Trastorno por déficit de atención con hiperactividad y trastorno bipolar en gemelas dicigóticas. A propósito de un caso

Desde que Wozniak et al describieran una elevada incidencia de trastorno bipolar (16%) entre los niños y adolescentes diagnosticados de trastorno por déficit de atención con hiperactividad (TDAH) ha existido un interés creciente en el estudio y la descripción de ambas afecciones. Al mismo tiempo todavía hay cierta confusión (y posible desconocimiento por parte de los profesionales) a la hora de realizar un correcto diagnóstico diferencial. En este sentido, se ha tratado de esclarecer la relación entre ambas enfermedades, tanto desde el aspecto clínico como genético, como también se ha validado los diagnósticos y se ha tratado de definir los síntomas característicos. Presentamos el caso de dos hermanas gemelas dicigóticas que pone de manifiesto, por un lado, que ambas enfermedades están relacionadas y, por otro, la condición de heredabilidad del trastorno bipolar. Además, consideramos un hallazgo clínico destacable la clínica compatible con TDAH en una niña con síndrome de Turner.Since Wozniak et al reported a high prevalence rate (16%) of bipolar disorder (BP) among children and adolescents diagnosed with attention-deficithyperactivity-disorder (ADHD), interest in the study and description of both disorders has inreased. At the same time, there is some confusion (and possibly some lack of awareness among psychiatrists) surrounding correct differential diagnosis between these disorders. Attempts have been made to clarify the relationship (both clinical and genetic) between these two disorders. Equally, the diagnoses have been validated and the characteristic symptoms have been defined. We report the cases of two dizygotic twin sisters, which reveal the existence of the above-mentioned associations and the role of inheritability in BP. In addition, we believe that the presence of an ADHD in a child with Turner syndrome child is highly unusual

Accidental Contamination with Oil during Endodontic Surgery

The modern surgical endodontic treatment is a safe and predictable procedure with high success rate. However, several factors can retard or impede the proper healing process. Use of a high speed handpiece during hard tissues management (osteotomy and apical resection) can potentially be one of these factors. Formation of metallic debris from the surgical diamond burs, production of necrotic local tissue due to overheating and the direct liberation of air from conventional handpiece into the working area are potential irritants able to delay the tissue healing. The aim of the present article is to report the histopathological findings of the trans-operational accidental contamination with oil in the surgical area during an endodontic surgery.Keywords: Endodontic Surgery; Histopathological; Tissue Contaminatio

Trastorno por déficit de atención con hiperactividad y trastorno bipolar en gemelas dicigóticas. A propósito de un caso

Desde que Wozniak et al describieran una elevada incidencia de trastorno bipolar (16%) entre los niños y adolescentes diagnosticados de trastorno por déficit de atención con hiperactividad (TDAH) ha existido un interés creciente en el estudio y la descripción de ambas afecciones. Al mismo tiempo todavía hay cierta confusión (y posible desconocimiento por parte de los profesionales) a la hora de realizar un correcto diagnóstico diferencial. En este sentido, se ha tratado de esclarecer la relación entre ambas enfermedades, tanto desde el aspecto clínico como genético, como también se ha validado los diagnósticos y se ha tratado de definir los síntomas característicos. Presentamos el caso de dos hermanas gemelas dicigóticas que pone de manifiesto, por un lado, que ambas enfermedades están relacionadas y, por otro, la condición de heredabilidad del trastorno bipolar. Además, consideramos un hallazgo clínico destacable la clínica compatible con TDAH en una niña con síndrome de Turner.Since Wozniak et al reported a high prevalence rate (16%) of bipolar disorder (BP) among children and adolescents diagnosed with attention-deficithyperactivity-disorder (ADHD), interest in the study and description of both disorders has inreased. At the same time, there is some confusion (and possibly some lack of awareness among psychiatrists) surrounding correct differential diagnosis between these disorders. Attempts have been made to clarify the relationship (both clinical and genetic) between these two disorders. Equally, the diagnoses have been validated and the characteristic symptoms have been defined. We report the cases of two dizygotic twin sisters, which reveal the existence of the above-mentioned associations and the role of inheritability in BP. In addition, we believe that the presence of an ADHD in a child with Turner syndrome child is highly unusual

The activity of the Spanish Teratology Information Services (SITTE and SITE) during year 2011

Otros Resultados: Actividad TraslacionalWe present a summary of the activity of the two Teratology Information Services: SITTE (for health professionals) and SITE (for the general population) during year 2011. The total number of calls received in both services was 5,340 (829 from SITTE and 4,511 from SITE). We also analyzed calls asking for maternal diseases because some of them, like diabetes and hypertension, can be of risk for the correct prenatal development, either by themselves or by the treatment. Like all these previous years, drugs have been the main issue of concern in consulting (68.67% SITTE; 40.84% SITE), particulary about psychoanaleptics (12.71% SITTE; 12.55% SITE) and psycholeptics (12.37% SITTE; 12.90% SITE). Sometimes this concern is the reason for many chronic treatments to be withdrawn when knowing about the pregnancy, without taking into account the risk this may bring to the mother´s illness.N

Las funciones ecuestres de la Real Maestranza de Caballería de Valencia reseñadas por el Marqués de Cruilles por acuerdo de la misma Real Maestranza

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The activity of the Spanish Teratology Information Services (SITTE and SITE) during the year 2010

Otros Resultados: Actividad TraslacionalWe present a summary of the activity of the two Teratology Information Services: SITTE (for health professionals) and SITE (for the general population) during the year 2010. The total number of calls received in both services was 5,087 (814 received by SITTE and 4,273 by SITE). We present the distribution of calls along the years, as well as by the types of health professionals who performed the calls and the types of questions. Also, we show the distribution by different groups of exposures, including maternal diseases and their treatments, professional exposures, life styles, and others. Quantitatively, drug use has been the main reason for these queries. In addition, we have analyzed for the first time, the question regarding paternal diseases, treatments and professional exposures.N

The Activity of the Spanish Teratology Information Services (SITTE and SITE) during 2008

Otros Resultados: Actividad TraslacionalWe summarize the activity of the two Teratology Information Services: SITTE (for health professionals) and SITE (for the general population), during 2008. The total number of calls received in both services was 4,910 (943 from SITTE and 3,967 from SITE). This number has increased compared to previous year. The main users of the SITTE (gynecologists 54.96%) and the SITE (pregnant women 79.89%), have asked preponderantly about the use of drugs (70.22% of the SITTE and 37.49% of the SITE phone calls), during ongoing pregnancies at the moment they were calling (82.82% in the SITTE and 85.18% in the SITE). Additionally, we analyze the type of consulted factors and some characteristics of the users to orientate our work more effectively to the actual demand.N

Polymorphisms in GSTT1, GSTZ1, and CYP2E1, Disinfection By-products, and Risk of Bladder Cancer in Spain

Background: Bladder cancer has been linked with long-term exposure to disinfection by-products (DBPs) in drinking water.Objectives: In this study we investigated the combined influence of DBP exposure and polymorphisms in glutathione S-transferase (GSTT1, GSTZ1) and cytochrome P450 (CYP2E1) genes in the metabolic pathways of selected by-products on bladder cancer in a hospital-based case–control study in Spain. Methods: Average exposures to trihalomethanes (THMs; a surrogate for DBPs) from 15 years of age were estimated for each subject based on residential history and information on municipal water sources among 680 cases and 714 controls. We estimated effects of THMs and GSTT1, GSTZ1, and CYP2E1 polymorphisms on bladder cancer using adjusted logistic regression models with and without interaction terms. Results: THM exposure was positively associated with bladder cancer: adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were 1.2 (0.8–1.8), 1.8 (1.1–2.9), and 1.8 (0.9–3.5) for THM quartiles 2, 3, and 4, respectively, relative to quartile 1. Associations between THMs and bladder cancer were stronger among subjects who were GSTT1 +/+ or +/– versus GSTT1 null (pinteraction = 0.021), GSTZ1 rs1046428 CT/TT versus CC (pinteraction = 0.018), or CYP2E1 rs2031920 CC versus CT/TT (pinteraction = 0.035). Among the 195 cases and 192 controls with high-risk forms of GSTT1 and GSTZ1, the ORs for quartiles 2, 3, and 4 of THMs were 1.5 (0.7–3.5), 3.4 (1.4–8.2), and 5.9 (1.8–19.0), respectively. Conclusions: Polymorphisms in key metabolizing enzymes modified DBP-associated bladder cancer risk. The consistency of these findings with experimental observations of GSTT1, GSTZ1, and CYP2E1 activity strengthens the hypothesis that DBPs cause bladder cancer and suggests possible mechanisms as well as the classes of compounds likely to be implicated.This work was funded by the Intramural Research Program of the National Institutes of Health, National Cancer Institute (N02-CP-11015), the Fondo de Investigación Sanitaria (00/0745, G03/174, G03/160, C03/09, and C03/90), and the Instituto de Salud Carlos III, Spanish Health Ministry (CP06/00341

Antipsychotics and pregnancy: a review of the literature and experience in the ECEMC

Teratología ClínicaThe antipsychotic drugs are medications about which a considerable number of telephone calls are received in our teratology information services (SITTE and SITE). We present a review of the literature about the use of this group of drugs during pregnancy. On the other hand, in order to assess the experience in the CIAC, we have studied the intake of antipsychotics in the ECEMC and the queries made on these medications to both teratology information services. Our results show that the intake of antipsychotics during pregnancy is low. However, the number of queries about this type of drugs is increasing, both in the SITTE and in the SITE, probably because of the concern they generate due to the lack of clear information about their use during pregnancy.N

Modulation of SHBG binding to testosterone and estradiol by sex and morbid obesity.

Objective: Sex hormone-binding globulin (SHBG) binds and transports testosterone and estradiol in plasma. The possibility that SHBG is a mixture of transporting proteins has been postulated. We analyzed in parallel the effects of obesity status on the levels and binding capacity of circulating SHBG and their relationship with testosterone and estradiol.Design: Anthropometric measures and plasma were obtained from apparently healthy young (i.e. 35 +/- 7 years) premenopausal women (n = 32) and men (n = 30), with normal weight and obesity (BMI > 30 kg/m(2)).Methods: SHBG protein (Western blot), as well as the plasma levels of testosterone, estradiol, cortisol and insulin (ELISA) were measured. Specific binding of estradiol and testosterone to plasma SHBG was analyzed using tritiumlabeled hormones.Results: Significant differences in SHBG were observed within the obesity status and gender, with discordant patterns of change in testosterone and estradiol. In men, testosterone occupied most of the binding sites. Estrogen binding was much lower in all subjects. Lower SHBG of morbidly obese (BMI > 40 kg/m(2)) subjects affected testosterone but not estradiol. The ratio of binding sites to SHBG protein levels was constant for testosterone, but not for estradiol. The influence of gender was maximal in morbid obesity, with men showing the highest binding/SHBG ratios.Conclusions: The results reported here are compatible with SHBG being a mixture of at least two functionally different hormone-binding globulins, being affected by obesity and gender and showing different structure, affinities for testosterone and estradiol and also different immunoreactivity