Tratamiento actual del trastorno por déficit de atención e hiperactividad (TDAH)

El tratamiento del trastorno por déficit de atención e hiperactividad (TDAH) incluye intervenciones farmacológicas, psicosociales y educativas, y en él se aconseja un diseño personalizado teniendo en cuenta las características del paciente, el tipo de trastorno y la comorbilidad que lo acompaña. Los fármacos de primera línea son el psicoestimulante metilfenidato (MTF) y atomoxetina (ATX), un simpaticomimético de acción central no estimulante. Ambos reducen las manifestaciones clínicas de inquietud, inatención e impulsividad, mejorando la calidad de las relaciones sociales y el rendimiento académico. Metilfenidato bloquea el transportador presináptico de dopamina (DA) y noradrenalina (NA), aumentando la concentración de estos neurotransmisores en el espacio presináptico neuronal. Se presenta en formas de liberación inmediata (LI) (Rubifen® y Medicebran® en preparados de acción prolongada con tecnología OROS® [osmotic controlled-release oral delivery system], Concerta® y Metilfenidato Sandoz®) y en pellets (Medikinet®), que permiten seleccionar adecuadamente la dosis y la pauta posológica. Las formas de LI pueden inducir efecto rebote al provocar un pico plasmático elevado que decae en poco tiempo. Atomoxetina (Strattera®) es un inhibidor muy selectivo y potente del transportador presináptico de NA; aumenta los niveles de NA y DA en la corteza prefrontal, pero no en las regiones corticales relacionadas con el desarrollo de tics o riesgo de abusos de sustancias. Puede ser la alternativa a MTF cuando éste pierde eficacia o está contraindicado. La efectividad de ambos fármacos debe considerarse a partir de las 2-4 semanas. Sus reacciones adversas son numerosas y con frecuencia causan malestar, lo que dificulta la adherencia. Por ello es necesario el seguimiento de estos pacientes, y el farmacéutico puede ejercer un papel destacado para mejorar el cumplimiento y los efectos de la farmacoterapia

Tratamiento actual del trastorno por déficit de atención e hiperactividad (TDAH)

El tratamiento del trastorno por déficit de atención e hiperactividad (TDAH) incluye intervenciones farmacológicas, psicosociales y educativas, y en él se aconseja un diseño personalizado teniendo en cuenta las características del paciente, el tipo de trastorno y la comorbilidad que lo acompaña. Los fármacos de primera línea son el psicoestimulante metilfenidato (MTF) y atomoxetina (ATX), un simpaticomimético de acción central no estimulante. Ambos reducen las manifestaciones clínicas de inquietud, inatención e impulsividad, mejorando la calidad de las relaciones sociales y el rendimiento académico. Metilfenidato bloquea el transportador presináptico de dopamina (DA) y noradrenalina (NA), aumentando la concentración de estos neurotransmisores en el espacio presináptico neuronal. Se presenta en formas de liberación inmediata (LI) (Rubifen® y Medicebran® en preparados de acción prolongada con tecnología OROS® [osmotic controlled-release oral delivery system], Concerta® y Metilfenidato Sandoz®) y en pellets (Medikinet®), que permiten seleccionar adecuadamente la dosis y la pauta posológica. Las formas de LI pueden inducir efecto rebote al provocar un pico plasmático elevado que decae en poco tiempo. Atomoxetina (Strattera®) es un inhibidor muy selectivo y potente del transportador presináptico de NA; aumenta los niveles de NA y DA en la corteza prefrontal, pero no en las regiones corticales relacionadas con el desarrollo de tics o riesgo de abusos de sustancias. Puede ser la alternativa a MTF cuando éste pierde eficacia o está contraindicado. La efectividad de ambos fármacos debe considerarse a partir de las 2-4 semanas. Sus reacciones adversas son numerosas y con frecuencia causan malestar, lo que dificulta la adherencia. Por ello es necesario el seguimiento de estos pacientes, y el farmacéutico puede ejercer un papel destacado para mejorar el cumplimiento y los efectos de la farmacoterapia

Evaluation of live microalgal diets for the seed culture of Ruditapes decussatus using physiological and biochemical parameters

13 páginas, 3 figuras, 3 tablasThe nutritional quality of several microalgal diets used in the seed culture of the little-neck clam, Rudifupes decussatus, was evaluated in the present study. The live diets tested were Isochrysis galbana, clone T-ISO, Tetraselmis suecica and Phaeodactylum tricornutum. Criteria used in the evaluation of the diets were acceptability, digestibility, growth and biochemical composition. The highest growth rate was registered in the seed fed the T. suecicu diet, followed by the seed fed I. galbana, while the lowest one was obtained in the seed fed P. tricornutum. Food ingestion rates were higher in the seed fed Tetruselmis. This fact would partly explain the higher growth observed with this diet. The limited nutritional value of Phaeodactylum could be related to the low digestibility of its cell wall, the degree of acceptability of this diet being similar to or even higher than that of the other two. The low protein content of Tetraselmis seems to indicate that R. decussatus shows a low requirement for proteins, which can be spared by carbohydrate, an abundant component in the cells of Tetraselmis. Lipid needs of this bivalve also seem to be rather low.This study has been financed by CICYT-CSIC-IEO I + D project MAR90-0812-C02-01.Peer reviewe

Fatty acid composition of Ruditapes decussatus spat fed on different microalgae diets

7 páginas, 3 tablasThe fatty acid composition of the Ruditages d.ecussatw spat fed on three different microalgal diets during 4 weeks was determined. The fatty acid pattern of each diet was also analysed. The diets used were Zsochrysk galbana, clone T-ISO, Tetraselmis suecica, and Phaeodactylum tricornutum. The fatty acid composition of the spat was usually well correlated with that of the diet supplied. Major differences among spat cultures were found in 14:0, 16:0, 16:ln-9, 16:ln-7, 18:ln-9, 18:2n-6, 18:3x1-3, 18:4n-3, 20:5n-3, 22:5n-6 and 22: 6n-3 fatty acids. These differences were correlated with the particular fatty acid content of each diet supplied. It has been shown that R. decussatus spat have a very low capacity to elongate and desaturate linolenic acid to n-3 PUFA, so when 20: Sn-3 or 22:6n-3 were not present in the diet, they were also absent, at least in measurable amounts, in the clams. The absence of any of the “essential” fatty acids, 20 : Sn-3 in T-IS0 or 22 : 6n-3 in Tetmselmis, did not limit spat growth, so their role as “essential” fatty acids might be a matter for discussion. Finally, the nutritive value of each diet was discussed in terms of its fatty acid composition.This study was funded by CICYT-CSIC-IEO project I + D number MAR90-082 1 X02-01.Peer reviewe

Fatty acid composition of Venerupis pullastra spat fed on different microalgae diets

10 páginas, 3 tablasVenerupis pullastra spat were fed for 4 weeks on diets consisting of two species of algae which were supplied in single or mixed diets. The microalgal species tested were hochrysis aff. galbana T-ISO and Tetraselmis suecica. The fatty acid pattern of the spat was basically dependent on the diet supplied. Major differences between spat cultures were detected on 14:0, 16:1n—7, 18:0, 18:1n—9, 18:3n-3, 18:4n—3, 20:5n—3 and 22:6n—3 fatty acids. These differences were correlated to those fatty acid contents in the diets supplied, with the exception of the 18:4n —3 fatty acid. This acid was not detected in the Tetraselmis diet but appeared, however, in the spat fed on this microalga. This fatty acid could be obtained from linolenic acid which was present in the Tetraselmis lipids in a high proportion. Special attention was given to the essential fatty acids, 20:5n — 3 and 22:6n — 3. While I. galbana T-ISO cells contain both fatty acids, although 20:5n — 3 in a very low proportion, T. suecica is deficient in 22:6n — 3. Similarly, the T. suecica fed spat is also deficient in 22:6n — 3. Spat fed on the mixed diet shows a fatty acid profile halfway between the two algal species. The absence of 22:6n — 3 in Tetraselmis cells may explain the lower growth rate obtained with this diet.This work was funded by CICYT-CSIC-IEO project I+D number MAR90-0821-CO2-01Peer reviewe

Nutritional value of algal diets to clam spat Venerupis pullastra

9 pages, 8 figures, 7 tables.Clam spat Venerupis pdlastra were fed for 4 wk on diets of 2 species of microalgae supplied singly or mixed. Microalgae were Isochrysis galbana and Tetraselmis suecica. species normaliy used in bivalve hatcheries. Observed growth responses were high for mixed and I. galbana diets and intermediate for the T suecica diet. A slightly higher growth rate was obtained with the mixed diet than with the I. galbana diet. Differences in growth rate were explained by differences in rates of ingestion and digestibility and in the biochemical composition of diets. The intermediate growth rate for spat fed on T. suecica was related to lower ingestion rates, lower assimilation efficiencies and lower dietary protein and lipid content. Spat biochemical composition was correlated with growth indices. Lower growth indices were related to lower protein and higher lipid content of spat. The high growth response to the mixed diet was not explained by the factors considered.This work was funded bv CICYT-CSIC-IEO project I+D number MAR90-0821-C02-01.Peer reviewe

Virological outcome among HIV infected patients transferred from pediatric care to adult units in Madrid, Spain (1997–2017)

The aim of this transversal study was to describe the virological and immunological features of HIV-infected youths transferred from pediatric to adult care units since 1997 vs. the non-transferred patients from the Madrid Cohort of HIV-infected children and adolescents in Spain. We included 106 non-transferred and 184 transferred patients under clinical follow-up in 17 public hospitals in Madrid by the end of December 2017. Virological and immunological outcomes were compared in transferred vs. non-transferred patients. ART drug resistance mutations and HIV-variants were analyzed in all subjects with available resistance pol genotypes and/or genotypic resistance profiles. Among the study cohort, 133 (72.3%) of 184 transferred and 75 (70.7%) of 106 non-transferred patients had available resistance genotypes. Most (88.9%) of transferred had ART experience at sampling. A third (33.3%) had had a triple-class experience. Acquired drug resistance (ADR) prevalence was significantly higher in pretreated transferred than non-transferred patients (71.8% vs. 44%; p = 0.0009), mainly to NRTI (72.8% vs. 31.1%; p < 0.0001) and PI (29.1% vs. 12%; p = 0.0262). HIV-1 non-B variants were less frequent in transferred vs. non-transferred (6.9% vs. 32%; p < 0.0001). In conclusion, the frequent resistant genotypes found in transferred youths justifies the reinforcement of HIV resistance monitoring after the transition to avoid future therapeutic failures