Calidad de vida en el trastorno por déficit de atención con hiperactividad: disfunción ejecutiva y comorbilidad

El Trastorno por Déficit de Atención e Hiperactividad (TDAH) es uno de los trastornos neuropsiquiátricos más comunes de inicio en la infancia con persistencia en la edad adulta hasta en el 65 % de los casos, y que genera importantes alteraciones en las diferentes áreas vitales. Se estima una prevalencia entre el 2 y el 5 % en la edad adulta (1). El diagnóstico precoz y la presencia de comorbilidad predicen significativamente la disfunción asociada al trastorno y condicionan su maduración personal, y por ende su adaptación y personalidad adulta. La etiología del TDAH aunque actualmente no del todo conocida, se sustenta en un enfoque multifactorial, y se admite que, a la alta heredabilidad (75 %), hay que añadirle una desregulación neurobiológica modulada por factores ambientales. Los criterios diagnósticos del TDAH fueron diseñados desde una perspectiva propia de la psiquiatría infantil (2) y por tanto no se basan en el estudio sistemático de adultos (3) y no es hasta la publicación del DSM-5 cuando se produce la adaptación de los criterios específicos para el adulto (4)..

Efectividad del índice de Brass en la planificación del alta por enfermeras gestoras de casos

Classifying patients according to complexity and frailty during hospitalization allows efficient planning of the scope of care required by the patient at discharge. The aim of this study was to measure the screening validity of the Blaylock Risk Assessment Screening Score and its effectiveness in discharge planning.Methods: We analyzed the variables hospital stay, destination at discharge, use of healthcare resources and mortality in 370 patients. Results: Analysis of the relationship between mortality and the BRASS-Sp index with regard to gender and number of days of stay yielded a hazard ratio of 1.73 (95% CI 1.22-2.46; p=0.002) for male gender and 2.08 (95% CI 1.43-3.04; p<0.001) for the BRASS-Sp score. Patients who continued in case management in Primary Care had a mean BRASS-Sp of 20.97 (standard deviation 6.11), while in the other patients the mean was 19.35 (standard deviation 5.60), p=0.02. Conclusions: The BRASS-Sp proved easy-to-use with verified content validity that is effective for screening hospitalized patients by case management nursesEstratificar a los pacientes en relación con la complejidad y fragilidad durante la hospitalización, nos permite planificar de manera más eficiente los cuidados y el ámbito de atención que precisa al alta. El objetivo de este trabajo es evaluar la efectividad de la traducción al español de índice de BRASS en la planificación del alta hospitalaria por enfermeras gestoras de casos de atención hospitalaria.Método: Se analizaron variables relacionadas con la estancia hospitalaria, destino al alta, utilización de recursos sanitarios y mortalidad en 370 pacientes.. Resultados: La edad media fue 72.6 años (DE 14.05), 191 (51.6%) eran mujeres. Cuando analizamos la relación entre mortalidad e índice de BRASS-Sp en relación al sexo y número de días de ingreso encontramos una HR=1.73 (95% CI de 1.22 a 2.46) con una p=0.002 para sexo masculino y una HR=2.08 (95% CI 1.43 a 3.04) con una p<0.001 para puntuación del índice de BRASS_Sp. Los pacientes que continuaron en gestión de casos en Atención Primaria obtuvieron una media del BRASS-Sp de 20.97 (DE 6.11) mientras que en los demás fue de 19.35 (DE 5.60), p=0.02. Conclusiones: La traducción al español del índice de BRASS se muestra como un instrumento fácil de usar y con validez de contenido y efectividad para cribado de pacientes hospitalizados por enfermeras gestoras de casos. &nbsp

Compuestos neurogénicos basados en melatonina y su uso en el tratamiento de enfermedades del sistema nervioso

La presente invención, que se incluye en el campo de la investigación e industria farmacéutica, se refiere a nuevas entidades químicas derivadas de melatonina con propiedades neurogénicas, moduladoras de los receptores de melatonina y/o serotonina, antioxidantes y/o colinérgicas. También se refiere a los procedimientos para la preparación de estos nuevos compuestos, a las composiciones farmacéuticas que los contienen y a su uso para la fabricación de un medicamento para el tratamiento de enfermedades del sistema nervioso relacionadas con degeneración neuronal, depresión, trastornos psiquiátricos y cognitivos, trauma o lesión celular, u otro trastorno neurológico relacionado, tratamiento de fatiga diurna, trastornos del sueño, pérdida de eficacia mental, debilidad e irritabilidad y síntomas relacionados con la descompensación horaria (efecto jet-lag o síndrome transoceánico).Peer reviewedConsejo Superior de Investigaciones Científicas, Universidad Autónoma de MadridB1 Patente sin examen previ

Pharmacological tools based on imidazole scaffold proved the utility of PDE10A inhibitors for Parkinson’s disease

[Aim]: Since neuroinflammation is partially mediated by cAMP levels and PDE10A enzyme is able to regulate these levels being highly expressed in striatum, its inhibitors emerged as useful drugs to mitigate this inflammatory process and hence the neuronal death associated with Parkinson’s disease (PD).[Methodology & results]: To study the utility of PDE10A as a pharmacological target for PD, in this work we propose the search and development of new PDE10A inhibitors that could be useful as pharmacological tools in models of the disease and presumably as potential drug candidates. By using different medicinal chemistry approaches we have discovered imidazole-like PDE10A inhibitors and showed their neuroprotective actions.[Conclusion]: Here, we demonstrate the neuroprotective effect of PDE10A inhibitors in cellular models of PD.Peer reviewe

Real Implication of Fertility-Sparing Surgery for Ovarian Cancer: Reproductive Outcomes

Background: to prove the effectivity of fertility-sparing procedures in early-stage ovarian cancer by assessing pregnancy rates and obstetrical outcomes. Methods: we performed a retrospective multicenter study among 55 Spanish hospitals, collecting patients from 18 to 40 years old with diagnosis of early-stage ovarian cancer, epithelial (EOC) or non-epithelial (non-EOC), from January 2010 to December 2019. Data on the use of assisted reproductive techniques, pregnancy attempts and obstetrical outcomes were collected. Results: a total of 150 patients met inclusion criteria, 70 (46.6%) EOC and 80 (53.4%) non-EOC. Pregnancy attempts were reported in 51 (34%) patients, with 42 (28%) patients carrying the pregnancy to term. Among them, 30 (71.4%) underwent surgery alone and 12 (28.6%) had additional postoperative chemotherapy. A total of 32 (76.1% patients) had spontaneous pregnancies and 10 (23.9%) required in vitro fertilization. There was only one (2.4%) complication reported. Vaginal delivery was reported in twenty-nine (69%) patients and cesarean section in five (11.9%) patients. Conclusions: fertility-sparing management for ovarian cancer seems to be an option with proven good pregnancy rates and low complications. The selection of patients must consider strict criteria in order to maintain a good prognosis

Health-related quality of life with palbociclib plus endocrine therapy versus capecitabine in postmenopausal patients with hormone receptor–positive metastatic breast cancer: Patient-reported outcomes in the PEARL study

Background: The PEARL study showed that palbociclib plus endocrine therapy (palbociclib/ET) was not superior to capecitabine in improving progression-free survival in postmenopausal patients with metastatic breast cancer resistant to aromatase inhibitors, but was better tolerated. This analysis compared patient-reported outcomes. Patients and methods: The PEARL quality of life (QoL) population comprised 537 patients, 268 randomised to palbociclib/ET (exemestane or fulvestrant) and 269 to capecitabine. Patients completed the European Organisation for Research and Treatment of Cancer QLQC30 and QLQ-BR23 and EQ-5D-3L questionnaires. Changes from the baseline and time to deterioration (TTD) were analysed using linear mixed-effect and stratified Cox regression models, respectively. Results: Questionnaire completion rate was high and similar between treatment arms. Significant differences were observed in the mean change in global health status (GHS)/QoL scores from the baseline to cycle 3 (2.9 for palbociclib/ET vs.-2.1 for capecitabine (95% confidence interval [CI], 1.4-8.6; P = 0.007). The median TTD in GHS/QoL was 8.3 months for palbociclib/ET versus 5.3 months for capecitabine (adjusted hazard ratio, 0.70; 95% CI, 0.55-0.89; P = 0.003). Similar improvements for palbociclib/ET were also seen for other scales as physical, role, cognitive, social functioning, fatigue, nausea/vomiting and appetite loss. No differences were observed between the treatment arms in change from the baseline in any item of the EQ-5D-L3 questionnaire as per the overall index score and visual analogue scale. Conclusion: Patients receiving palbociclib/ET experienced a significant delay in deterioration of GHS/QoL and several functional and symptom scales compared with capecitabine, providing additional evidence that palbociclib/ET is better tolerated. Trial registration number: NCT02028507 (ClinTrials.gov). EudraCT study number: 2013-003170-27. 2021 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Influx of kynurenine into the brain is involved in the reduction of ethanol consumption induced by Ro 61‐8048 after chronic intermittent ethanol in mice

Background and Purpose: The kynurenine pathway has been proposed as a target for modulating drug abuse. We previously demonstrated that inhibition of kynurenine 3-monooxygenase (KMO), using Ro 61-8048, reduces ethanol consumption in a binge drinking model. Here, we investigate the effect of the kynurenine pathway modulation in ethanol-dependent mice. Experimental Approach: Adult male and female mice were subjected to a Chronic Intermittent Ethanol (CIE) paradigm. On the last day of CIE, mice were treated with Ro 61-8048, Ro 61-8048 + PNU-120596, a positive allosteric modulator of α7nAChR, and Ro 61-8048 + L-leucine or probenecid, which blocks the influx or efflux of kynurenine from the brain, respectively. Ethanol, water consumption and preference were measured and kynurenine levels in plasma and limbic forebrain were determined. Key Results: Ro 61-8048 decreases consumption and preference for ethanol in both sexes exposed to the CIE model, an effect that was prevented by PNU-120596. The Ro 61-8048-induced decrease in ethanol consumption depends on the influx of kynurenine into the brain. Conclusion and Implications: Inhibition of KMO reduces ethanol consumption and preference in both male and female mice subjected to CIE model by a mechanism involving α7nAChR. Moreover, this centrally-mediated effect depends on the influx of peripheral kynurenine to the brain and can be prolonged by blocking the efflux of kynurenine from the brain. Here, for the first time, we demonstrate that the modulation of the kynurenine pathway is an effective strategy for the treatment of ethanol dependence in both sexe

Smart Solar Micro-exchangers for Sustainable Mobility of University Camps

Publicado el resumen en: https://www.wmcaus.org/files/WMCAUS2020_Book.pdf. Pendiente de publicación de las contribuciones en IOP Conference Series: Materials Science and Engineering.A significant number of universities have several campuses located in urban or rural settings, or with scattered university buildings that require the use of means of transportation. This implies the mobility and potential displacement of a large community of students, professors and researchers. The use of electric bicycles (e-bikes) is an intermediate alternative between the bicycle and electric cars. It can be an important stimulus for the promotion of the decarbonisation of the University Campus, avoiding the traffic congestion and reducing space requirements for parking. This paper presents the smart solar micro-exchanger model managed through a sustainable mobility web platform, applied to the case study of the University of Malaga (Spain). It is a solar charging station for e-bike, whose design is based on the principles of solar architecture (providing great security to e-bike). It managed by a web platform and app that allows the user to make reservations and learn about the savings in CO2 emissions. The system allows performing an aerobic sports activity without sweating problems when you reach the job. The platform also incorporates a database of quiet and safe routes for e-bike users.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tec

Primer molar permanente : Taller educativo con niños de 6 a 9 años

El primer molar permanente, juega un rol determinante en el desarrollo óseo facial, función masticatoria y patrones de oclusión. Es el primero de esta dentición en irrumpir en la cavidad bucal; conviviendo con la dentición temporaria; transformándola en mixta. La cronología de erupción, morfología oclusal compleja, el hecho de que no reemplaza a una pieza temporaria, así como la falta de calcificación hacen de ésta la pieza permanente más expuesta y con mayores posibilidades de contraer enfermedad. Como consecuencia, un alto porcentaje de niños entre los 6 y 9 años de edad presentan el primer molar afectado por caries.Categoría: Trabajos de extensión.Facultad de Odontologí

Primer molar permanente : Taller educativo con niños de 6 a 9 años

El primer molar permanente, juega un rol determinante en el desarrollo óseo facial, función masticatoria y patrones de oclusión. Es el primero de esta dentición en irrumpir en la cavidad bucal; conviviendo con la dentición temporaria; transformándola en mixta. La cronología de erupción, morfología oclusal compleja, el hecho de que no reemplaza a una pieza temporaria, así como la falta de calcificación hacen de ésta la pieza permanente más expuesta y con mayores posibilidades de contraer enfermedad. Como consecuencia, un alto porcentaje de niños entre los 6 y 9 años de edad presentan el primer molar afectado por caries.Categoría: Trabajos de extensión.Facultad de Odontologí