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Este ensayo practica una hermenéutica a Totalidad e infinito a partir de cinco epígrafes, abocados todos a explorar los múltiples sentidos de la propuesta levinasiana en torno al fundamento trascendental de lo ético. El primer apartado busca analizar la relación entre lo que Lévinas designa como la faz del ser y el concepto de totalidad; en el epígrafe siguiente se explicita la diferencia existente, en el interior de la comprensión temporal de lo total, entre lo histórico y lo escatológico; en el tercer epígrafe se analizan los móviles que llevan a Lévinas a sustituir lo metafísico por lo ético, revelando a este segundo saber como filosofía primera; y, finalmente, el cuarto y el quinto epígrafe quedan dedicados a entender dos conceptos que, entrelazados, condensan la matriz conceptual desde donde Lévinas acentúa la originalidad de su propuesta: el rostro del Otro y la idea de infinito.

<i>Background:</i> Alcohol craving is a central aspect of alcoholism about which various explanatory theories and assessment questionnaires, based on such craving, have been developed. However, there are no instruments for the assessment of craving in line with the integrative hypotheses recently formulated that propose three types of craving: positive reinforcement, negative reinforcement, and loss of control. <i>Objectives:</i> The construction and validation of a craving scale based on three factors. We expect to obtain a correlation between each factor and associated variables from prior studies. We also expect significant differences in craving between alcoholic individuals and controls. <i>Sample:</i> The scale was administered to 209 alcohol-dependent subjects and 137 controls. <i>Instruments:</i> Alcohol Craving Scale Based on Three Factors (ACS-3F); Sensitivity to Punishment and Sensitivity to Reward Questionnaire, Barratt Impulsiveness Scale, Severity of Alcohol Dependence Scale. <i>Results:</i> We confirmed the existence of the three factors initially proposed in the structure of the instrument, with high reliability. The relationship between the scale and the measures employed for its validation was confirmed. Adequate capacity of the scale to discriminate between the sample of alcoholics and the controls was observed. <i>Conclusions:</i> The ACS-3F has adequate psychometric properties and may be useful in future research and in clinical practice.

Índex d'apnea-hipopnea; Circadià; Hemoglobina glicada ; Índice de apnea-hipopnea; Circadiano; Hemoglobina glicada ; Apnea-hypoapnea index; Circadian; Glycated hemoglobin ; Sleep apnea, a condition that modifies sleep and circadian rhythms, is highly prevalent in patients with diabetes. However, it is not known if there is an association between sleep apnea, circadian alterations and glycemic regulation in this type of patient. Here, a polysomnographic study was carried out on 21 women and 25 men (mean age = 64.3 ± 1.46 years) with diagnoses of type 2 diabetes to detect the presence of sleep apnea. Moreover, patients wore an actigraph and a temperature sensor on the wrist for one week, to study the manifestation of the circadian rhythms. The correlations of circadian and polysomnographic variables with the severity of apnea, measured by the apnea-hypopnea index, and with glycemic dysregulation, measured by the percentage of glycated hemoglobin, were analyzed. The mean apnea-hypoapnea index of all the participants was 39.6 ± 4.3. Apnea-hypoapnea index correlated with % N1, negatively with % N3, and also the stability of the active circadian rhythm. However, no significant correlation was found between the apnea-hypopnea index and wrist temperature rhythm and glycated hemoglobin. Glycated hemoglobin levels were negatively associated with the percentage of variance explained by the wrist temperature circadian rhythm (calculated via 24 and 12 h rhythms). This association was independent of body mass index and was strongest in patients with severe apnea. In conclusion, patients with diabetes showed altered circadian rhythms associated with a poor glycemic control and this association could partially be related to the coexistence of sleep apnea. ; This research was supported by grants from de Instituto de Salud Carlos III ISCIII (Fondo de Investigación Sanitaria PI12/00803 and PI15/00260). European Union (European Regional Development Fund. Fondo Europeo de Desarrollo Regional. FEDER. "Una manera de hacer Europa"). CIBER de Diabetes y Enfermedades Metabólicas Asociadas and CIBER de Enfermedades Respiratorias are initiatives of the Instituto de Salud Carlos III.

<i>Aim:</i> To evaluate the effectiveness of pregabalin as a tapering therapy on the subjective sleep quality of patients who underwent a benzodiazepine withdrawal program in routine medical practice. <i>Methods:</i> Secondary analysis of a 12-week prospective, open noncontrolled study carried out in patients who met DSM-IV-TR criteria for benzodiazepine dependence. Sleep was evaluated with the Medical Outcomes Study Sleep Scale (MOS Sleep Scale). <i>Results:</i> 282 patients were included in the analysis. Mean (±SD) pregabalin dose was 315 ± 166 mg/day at the end of the trial. We observed a significant and clinically relevant improvement in sleep outcomes at the endpoint, with a total score reduction from 55.8 ± 18.9 to 25.1 ± 18.0 at week 12 (i.e. a 55% reduction). Similar findings were apparent using the six dimensions of the MOS Sleep Scale. Moderate correlations were observed between the MOS Sleep summary index and sleep domains, and there were improvements in anxiety symptoms and disease severity. <i>Conclusions:</i> These findings suggest that pregabalin may improve subjective sleep quality in patients who underwent a benzodiazepine withdrawal program. This effect appears to be partly independent of improvements in symptoms of anxiety or withdrawal. However, controlled studies are needed to establish the magnitude of the effect of pregabalin.

Abstract

Background
The number of inpatients with alcohol and other substance-related problems (ASRP) in the general hospital population at any time is vast. To meet the needs of those patients, most hospitals have an Addiction Liaison Team (ALT) that diagnoses and initiates the treatment of the addictive disorder. In our hospital, this team is part of a more extensive and intensive Outpatient Alcoholism Treatment Programme that facilitates the continuity of care.


Aim
the main goal of this study is to evaluate the performance and effectiveness of our inpatient ALT.


Methodology
we carried out an observational cohort study of patients with ASRP admitted to the hospital from 2015 to 2017. We evaluated the performance and effectiveness of our ALT: referrals to the programme, inpatients mortality, readmissions to hospital, hospital length of stay (LOS) and medical or surgical treatment adherence.


Results
out of 133,181 admissions, 17,387 (13.14%) were positive for ASRP, and 615 (3.54%) were referred to the ALT. Referred patients had less in-hospital mortality, shorter LOS and lower risk of readmissions during the first year of follow-up. Subjects treated in the programme had better therapeutic adherence.


Conclusions
integrating the ALT into an outpatient programme facilitates an earlier detection and initiation of treatment during the hospital stay and the continuity of care. Alcohol misuse conditions affect the patient's prognosis and health outcomes, so appropriate care is needed. Inclusion in the programme was associated with less risk of hospital mortality, fewer readmissions and a lower LOS.