Abandonos terapéuticos registrados en el ámbito de la hiperactividad y los trastornos del comportamiento: Influencia de variables individuales y familiares

Se analiza la influencia del trastorno infantil (trastorno por déficit de atención con hiperactividad y trastorno negativista desafiante), los métodos de manejo conductual adoptados por los padres y su estado de salud en la continuidad o abandono terapéutico por parte de los niños previamente diagnosticados. En el estudio han participado 62 niños (5-12 años). Tras el diagnóstico, el registro de la asistencia/ausencia de los pacientes a las sesiones de tratamiento programadas permitió diferenciar tres grupos: a) niños que rehusaron la terapia recomendada, b) menores que, tras varias sesiones, interrumpieron el tratamiento y c) pacientes que finalizaron el programa de intervención. Los resultados muestran influencia significativa del trastorno diagnosticado y los métodos de manejo conductual adoptados por los padres en los abandonos terapéuticos, cuya tasa se estima en el 37% de los casos, similar a los hallazgos de las investigaciones sobre el tema.Throughout this work we are going to analyze the influence of the infantile disorder (deficit attention-hyperactivity disorder and oppositional defiant disorder), the methods of behavior management used by the parents and their condition in the continuity or therapeutic drop-out on the part of the children previously diagnosed. 62 children have participated (5-12 years) in this study. After the diagnosis, the register of the presence/absence of patients to the programmed sessíons of treatment allowed us to differentiate three groups: a) children who refused the recommended therapy, b) children who, after several sessions, interrupted the treatment and c) patients who ended up the intervention program. The results show the significant influence of the diagnosed disorder and the methods of behavioural management adopted by the parents in the therapeutic drop-outs, whose rate is estimated in 37% of the cases, similar to the results of published investigations on the subject

Perfil social de los subtipos del Trastrono por Déficit de Atención con Hiperactividad

Este estudio analiza la relación existente entre el trastorno por déficit de atención con hiperactividad y distintos perfiles sociales, tanto a nivel descriptivo como predictivo. Para ello, se han evaluado a 150 alumnos (10-16 años) y 14 profesores, seleccionados aleatoriamente de 14 centros escolares. Los resultados obtenidos han puesto de manifiesto que los niños con sintomatología hiperactiva difieren de los alumnos controles en todas las variables de socialización, excepto en ansiedad social y timidez. El autocontrol social constituye la principal variable implicada en la disminución de la sintomatología hiperactiva. Asimismo, negativismo y retraimiento social acentúan los síntomas hiperactivos en los subtipos TDAH diferenciados (Subtipo déficit atencional y Subtipo combinado. Por último, el grupo con sintomatología combinada muestra comparativamente un perfil de socialización más desajustado, con elevado negativismo y escasa consideración hacia los demás.This study analyzes the existing relation between attention-deficit hyperactivity disorder and different social profiles, as much at descriptive level as predictive. For it, 150 students (10-16 years) and 14 professors, selected randomly of 14 scholastic centers have evaluated themselves to. The obtained results have shown that the children with hyperactive symptoms differ from the students controls in all the variables of socialization, except in social anxiety and timidity. The social self-control constitutes the main variable implied in the diminution of the hyperactive symptoms. Also, oppositional and social retirement accentuate the hyperactive symptoms in differentiated ADHD subtypes (attention-deficit and combined Subtype). Finally, the group with combined symptoms shows a misadjusted profile of socialization comparatively more, with high and little consideration with the others

Negativismo, ansiedad y retraimiento social como predictores de la sintomatología del déficit de atención con hiperactividad

Se analiza la capacidad predictora de la ansiedad, la socialización, la autoestima y el negativismo respecto a los déficit de atención e hiperactividad, considerando en primer lugar, población normal y, posteriormente, individuos con sospecha de déficit de atención con hiperactividad (TDAH). Han participado 259 niños (M=13,05; DT=1,92) y 241 niñas (M=12,90; DT=2,04). Se han diferenciado dos grupos a partir de la información aportada por los profesores a través de la “Escala para la evaluación del TDAH” (ADHD Rating Scale-IV; DuPaul, Power, Anastopoulos y Reid, 1998). Los resultados muestran índices de varianza explicada entre el 33,5%, F(6, 349)= 30,854; p= 0,008, de la puntuación en inatención y el 45,2%, F(3,102)= 29,901; p= 0,008, en sintomatología combinada. Destacan síntomas de negativismo, ansiedad estado y retraimiento social, como las variables más relevantes con tendencia a incrementar las puntuaciones en inatención e impulsividad. La autoestima escolar y consideración con los demás resultan las principales variables moderadoras de la sintomatología hiperactiva.Predictive ability of anxiety, socialization, self-esteem and negativism for attentional deficiencies and hyperactivity was analyzed, considering firstly a normal population and then individuals with suspected attentiondeficit/ hyperactivity disorder (ADHD). 259 children (M= 13.05, SD= 1.92) and 241 girls (M= 12.90, SD= 2.04) have participated in this study. Two groups have been differentiated from the information provided by teachers through the ADHD Rating Scale-IV (DuPaul, Power, Anastopoulos y Reid, 1998). The results show variance explained rates between 33.5%, F(6, 349)= 30.854, p= 008, inattention score and 45.2%, F(3,102)= 29.901, p= .008, combined symptoms. Symptoms of negativism, state anxiety and social withdrawal stand out, as the most relevant variables that tend to increase scores on inattention and impulsivity. The school esteem and consideration to others are the main moderating variables of overactive symptoms

Multi-modal intervention in a case of child’s hyperactivity: content, results and troubles with treatment

En este artículo se describe el tratamiento aplicado a un niño de siete años con diagnóstico de hiperactividad y déficit de atención. La intervención se ha desarrollado mediante un programa multimodal destinado al propio paciente, sus padres y su profesora. El niño ha sido tratado mediante autoinstrucciones y solución de problemas. Los adultos han recibido entrenamiento para aplicar las técnicas operantes y asegurar la consolidación de la mejora del paciente en casa y en el colegio. Los resultados obtenidos muestran, respecto al niño, un aumento en la capacidad de autocontrol, atención y mejoras en el rendi - miento académico. Como conclusión, destacar la efectividad del entre n a - miento cognitivo mediatizado por la estabilidad y equilibrio del ambiente fami - liar.This paper describes the treatment used with a seven-year-old child diag - nosed with hyperactive and attention deficit disorder. The intervention consis - ted of a multi-modal program for the child, his parents and his teacher. The child received training in self-instructions and problem solving skills; the adults received instructions in the administration of operant techniques in order to consolidate the improvements of the patient both at home and at school. The results showed an increase in the child’s capacity for self-control, attention, and academic achievement. To conclude, we could emphasise the effective ness of the cognitive training, mediated by the stability and balance of his family environment

Validez de la evaluación electroencefalográfica en la identificación del Trastorno por Déficit de Atención con Hiperactividad

Referencia de la publicación original: Moreno García, I., Lora Muñoz, J.A. y Sánchez Blanco, J. (2011). Validez de la evaluación electroencefalográfica en la identificación del Trastorno por Déficit de Atención con Hiperactividad. Apuntes de Psicología, 29 (2), 227-242.En este trabajo se analiza la validez del EEG como prueba añadida en el diagnóstico del TDAH así como de la SNAP-IV, instrumento empleado con frecuencia en atención primaria para la detección de este trastorno. Han participado 108 niños con edades comprendidas entre 7 y 14 años, derivados por presentar sintomatología hiperactiva– atencional. La validez del EEG se ha estimado a partir de la ratio theta/beta y considerando las variables tarea realizada (mirar un punto fijo, leer, escuchar y dibujar) mientras se realizaba la evaluación y grupo de edad de los menores que han participado. Los resultados muestran índices de sensibilidad y especificidad entre el 70% y el 80%, con una eficacia en la clasificación real superior al 75%. La edad se establece como un criterio fundamental tanto a la hora de seleccionar la ratio theta/beta más adecuada, como las tareas a emplear durante la evaluación. Estos datos avalan la utilidad del EEG en el diagnóstico del TDAH.This paper examines the validity of the EEG as an additional diagnostic test of ADHD as well as the SNAP-IV, an instrument ofien used in primary care screening for this disorder. It has be en included a total of 108 children, aged between 7 and 14 years, with hyperactive–attention symptomatology. The validity of the EEG has been estimated from the ratio of theta / beta variables and considering the work done (look at a fixed point, reading, listening and drawing) while performing the evaluation and age group of children who participated. The results show sensitivity and specificity rates between 70% and 80%, with an efficacy in the real c1assification aboye 75%. The age is a fundamental criterion for selecting the adequate ratio theta/ beta and the tasks used during the evaluation.These data support the utility of EEG in the diagnosis of ADHD

Additional Physical Interventions to Conventional Physical Therapy in Parkinson’s Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Parkinson's disease (PD) represents the second most common neurodegenerative disease. Currently, conventional physical therapy is complemented by additional physical interventions with recreational components, improving different motor conditions in people with PD. This review aims to evaluate the effectiveness of additional physical interventions to conventional physical therapy in Parkinson's disease. A systematic review and meta-analysis of randomized controlled trials were performed. The literature search was conducted in PubMed, Physiotherapy Evidence Database (PEDro), Scopus, SciELO and Web of Science. The PEDro scale was used to evaluate the methodological quality of the studies. A total of 11 randomized controlled trials were included in this review. Five of them contributed information to the meta-analysis. The statistical analysis showed favorable results for dance-based therapy in motor balance: (Timed Up and Go: standardized mean difference (SMD) = −1.16; 95% Confidence Interval (CI):(−2.30 to −0.03); Berg Balance Scale: SMD = 4.05; 95%CI:(1.34 to 6.75)). Aquatic interventions showed favorable results in balance confidence (Activities-Specific Balance Confidence: SMD=10.10; 95%CI:(2.27 to 17.93)). The results obtained in this review highlight the potential benefit of dance-based therapy in functional balance for people with Parkinson's disease, recommending its incorporation in clinical practice. Nonetheless, many aspects require clarification through further research and high-quality studies on this subject

Pharmacological interactions of anti-microbial agents in odontology

In this third article we describe the pharmacological interactions resulting from the use of anti-microbial agents. Although the antimicrobials prescribed in odontology are generally safe they can produce interactions with other medicaments which can give rise to serious adverse reactions which are well documented in clinical studies. Antibiotics with grave and dangerous life threatening consequences are erythromycin, clarithromycin and metronidazol and the anti-fungal agents are ketoconazol and itraconazol. Regarding the capacity of the anti-microbials to reduce the efficacy of oral anti-contraceptives the clinical studies to date are inconclusive, however, it would be prudent for the oral cavity specialist to point out the risk of a possible interaction. Therefore the specialist should be aware of possible interactions as a consequence of administering an antibiotic together with other medicaments the patient may be taking

Pharmacological interactions of anti-inflammatory-analgesics in odontology

In this second article we describe the more interesting pharmacological interactions in dental practice based on the prescription of analgesic narcotics, paracetamol and non-selective non-steroid anti-inflammatory drugs (NSAI) (which inhibit cyclooxigenase 1 ?COX 1- and cyclooxigenase 2 ?COX 2-) and selective NSAIs (COX 2 inhibitors). The importance of preventing the appearance of these pharmacological interactions is because these are medicaments prescribed daily in odontology for moderate pain treatment and inflammation in the oral cavity. Paracetamol can interact with warfarin and therefore care should be taken with chronic alcoholic patients. All NSAIs reduce renal blood flow and consequently are capable of reducing the efficacy of medicaments used for treating arterial hypertension, which act via a renal mechanism. Especial attention should be taken considering the risk of interaction between the antagonists of AT1 receptors of angiostensin II (ARAII) and the NSAIs