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This study screened for Fabry disease (FD) in patients in hemodialysis (HD) in the region of Madrid (CAM) with a cross-sectional design to evaluate HD-prevalent patients, followed by a three-year period prospective design to analyze HD-incident patients. Inclusion criteria: patients older than 18 years on HD in the CAM, excluding patients diagnosed with any other hereditary disease with renal involvement different from FD, that sign the Informed Consent (IC). Exclusion criteria: underaged patients or not agreeing or not being capable of signing the IC. Results: 3470 patients were included, 63% males and with an average age of 67.9 ± 9.7 years. 2357 were HD-prevalent patients and 1113 HD-incident patients. For HD-prevalent patients, average time in HD was 45.2 months (SD 51.3), in HD-incident patients proteinuria was present in 28.4%. There were no statistical differences in plasmatic alpha-galactosidase A (α-GAL-A) activity or Lyso-GL-3 values when comparing HD-prevalent and HD-incident populations and neither between males and females. A genetic study was performed in 87 patients (2.5% of patients): 60 male patients with decreased enzymatic activity and 27 female patients either with a decreased GLA activity, increased Lyso-Gl3 levels or both. The genetic variants identified were: p.Asp313Tyr (4 patients), p.Arg220Gln (3 patients) and M290I (1 patient). None of the identified variants is pathogenic. Conclusions: 76% of HD Centers of the CAM participated in the study. This is the first publication to describe the prevalence of FD in the HD-population of a region of Spain as well as its average α-GAL-A-activity and plasmatic Lyso-Gl3 levels. It is also the first study that combines a cross-sectional design with a prospective follow-up design. This study has not identified any FD patient. Resumen: El objetivo del estudio ha sido realizar un mapa descriptivo de la enfermedad de Fabry (EF) en la Comunidad de Madrid, así como realizar un despistaje de la EF a todo paciente incidente durante un período de 3 años. Criterios de inclusión: Pacientes mayores de 18 años, excluyendo aquellos diagnosticados de cualquier otra enfermedad hereditaria con afectación renal diferente de la EF, que firmaran el consentimiento informado. Criterios de exclusión: pacientes menores de edad, no estar de acuerdo o no ser capaces de firmar el consentimiento informado. Resultados: Se incluyeron 3.470 pacientes (63% hombres), con una edad media de 67,9 ± 9,7 años, de los cuales 2.357 eran pacientes prevalentes y 1.113 incidentes. En el caso de los pacientes prevalentes, el tiempo medio en hemodiálisis (HD) fue de 45,2 (DE 51,3) meses. En pacientes incidentes, la proteinuria estuvo presente en el 28,4%. No hubo diferencias estadísticamente significativas en la actividad plasmática de alfa-galactosidasa A o valores de Lyso-Gl3 al comparar las poblaciones de incidentes y de prevalentes, y tampoco entre hombres y mujeres. Se realizó estudio genético en 87 pacientes (2,5% de los pacientes): 60 varones con disminución de la actividad enzimática y 27 mujeres con una disminución de la actividad enzimática, aumento de los niveles de Lyso-Gl3 o ambos. Las variantes genéticas identificadas fueron: p.Asp313Tyr (4 pacientes), p.Arg220Gln (3 pacientes) y M290I (un paciente). Ninguna de las variantes identificadas fue patógena. Conclusiones: El 76% de los centros de HD de la Comunidad de Madrid participaron en el estudio. Este es el primer estudio epidemiológico prospectivo de EF en la población de HD de una región de España. También es la primera vez que se describen niveles de alfa-galactosidasa A y Lyso-Gl3 en HD, sin embargo, en este estudio no se han identificado pacientes con EF.

Recent developments in pattern analysis research have made this methodology suitable for the study of the processes that are set in motion in psychological interventions. Outcome research, based on the comparison between clinical results from treatment and control groups, has leveraged our empirical knowledge about the efficacy of psychological interventions. However, these methods of research are not precise enough for the analysis of these processes. On the contrary, pattern analysis could be a powerful tool to study moment-to-moment interactions typical of psychological interventions. This is methodology is relevant because clinical psychology is experiencing a paradigm shift from a protocol for syndrome perspective to a principle-based and person-centered intervention. This evidence-based, theory-grounded, and process-oriented paradigm of clinical intervention needs new research methods to thrive (i.e., pattern analysis). The analysis of the therapeutic relationship built into the verbal interaction between the clinician and the client is one of the cornerstones of this new era of research. So, the purpose of this article is three-fold: (1) to discuss the role of the verbal interaction pattern analysis in the clinical context to the development of the principle-based clinical psychology, (2) to analyze the patterns of verbal interaction in a clinical case, and (3) to compare the results using two different methods. To reach these purposes, using the observational methodology, we have coded the verbal interaction of 16 clinical sessions with a person diagnosed with a borderline personality disorder. We have analyzed the data using sequential analysis (GSEQ) and pattern recognition algorithms (i.e., T-Pattern detection). We have been able to detect typical patterns during different phases of psychological intervention (i.e., evaluation, explanation, treatment, and consolidation). Finally, the conceptual, methodological, and empirical implications of this study will be discussed within the realms of pattern analysis research and principle-based clinical psychology.

Embora várias técnicas tenham sido descritas para a reconstrução do lábio superior, a reconstrução funcional dos defeitos totais do lábio superior permanece um desafio. Neste caso, realizou-se a exérese de um carcinoma espinocelular de tamanho significante, em região labial superior, por meio da técnica de duplo avanço, com resultados funcional e estético positivos.

ABSTRACT Syphilis is a chronic bacterial sexually transmitted infectious disease caused by Treponema pallidum. Different age groups are affected by heterogeneous clinical forms of the disease. We report a case of atypical secondary syphilis in an elderly patient with diffuse annular erythematous lesions on the chest, back, upper and lower limbs diagnosed by histopathological, immunohistochemical and serological tests.

In order to reduce the incidence and mortality rate of cervical cancer, the World Health Organization (WHO) declared the Global Strategy Goal for 2030, advocating for reaching a vaccination coverage rate of >90% against human papillomavirus for girls by the age of 15 years. The main objectives of this study were (1) to determine the papillomavirus vaccination coverage among women 15–40 years old and (2) to identify the at-risk subgroups and possible barriers to achieving WHO’s 2030 goal. Multicentre, observational, retrospective, and community-based cohort studies were conducted on women from a rural area in southern Catalonia until 31 December 2021. A total of 23,136 women were included, with a mean age of 26.6 (SD = 5.6) years. The average dose number was 1.7 (SD = 0.7). The results showed overall vaccination coverage of 17.4% among the target women. This coverage was unequal across regions (16.6–24.5%, p < 0.001), primary healthcare teams (15.5–24.3%, p < 0.001), and age groups (56.7% (15–19-year-olds) vs. 3.8% (35–40-year-olds), p < 0.001), related to accessibility to vaccination and economic–geographical indicators. Clinical practice guidelines on screening individuals at risk in terms of vaccination access and public vaccination protocols should be implemented in order to improve the vaccination coverage rate.

A cultura da mandioquinha-salsa constitui-se em ótima alternativa para pequenos e médios produtores, especialmente dentro dos conceitos de agricultura familiar. O objetivo deste trabalho foi conhecer a produtividade agroeconômica da mandioquinha-salsa cultivada com dois espaçamentos entre plantas (20 e 25 cm) e formas de adição de massa seca de cama de frango ao solo [cobertura (10 t ha-1), incorporada (10 t ha-1), cobertura (5 t ha-1) + incorporada (5 t ha-1) e sem cama de frango (0 t ha-1)], realizando duas colheitas independentes em diferentes estágios de maturação, 50% e 70% de senescência, que ocorreram respectivamente aos 224 e 249 dias após o plantio (DAP). As características avaliadas não foram influenciadas significativamente pela interação espaçamentos entre plantas e formas de adição de cama de frango, mas foram influenciadas pelas formas isoladas. As maiores massas de matérias frescas de folhas, coroas e os rebentos foram obtidos com o espaçamento de 25 cm entre plantas, nas duas colheitas. Aos 50% de senescência os aumentos foram de 27% (folhas), 28% (coroas) e 37% (rebentos) e aos 249 DAP foram de 25% (folhas), 13% (coroas), 18% (rebentos) e 22% (raízes comerciais) em relação a 20 cm entre plantas. Aos 70% de senescência as melhores produções de raízes comerciais foram com a cama de frango incorporada e em cobertura + incorporada, que superaram em 10,27 t ha-1 e 7,29 t ha-1, respectivamente, sem a cama de frango. Para serem obtidas maiores produtividades de raízes comerciais, o cultivo em canteiros da mandioquinha-salsa 'Amarela de Carandaí' deve ser feito com espaçamento de 25 cm entre plantas e com a adição ao solo de cama de frango na forma incorporada, realizando a colheita com 70% de senescência da parte foliar aos 249 DAP.

Yield of Taro is very variable by the unknowing of its genotype characteristics and by differences of planting practices, mainly about the use of organic residues as covering or incorporated to the soil. The aim of this work was to analyze the productivity, gross income and bromatological composition of ‘Chinês’ and ‘Macaquinho’ taro, cultivated with different forms of adding semi-decomposed chicken manure to the soil (soil without chicken manure; with chicken manure as covering; with chicken manure incorporated to the soil and with chicken manure as covering + incorporated to the soil). Treatments were arranged in a 2 x 4 factorial scheme in a randomized complete block design with five replications. Two harvests were performed at 183 and 211 days after transplanting. There was no difference for most of the characteristics evaluated under addiction of chicken manure. Yields of commercial cormels from Macaquinho were higher than Chinês, which can be seen as positive feature for higher gross income. Plants of ‘Macaquinho’ taro were precocious and more productive than ‘Chinês’ taro. To obtain higher gross income, ‘Macaquinho’ taro must be cultivated with adding chicken manure to the soil as covering (5 t ha-1) + incorporated to the soil (5 t ha-1) and harvested 183 days after planting. Bromatological analysis showed that corms and cormels of ‘Chinês’ taro were more nutritious than ‘Macaquinho’ taro when grown without chicken manure.