Evolución de los síntomas del TDAH y problemas asociados: efectos del tratamiento farmacológico

Introducción. El objetivo de esta investigación fue analizar los efectos del tratamiento con psicoestimulantes sobre la severidad de los síntomas de TDAH y problemas asociados. Método. 65 niños con TDAH fueron clasificados de acuerdo con su historial de medicación en tres grupos: Grupo-1: TDAH-MP (medicación prolongada; N=23), con medicación al menos durante tres años; Grupo-2: TDAH-MB (medicación breve; N=20), con medicación menos de tres años y Grupo-3: TDAH-SM (sin medicación; N=22). En la fase-1 y en la fase-2 de seguimiento los padres cumplimentaron la escala de Conners. Resultados. Las manifestaciones de inatención, hiperactividad e impulsividad y los problemas de conducta en general disminuyeron en el seguimiento en comparación con la primera fase. La ansiedad fue la única variable que mostró un aumento significativo en el tiempo. Respecto a la medicación, en las variables relacionadas con síntomas del TDAH se observó la misma tendencia, mostrando el grupo TDAH-MP puntuaciones significativamente superiores al grupo TDAH-SM. No aparecieron efectos de interacción de Tiempo X Medicación. Conclusiones. Los resultados evidencian la necesidad de análisis más complejos para valorar la respuesta a largo plazo de los fármacos en el tratamiento del TDAH.Introduction. The aim of this research was to analyze the effects of psychostimulant treatment on the severity of ADHD symptoms and associated problems. Method. 65 children with ADHD were classified into three groups according to their medication history: Group-1: ADHD-MP (long-term medication, N=23), under medication for at least three years; Group-2: ADHD-MB (short medication, N=20), under medication for less than three years and Group-3: ADHD-SM (without medication, N=22). In time 1 and time 2 (follow-up) parents filled out the Conners rating scale. Results. Generally, inattention, hyperactivity and impulsivity symptoms and behavioral problems decreased in the follow-up. Anxiety was the only variable that showed a significant increase over time. Moreover, the ADHD-MP group showed significantly higher scores than ADHD-SM group on variables related to ADHD symptoms. There were no interaction effects of Time x Medication. Conclusions. The results suggest the need for more complex analysis to assess the long-term response to medication in the treatment of ADHD

Analysis of personal and family factors in the persistence of attention deficit hyperactivity disorder: results of a prospective follow-up study in childhood

Objectives To study the course of ADHD during childhood and analyze possible personal and family predictor variables of the results. Method Sixty-one children with ADHD who were between 6 and 12 years old at the baseline assessment were evaluated 30 months later (mean age at baseline: 8.70 ± 1.97; mean age at follow-up: 10.98 ± 2.19). Status of ADHD in follow-up was identified as persistent (met DSM-IV-TR criteria according to parents’ and teachers’ ratings), contextually persistent (met ADHD criteria according to one informant, and there was functional impairment) and remitted ADHD (with subthreshold clinical symptomatology). Associated psychological disorders of the three groups were analyzed in the follow-up with the Conners' Rating Scales. The groups were compared on ADHD characteristics (symptoms of ADHD and impairment), child psychopathology, executive functioning (EF; inhibition, working memory) and parenting characteristics (parental stress and discipline styles) at baseline. Results At the follow-up, 55.7% of the children continued to meet the DSM-IV-TR criteria for ADHD, 29.5% showed contextual persistence, and 14.8% presented remission of the disorder. The persistent and contextually persistent ADHD groups showed more associated psychological disorders. Inattention, oppositional problems, cognitive problems and impairment at baseline distinguished the remitted ADHD children from the persistent and contextually persistent ADHD children. Moreover, the persistent groups had significantly more emotional liability and higher parental stress than the group in remission, while no differences in EF where found among the groups. Conclusions ADHD children continue to present symptoms, as well as comorbid psychological problems, during adolescence and early adulthood. These findings confirm that persistence of ADHD is associated with child psychopathology, parental stress and impairment in childhood.MICINN (Ministerio de Educacion y Ciencia, Spain) EDU2009-0767

Evolución de los síntomas del TDAH y problemas asociados: efectos del tratamiento farmacológico

Introducción. El objetivo de esta investigación fue analizar los efectos del tratamiento con psicoestimulantes sobre la severidad de los síntomas de TDAH y problemas asociados. Método. 65 niños con TDAH fueron clasificados de acuerdo con su historial de medicación en tres grupos: Grupo-1: TDAH-MP (medicación prolongada; N=23), con medicación al menos durante tres años; Grupo-2: TDAH-MB (medicación breve; N=20), con medicación menos de tres años y Grupo-3: TDAH-SM (sin medicación; N=22). En la fase-1 y en la fase-2 de seguimiento los padres cumplimentaron la escala de Conners. Resultados. Las manifestaciones de inatención, hiperactividad e impulsividad y los problemas de conducta en general disminuyeron en el seguimiento en comparación con la primera fase. La ansiedad fue la única variable que mostró un aumento significativo en el tiempo. Respecto a la medicación, en las variables relacionadas con síntomas del TDAH se observó la misma tendencia, mostrando el grupo TDAH-MP puntuaciones significativamente superiores al grupo TDAH-SM. No aparecieron efectos de interacción de Tiempo X Medicación. Conclusiones. Los resultados evidencian la necesidad de análisis más complejos para valorar la respuesta a largo plazo de los fármacos en el tratamiento del TDAH.Introduction. The aim of this research was to analyze the effects of psychostimulant treatment on the severity of ADHD symptoms and associated problems. Method. 65 children with ADHD were classified into three groups according to their medication history: Group-1: ADHD-MP (long-term medication, N=23), under medication for at least three years; Group-2: ADHD-MB (short medication, N=20), under medication for less than three years and Group-3: ADHD-SM (without medication, N=22). In time 1 and time 2 (follow-up) parents filled out the Conners rating scale. Results. Generally, inattention, hyperactivity and impulsivity symptoms and behavioral problems decreased in the follow-up. Anxiety was the only variable that showed a significant increase over time. Moreover, the ADHD-MP group showed significantly higher scores than ADHD-SM group on variables related to ADHD symptoms. There were no interaction effects of Time x Medication. Conclusions. The results suggest the need for more complex analysis to assess the long-term response to medication in the treatment of ADHD

Identintifying anaerobic digestion models using simultaneous batch experiments

Postprint (published version

Extrauterine Growth Restriction in Very Low Birth Weight Infants: Concordance Between Fenton 2013 and INTERGROWTH-21st Growth Charts

Postnatal growth restriction has high prevalence in very low birth weight (VLBW) preterm neonates, and this could affect their long-term prognosis. Nowadays, there is no consensus on how to monitor growth in these neonates.Objective: This study aimed to compare prevalence of intra- and extrauterine growth restriction (IUGR and EUGR) in a sample of VLBW infants according to the Fenton 2013 charts and INTERGROWTH-21st (IW-21) standards and to analyze concordance between both in the different EUGR definitions criteria (cross-sectional, dynamic, and true).Patients and Methods: An observational retrospective study of 635 VLBW preterm was performed. The study was carried out in Central University Hospital of Asturias. Body measurements (weight, length, and head circumference) were collected at birth and at hospital discharge and expressed in z-scores for the two references (Fenton 2010 and IW-21). Kappa concordance was calculated.Results: Kappa concordance between Fenton and IW-21 was 0.887 for IUGR and 0.580 for static EUGR. Prevalence was higher according to Fenton in IUGR (36.5 vs. 35.1%), in static EUGR (73.8 vs. 59.3%), and in dynamic EUGR (44.3 vs. 29.3%). Despite observing low prevalence of EUGR when IW-21 was used to define EUGR, a statistical association between neonatal morbidity and diagnosis of EUGR was observed.Conclusion: The Fenton and IW-21 concordance for IUGR is good. IW-21 is more restrictive than Fenton in EUGR. Patients diagnosed by IW-21 as EUGR are more likely to have neonatal morbidity, especially if we use EUGR dynamic definition. In our study, we cannot conclude that one graph is better than the other

Psychometric properties of the d2 selective attention test in a sample of premature and born-at-term babies

Se analizan las propiedades ricas del test de atención selectiva «d2» en dos grupos de niños: prematuros (n= 63) y nacidos a término (n=78). Los coeficientes de fiabilidad, calculados por métodos de consistencia interna, se han situado en valores en torno a 0,90. El análisis de componentes principales ha mostrado una estructura de tres factores explicando el 58% de la varianza, coincidiendo con el número de factores presentados en el manual de la adaptación española de la prueba pero no en cuanto a la composición de los mismos. Se concluye que la prueba d2 tiene un comportamiento psicométricamente adecuado tanto para el grupo global como para cada una de las submuestras empleadas

Evaluation of procalcitonin for diagnosis of neonatal sepsis of vertical transmission

BACKGROUND: The results of recent studies suggest the usefulness of PCT for early diagnosis of neonatal sepsis, with varying results. The aim of this prospective multicenter study was to determine the behavior of serum PCT concentrations in both uninfected and infected neonates, and to assess the value of this marker for diagnosis of neonatal sepsis of vertical transmission. METHODS: PCT was measured in 827 blood samples collected prospectively from 317 neonates admitted to 13 acute-care teaching hospitals in Spain over one year. Serum PCT concentrations were determined by a specific immunoluminometric assay. The diagnostic efficacy of PCT at birth and within 12–24 h and 36–48 h of life was evaluated calculating the sensitivity, specificity, and likelihood ratio of positive and negative results. RESULTS: 169 asymptomatic newborns and 148 symptomatic newborns (confirmed vertical sepsis: 31, vertical clinical sepsis: 38, non-infectious diseases: 79) were studied. In asymptomatic neonates, PCT values at 12–24 h were significantly higher than at birth and at 36–48 h of life. Resuscitation at birth and chorioamnionitis were independently associated to PCT values. Neonates with confirmed vertical sepsis showed significantly higher PCT values than those with clinical sepsis. PCT thresholds for the diagnosis of sepsis were 0.55 ng/mL at birth (sensitivity 75.4%, specificity 72.3%); 4.7 ng/mL within 12–24 h of life (sensitivity 73.8%, specificity 80.8%); and 1.7 ng/mL within 36–48 h of life (sensitivity 77.6%, specificity 79.2%). CONCLUSION: Serum PCT was moderately useful for the detection of sepsis of vertical transmission, and its reliability as a maker of bacterial infection requires specific cutoff values for each evaluation point over the first 48 h of life

Procalcitonin is not sufficiently reliable to be the sole marker of neonatal sepsis of nosocomial origin

BACKGROUND: It has recently been suggested that serum procalcitonin (PCT) is of value in the diagnosis of neonatal sepsis, with varying results. The aim of this prospective multicenter study was to assess the usefulness of PCT as a marker of neonatal sepsis of nosocomial origin. METHODS: One hundred infants aged between 4 and 28 days of life admitted to the Neonatology Services of 13 acute-care teaching hospitals in Spain over 1-year with clinical suspicion of neonatal sepsis of nosocomial origin were included in the study. Serum PCT concentrations were determined by a specific immunoluminometric assay. The reliability of PCT for the diagnosis of nosocomial neonatal sepsis at the time of suspicion of infection and at 12–24 h and 36–48 h after the onset of symptoms was calculated by receiver-operating characteristics (ROC) curves. The Youden's index (sensitivity + specificity - 1) was used for determination of optimal cutoff values of the diagnostic tests in the different postnatal periods. Sensitivity, specificity, and the likelihood ratio of a positive and negative result with the 95% confidence interval (CI) were calculated. RESULTS: The diagnosis of nosocomial sepsis was confirmed in 61 neonates. Serum PCT concentrations were significantly higher at initial suspicion and at 12–24 h and 36–48 h after the onset of symptoms in neonates with confirmed sepsis than in neonates with clinically suspected but not confirmed sepsis. Optimal PCT thresholds according to ROC curves were 0.59 ng/mL at the time of suspicion of sepsis (sensitivity 81.4%, specificity 80.6%); 1.34 ng/mL within 12–24 h of birth (sensitivity 73.7%, specificity 80.6%), and 0.69 ng/mL within 36–48 h of birth (sensitivity 86.5%, specificity 72.7%). CONCLUSION: Serum PCT concentrations showed a moderate diagnostic reliability for the detection of nosocomial neonatal sepsis from the time of suspicion of infection. PCT is not sufficiently reliable to be the sole marker of sepsis, but would be useful as part of a full sepsis evaluation

Les col·leccions de mineralogia de la UB. Una eina d'aprenentatge i de participació dels estudiants

Les col·leccions de Mineralogia de la Universitat de Barcelona poden ser de litoteca (emprades en l'ensenyament presencial i no presencial) i sistemàtica (usades com a material de referència de recerca). Comprenen mostres de mà, làmines primes i probetes. Les col leccions de referència son controlades per estudiants, els quals comproven la identitat del mineral i en fan la catalogació. Així s'introdueix els estudiants en les tècniques de caracterització i en les tècniques de musealització