Comorbilidad psiquiátrica y trastorno por dependencia de opiáceos: del diagnóstico al tratamiento

En los últimos años, las graves consecuencias sanitarias y sociales de la coexistencia de otros trastornos psiquiátricos en pacientes dependientes de opiáceos, han incrementado el interés por mejorar el diagnóstico y el tratamiento de estos trastornos. La identificación fiable y válida de otro trastorno psiquiátrico concomitante en los sujetos con drogodependencias ha mejorado sustancialmente con la utilización de los criterios DSM-IV y la utilización de la entrevista diagnóstica "Psychiatric Research Interview for Substance and Mental Disorders", especialmente diseñada para ello. Tomando como "patrón oro" los diagnósticos realizados con el método LEAD, mediante la entrevista PRISM-IV se obtuvieron diagnósticos válidos de depresión mayor, psicosis inducida, trastornos de ansiedad y trastornos de personalidad antisocial y límite. Así mismo, los diagnósticos obtenidos mediante la PRISM-IV mostraron mejores índices kappa que con la entrevista SCID-IV. La revisión de la literatura muestra que entre los sujetos dependientes de opiáceos que acuden a tratamiento se ha detectado una elevada prevalencia de comorbilidad psiquiátrica (47%-93%), siendo los trastornos depresivos y de ansiedad así como los trastornos de personalidad antisocial y límite los diagnósticos más frecuentes. Si bien se reconoce la necesidad de realizar tratamiento adecuado de los trastornos comórbidos, todavía no hay suficientes estudios controlados que aporten datos concluyentes sobre las pautas terapéuticas más adecuadas. En el caso de la depresión comórbida, la revisión sistemática de los ensayos clínicos controlados disponibles, avala la necesidad de nuevos estudios para clarificar las pautas de tratamientoDiagnosing and treating psychiatric comorbidity in substance abusers has become increasingly important in the last 10 years because of important consequences from a health and social point of view. The identification of reliable and valid diagnosis of psychiatric co morbidity in substance abusers has being improved using the "Psychiatric Research Interview for Substance and Mental Disorders" for DSM-IV criteria. This instrument is a structured interview designed "ad hoc" to diagnoses nonsubstance use disorders in substance abuser population. Compared to the Longitudinal, Expert, All Data (LEAD) procedure, as a "gold standard", the Spanish version of PRISM-IV seemed to be a valid instrument for diagnosing major depression, induced psychosis, anxiety disorders, antisocial and borderline personality disorders. Also the Spanish PRISM-IV resulted in better kappa statistics than the Spanish version of SCID-IV for diagnosing major depression, and borderline personality disorders in substance abusers. Many clinical studies have revealed a high degree of co-occurrence of opioid dependence and other psychiatric disorders, ranging from 44% to 93%. Major depression, anxiety disorders, antisocial and borderline personality disorders are the most prevalent non-substance use disorders in opioid dependent subjects. Most studies are needed to determinate the evidence based treatments for comorbid psychiatric disorders in opioid dependence. In the case of comorbid major depression in opioid abusers, after a systematic review of the randomized and controlled clinical trials available, new studies to clarify the evidence based treatments are require

Do we choose what we look at or it's our brain that chooses? : A cognitive approach to the relation between visual attention and perception based on advertising stimuli

This study questions whether, when talking about graphical stimuli (and in particular, advertisements), attention is above the surface of consciousness that leads to a voluntary perception of the existing stimuli; or if attention is an involuntary process so that we perceive a selection of the stimuli our brain has previously chosen. Previous research of Cognitive Psychology based on advertising attention and perception documents that our cognitive response directly depends on the level of attention focused on the existing stimuli. To understand this question, we need to determine the parameters governing our level of attention

Anaerobic co-digestion effluent as substrate for chlorella vulgaris and scenedesmus obliquus cultivation

Anaerobic digestate supernatant can be used as a nutrient source for microalgae cultivation, thus integrating phytoremediation processes with high value products storage in microalgae biomass. Microalgae are able to use nitrogen and phosphorous from digestate, but high nutrient concentration can cause growth inhibition. In this study, two microalgae strains (C. vulgaris and S. obliquus) were cultivated on the anaerobic co-digestion supernatant (obtained from the organic fraction of municipal solid waste (OFMSW) and waste activated sludge (WAS)) in a preliminary Petri plate screening at different dilutions (1:10 and 1:5) using a synthetic medium (ISO) and tap water (TW). Direct Nile red screening was applied on colonies to preliminarily identify hydrophobic compound storage and then a batch test was performed (without air insufflation). Results show that C. vulgaris was able to grow on digestate supernatant 1:5 diluted, while Nile red screening allowed the preliminary detection of hydrophobic compound storage in colonies. The analysis carried out at the end of the test on ammonia, phosphate, nitrate and sulphate showed a removal percentage of 47.5 ± 0.8%, 65.0 ± 6.0%, 95.0 ± 3.0% and 99.5 ± 0.1%, respectively

Evaluation of common supermarket products as positive controls in biochemical methane potential (BMP) tests

Biochemical methane potential (BMP) tests are commonly applied to evaluate the recoverable amount of methane from a substrate. Standardized protocols require inclusion of a positive control with a known BMP to check the experimental setup and execution, as well as the performance of the inoculum. Only if the BMP of the positive control is within the expected range is the entire test validated. Besides ignorance of this requirement, limited availability of the standard positive control microcrystalline cellulose might be the main reason for neglecting a positive control. To address this limitation, eight widely available grocery store products have been tested as alternative positive controls (APC) to demonstrate their suitability. Among them, Tic Tacs and gummi bears were very promising, although they are dominated by easily degradable sugars and so do not test for hydrolytic performance. Coffee filters exhibited a similar performance to microcrystalline cellulose, while whole milk might be chosen when a more balanced carbohydrate:protein:lipid ratio is important. Overall, the approach of predicting the BMP of a substrate based on the nutritional composition provided on the product packaging worked surprisingly well: BMP of the eight tested products was 81-91% of theoretical maximum BMP based on nutritional information and generic chemical formulas for carbohydrates, proteins, and lipids

Changes in the expression of the human adenine nucleotide translocase isoforms condition cellular metabolic/proliferative status

Human cells express four mitochondrial adenine nucleotide translocase (hANT) isoforms that are tissue-specific and developmentally regulated. hANT1 is mainly expressed in terminally differentiated muscle cells; hANT2 is growth-regulated and is upregulated in highly glycolytic and proliferative cells; and hANT3 is considered to be ubiquitous and non-specifically regulated. Here, we studied how the expression of hANT isoforms is regulated by proliferation and in response to metabolic stimuli, and examined the metabolic consequences of their silencing and overexpression. In HeLa and HepG2 cells, expression of hANT3 was upregulated by shifting metabolism towards oxidation or by slowed growth associated with contact inhibition or growth-factor deprivation, indicating that hANT3 expression is highly regulated. Under these conditions, changes in hANT2 mRNA expression were not observed in either HeLa or HepG2 cells, whereas in SGBS preadipocytes (which, unlike HeLa and HepG2 cells, are growth-arrest-sensitive cells), hANT2 mRNA levels decreased. Additionally, overexpression of hANT2 promoted cell growth and glycolysis, whereas silencing of hANT3 decreased cellular ATP levels, limited cell growth and induced a stress-like response. Thus, cancer cells require both hANT2 and hANT3, depending on their proliferation status: hANT2 when proliferation rates are high, and hANT3 when proliferation slows

Assessing the usefulness of clostridia spores for evaluating sewage sludge hygienization

The capability of clostridia spores to act as pathogen indicators in sewage sludge treatment was investigated. Sulfite-reducing clostridia and E. coli levels were monitored during waste activated sludge pre-treatments (alkali and ultrasound) and its subsequent mesophilic anaerobic digestion. E. coli was maintained or reduced depending on treatment type and intensity. However, alkali pre-treatment (35.3 gNaOH/kg TS) by itself and alkali (157 gNaOH/kg TS) and ultrasound (27,000 kJ/kg TS) pre-treatments followed by anaerobic digestion provoked reproducible clostridia increases. Specifically, up to 2.7 log10 after 35.3 gNaOH/kg TS pre-treatment and up to 1.9 and 1.1 log10 after digesting the 157 gNaOH/kg TS and 27,000 kJ/kg TS pre-treated sludge, respectively. Having rejected the hypotheses of sporulation and floc dissipation, the most plausible explanation for these clostridia increases is re-growth. These results question the suitability of clostridia spores as indicators of sludge treatment and other biological treatments where clostridia may have a role

Anaerobic co-digestion effluent as substrate for chlorella vulgaris and scenedesmus obliquus cultivation

Anaerobic digestate supernatant can be used as a nutrient source for microalgae cultivation, thus integrating phytoremediation processes with high value products storage in microalgae biomass. Microalgae are able to use nitrogen and phosphorous from digestate, but high nutrient concentration can cause growth inhibition. In this study, two microalgae strains (C. vulgaris and S. obliquus) were cultivated on the anaerobic co-digestion supernatant (obtained from the organic fraction of municipal solid waste (OFMSW) and waste activated sludge (WAS)) in a preliminary Petri plate screening at different dilutions (1:10 and 1:5) using a synthetic medium (ISO) and tap water (TW). Direct Nile red screening was applied on colonies to preliminarily identify hydrophobic compound storage and then a batch test was performed (without air insufflation). Results show that C. vulgaris was able to grow on digestate supernatant 1:5 diluted, while Nile red screening allowed the preliminary detection of hydrophobic compound storage in colonies. The analysis carried out at the end of the test on ammonia, phosphate, nitrate and sulphate showed a removal percentage of 47.5 ± 0.8%, 65.0 ± 6.0%, 95.0 ± 3.0% and 99.5 ± 0.1%, respectively

Power and limitations of biochemical methane potential (BMP) tests

As energy systems transition toward renewable sources, anaerobic digestion (AD), which can be used to recover energy from organic substrates, is receiving growing attention. AD research and practice both rely on biochemical methane potential (BMP) tests to determine the methane potential of sewage sludge, energy crops and organic wastes (Pearse et al., 2018). In contrast to continuous reactor experiments, BMP tests are batch, and can be conducted without a major investment of equipment, labor and time. However, this and other differences limit the applicability of results from a BMP test to full-scale plant operation. Yet even in the peer-reviewed literature, BMP test results are not always used appropriately. An example is the determination of synergistic or antagonistic effects during anaerobic co-digestion in substrate mixtures. A BMP test is a powerful and useful tool, but it is important to recognize the type of questions that can and cannot be answered with this experimental setup. Clarification of these issues is the objective of the present contribution

Exploring the potential of co-fermenting sewage sludge and lipids in a resource recovery scenario

In this study, co-fermentation of primary sludge (PS) or waste activated sludge (WAS) with lipids was explored to improve volatile fatty acid production. PS and WAS were used as base substrate to facilitate lipid fermentation at 20 °C under semi-aerobic conditions. Mono-fermentation tests showed higher VFA yields for PS (32-89 mgCOD gVS-1) than for WAS (20-41 mgCOD gVS-1) where propionate production was favoured. The principal component analysis showed that the base substrate had a notable influence on co-fermentation yields and profile. Co-fermentation with WAS resulted in a greater extent of oleic acid degradation (up to 4.7%) and evidence of chain elongation producing valerate. The occurrence of chain elongation suggests that co-fermentation can be engineered to favour medium-chain fatty acids without the addition of external commodity chemicals. BMP tests showed that neither mono-fermentation nor co-fermentation had an impact on downstream anaerobic digestion

Efficacy and Feasibility of an Osteopathic Intervention for Neurocognitive and Behavioral Symptoms Usually Associated With Fetal Alcohol Spectrum Disorder.

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