQ-CT).

RESULTS

Forty-three individuals were evaluated. The mean age at baseline (treatment onset) was 18.4±8.3 years in the RTT group and 19.1±6.9 years in the control group (p=0.74). Hyperphagia-related behaviours were significantly lower among those under RTT (RTT 5.7±3.7 vs control 13.1±7.5, p<0.0001). This was also identified within the three categories: arguing or manipulating to obtain food (2.71±2.1 vs 5.41±3.2, p=0.003), sneaking food (1.33±1.5 vs 3.55±3.3, p=0.007), and anger or tantrums related to food (1.67±1.8 vs 4.09±2.7, p=0.001). After a mean treatment duration of 41.0 months, the RTT group had a reduction in body mass index (baseline 38.7±17.1kg/m² vs follow-up 29.2±9.2kg/m²; p<0.0001). A significant association between RTT duration and BMI reduction (p=0.037) was identified.

CONCLUSION

We observed a positive impact on behaviours related to hyperphagia and a BMI reduction in PWS individuals in a context of a non-pharmacological nutritional approach as part of an RTT.

[Nudges and the pandemic: An analysis from economics and behavioural law. SESPAS Report 2022]

Behavioural economics (a combination of economics and psychology) provides keys to understand decisions made by politicians and citizens along the COVID-19 pandemic through the so-called cognitive biases. These biases can be offset by implementing behavioural interventions named "nudges" in order to promote responsible behaviours in the "new normality". This paper analyses, from a behavioural economics perspective, past, present and future of behavioural aspects surrounding the pandemic. Besides, this paper proposes different ways to formalize nudges according to law, which needs the fulfilment of three minimum requirements, namely: transparency, non-arbitrariness and efficiency. Furthermore, it is also suggested that protocols and contingency plans are set up to face future pandemics, in which both soft (nudge-type) interventions and hard legal regulations play different roles but complementary ones. Nudges can be implemented in a fast and less coercive way, so they are particularly suitable for changing mild misbehaviour, reserving legal sanctions for the more serious ones.

Effectiveness of brief counselling in a hospital setting for smoking cessation and risky alcohol drinking reduction: randomised clinical trial protocol

INTRODUCTION

Chronic diseases are a public health problem, and 80% of them are related to modifiable risk factors such as unhealthy diet, physical inactivity, smoking, and risky alcohol consumption. Although the intervention in smoking and hazardous alcohol drinking has proven to be effective in Primary Care, it is unknown whether it works in the same way in the hospital setting.

OBJECTIVE

To evaluate the effectiveness of brief counselling in order to modify the stage of change in smokers and at-risk drinkers treated in a high complexity hospital.

METHODS

A Randomised controlled trial to be conducted, in which an evaluation is made of four brief counselling strategies for smoking cessation and risky alcohol consumption compared to usual care, selected according to the patient's stage of change. The primary result will be the proportion of patients in each of the groups (intervention and control) with identified progress in the stage of change. The reduction of consumption will be also be analysed. Protocol registered at ClinicalTrials.gov (NCT03521622).

RESULTS

The results will be published in scientific journals, and its application aims to generate behavioural intervention protocols for modifiable risk factors in high complexity hospitals. The trial was presented and approved by the Ethics and Research Committee of the Pontificia Universidad Javeriana and Hospital Universitario de San Ignacio, Bogota, Colombia (Approval 01/2018).

Effectiveness of Brief Counseling in a Hospital Setting for Smoking Cessation and Risky Alcohol Drinking Reduction: Randomized Clinical Trial Protocol

INTRODUCTION

Chronic diseases are a public health problem, and 80% of them are related to modifiable risk factors such as unhealthy diet, physical inactivity, smoking, and risky alcohol consumption. Although the intervention in smoking and hazardous alcohol drinking has proven to be effective in Primary Care, it is unknown whether it works in the same way in the hospital setting.

OBJECTIVE

To evaluate the effectiveness of brief counselling in order to modify the stage of change in smokers and at-risk drinkers treated in a high complexity hospital.

METHODS

A Randomised controlled trial to be conducted, in which an evaluation is made of four brief counselling strategies for smoking cessation and risky alcohol consumption compared to usual care, selected according to the patient's stage of change. The primary result will be the proportion of patients in each of the groups (intervention and control) with identified progress in the stage of change. The reduction of consumption will be also be analysed. Protocol registered at ClinicalTrials.gov (NCT03521622).

RESULTS

The results will be published in scientific journals, and its application aims to generate behavioural intervention protocols for modifiable risk factors in high complexity hospitals. The trial was presented and approved by the Ethics and Research Committee of the Pontificia Universidad Javeriana and Hospital Universitario de San Ignacio, Bogota, Colombia (Approval 01/2018).

Factors associated with a rapid call for assistance for patients with ischemic stroke

OBJECTIVES

To identify factors related to a rapid response to the onset of symptoms and a call for help for patients with ischemic stroke.

MATERIAL AND METHODS

Observational cross-sectional study of all patients with ischemic stroke admitted consecutively to Hospital Universitario de Burgos in Spain during 1 year. We collected sociodemographic, clinical, behavioral, cognitive, and contextual data for all patients and applied uni- and multivariate analysis to explore possible associations with the patient's response time.

RESULTS

A total of 425 patients were included. The mean patient response time was 140.00 minutes. Patient delay accounted for 72.6% of the total prehospital response time. Factors associated with a rapid call for help were the presence of an accompanying person (OR, 9.57; 95% CI, 3.89-23.52), daytime onset of symptoms (OR, 8.77; 3.40- 22.63), patient knowledge of how to act in case of stroke symptoms (OR, 3.84; 2.77-7.09), first medical contact through the public health system's emergency medical service (OR, 3.03; 1.62-5.68), patient perception of symptoms as severe or very severe (OR, 2.38; 1.17-4.83), and stroke onset in an urban area (OR, 2.17; 1.16-4.06).

CONCLUSION

The patient's response time between onset of symptoms is related to behavioral, cognitive and contextual factors that should be taken into account when planning future patient education campaigns.

[Socio-demographic, Psychiatric and Legal Characterization of Colombian Unimputable Patients, 2000-2013]

INTRODUCTION

Mental illness has been associated with violent behaviour. Criminal behavior in the mentally ill population in Colombia has not been well studied.

METHODS

This is a retrospective, descriptive study, from a secondary source. An analysis was made of the sociodemographic, clinical, and legal variables of 127 unfit to plead patients. A descriptive analysis of quantitative variables was performed by measures of central tendency, and frequencies and percentages were calculated for the qualitative variables. The software SPSS^® version 21.0 was used to analyse the data, and the study was approved by the Research Committee of the CES University.

RESULTS

The median age was 34 years, interquartile range 19 years, and 92.1% were men. The primary diagnosis was schizophrenia in 63%, 66.9% consumed alcohol, and 58.3% other drugs at the time they committed the crime. Almost one/third (29.1%) had a criminal record, and the most common type of crime was murder in 44.1% of cases. Around half (50.3%) of the victims had some degree of consanguinity with the patient.

DISCUSSION

The study subjects had higher illiteracy and lower educational levels than the Colombian prison population. Schizophrenia was the main diagnosis, and homicide the most prevalent crime, which agrees with the literature where non-indictable patients are responsible for 5%-20% of murder cases worldwide.

CONCLUSIONS

To reduce the gap between the diagnosis and treatment of mental disorders, especially schizophrenia, should be within the specific actions to prevent violence and criminal behavior associated with mental illness.

Employee reactions to the use of management control systems in hospitals: motivation vs. threat

OBJECTIVE

Management control systems (such as budgets or balanced scorecards) are formal procedures used by managers to promote employee behavior aligned with organisational objectives. Employees may react to these control systems by either becoming more motivated or perceiving them as a threat. The aim of this paper is to determine the extent to which hospital ownership (public or private), professional group (physician, nurse, pharmacist or administrative employee), type of contract (fixed or temporary), gender and tenure can condition employee reaction to management control systems.

METHODS

We conducted the study in the three largest hospitals in the State of Santa Catarina (Brazil), two public (federal and state-owned) and one private (non-profit organisation). Physicians, nurses, pharmacists and administrative employees received a questionnaire between October 2013 and January 2014 concerning their current perceptions. We obtained 100 valid responses and conducted an ANOVA variance analysis.

RESULTS

Our results show that the effect of management control systems on employees differs according to hospital ownership, professional group and type of contract. However, no significant evidence was found concerning gender or tenure.

CONCLUSIONS

The results obtained contribute to creating specific knowledge on the reactions of employees to the use of management control systems in hospitals. This information may be important in adapting management control systems to the characteristics of the hospital and its employees, which may in turn contribute to reducing dysfunctional worker behavior.

[Suicidal Behavior and Attention Decifit Hyperactivity Disorder in Adolescents of Medellin (Colombia), 2011-2012]

BACKGROUND

Suicide is a public health problem. In Colombia, teenagers are considered a group at high risk for suicidal behavior.

OBJECTIVE

To explore the possible association between suicidal behavior and attention deficit hyperactivity disorder in adolescents of Medellin.

METHODOLOGY

Observational, cross-sectional, analytical study. The Composite International Diagnostic Interview was applied to a total of 447 adolescents and the sociodemographic, clinical, familiar, and life event variables of interest were analyzed. The descriptive analysis of qualitative variables are presented as absolute values and frequencies, and the age was described with median [interquartile range]. A logistic regression model was constructed with explanatory variables that showed statistical association. Data were analyzed with SPSS® software version 21.0.

RESULTS

Of the total, 59.1% were female, and the median age was 16 [14-18] years. Suicidal behavior was presented in 31% of females and 23% of males. Attention deficit was present in 6.3% of adolescents. The logistic regression analysis showed that the variables that best explained the suicidal behavior of adolescents were: female sex, post-traumatic stress disorder, panic disorder, and cocaine use.

CONCLUSIONS

The diagnosis and early intervention of attention deficit hyperactivity disorder in children may be a useful strategy in the prevention of suicidal behavior in adolescents.