Nanostructured Conducting Polymers and Their Applications in Energy Storage Devices.

Due to the energy requirements for various human activities, and the need for a substantial change in the energy matrix, it is important to research and design new materials that allow the availability of appropriate technologies. In this sense, together with proposals that advocate a reduction in the conversion, storage, and feeding of clean energies, such as fuel cells and electrochemical capacitors energy consumption, there is an approach that is based on the development of better applications for and batteries. An alternative to commonly used inorganic materials is conducting polymers (CP). Strategies based on the formation of composite materials and nanostructures allow outstanding performances in electrochemical energy storage devices such as those mentioned. Particularly, the nanostructuring of CP stands out because, in the last two decades, there has been an important evolution in the design of various types of nanostructures, with a strong focus on their synergistic combination with other types of materials. This bibliographic compilation reviews state of the art in this area, with a special focus on how nanostructured CP would contribute to the search for new materials for the development of energy storage devices, based mainly on the morphology they present and on their versatility to be combined with other materials, which allows notable improvements in aspects such as reduction in ionic diffusion trajectories and electronic transport, optimization of spaces for ion penetration, a greater number of electrochemically active sites and better stability in charge/discharge cycles.

Methodological guidelines for preparing a structured therapeutic education program: From design to evaluation.

BACKGROUND AND OBJECTIVE: Therapeutic patient education (TPE) is effective and essential in the context of the growing prevalence of chronic diseases in which tools are needed for planning structured programs. The objective of this project was to develop guidelines for designing and assessing a TPE program. METHODS: 1) We assembled a multidisciplinary group of 8 leaders in TPE, chronicity, quality and safety from the hospital and the university. 2) We conducted an exhaustive review of the scientific literature on the planning of TPE programs directed at chronically ill patients, their relatives and caregivers. 3) The final text underwent comments and suggestions by participants from the hospital and primary care centre during a course on information and TPE methodology. The recommendations were unanimously agreed upon by the writing group. RESULTS: We obtained a standardised work procedure targeted at professionals involved in planning TPE programs, based on international recommendations. The document is structured into sections: a) Definition of the health problem and analysis of the situation; b) Program structure (human resources and materials); objectives (health-related, behaviour-related and educational) and methodology; c) Path the patient and family/caregiver follows in the program; and d) Assessment and indicators. Assessment of the procedure, within the framework of the methodology courses, was favourable. CONCLUSIONS: The methodology provided by this document serves as an instrument for the standardised and systematic planning of educational programs and unifies the criteria in their drafting. However, the document needs to be adapted to the condition and population to which each program is addressed.

Relación entre contaminación atmosférica y consultas por enfermedades respiratorias en atención primaria de urgencia / Relationship between air pollution and respiratory disease consultations in primary emergency care

Resumen La presente investigación indaga la relación entre los niveles de contaminación ambiental por material particulado 2,5 y consultas respiratorias según tipo de enfermedad respiratoria y edad de los usuarios que consultaron en los Servicios de Atención Primaria de Urgencia de 2 comunas de la Región de Ñuble, Chile, entre los años 2016 y 2017 mediante un diseño de tipo ecológico. La unidad de análisis correspondió a medias agrupadas (promedios) de consultas diarias por enfermedades respiratorias y de concentración de material particulado 2,5. Los análisis estadísticos utilizados fueron Anova, test estadístico Dickey-Fuller, análisis inferencial basado en correlación de Spearman y Cross-Correlation. Se observó una correlación positiva entre los niveles de contaminación ambiental y consultas por enfermedades respiratorias registrados al día siguiente y al noveno día posterior a un episodio de emergencia ambiental. Desde la entrada en vigencia del Plan de Prevención y Descontaminación Atmosférica no se observan diferencias significativas en las concentraciones de MP2,5 entre los años 2016 y 2017. Los mayores niveles de contaminación ambiental se concentran entre los meses de abril a septiembre. En conclusión, existe relación entre los niveles de contaminación ambiental por MP2,5 con el número de consultas por enfermedades respiratorias y la edad de los usuarios.

The present investigation inquires the relation between the levels of environmental pollution by air borne particulate matter 2,5 and respiratory-related consultatons according to type of respiratory disease and age of the users who were admitted in the Primary Healthcare Emergency Services in two communes in Chile's Ñuble Region, between 2016 and 2017 through an ecological design. The unit of analysis corresponded to pooled means (averages) of daily consultations for respiratory diseases and concentration of particulate matter 2.5. The statistical methods used were: Anova, statistical test Dickey-Fuller, inferential analysis based on Spearman's correlation and Cross-Correlation. A positive correlation was observed between environmental pollution and consultations related to respiratory diseases recorded the next day and the ninth day after an environmental emergency episode. Since the entry into force of the Atmospheric Prevention and Decontamination Plan, no significant differences have been observed in the concentrations of PM2.5 between 2016 and 2017. The highest levels of environmental pollution are concentrated between the months of April to September. In conclusion, there is a relation between the levels of environmental pollution by PM2.5, the number of respiratory diseases consultatons and the age of users.

Recovering functional independence after a stroke through Modified Constraint-Induced Therapy.

BACKGROUND: Population ageing and changes in the epidemiological profile of neurological pathologies has resulted in an increase in patients with disabilities. Rehabilitation strategies such as Modified Constraint-Induced Movement Therapy (CIMTm) play a key role in treating patients with neurologic deficiencies and motor impairments. This intervention is intended to mitigate disability, promote maximum functional independence, and optimize social and economic participation of patients with upper extremity weakness. Our goal was to assess the recovery of functional independence in patients after a stroke using to CIMTm. PATIENTS AND METHOD: Thirty-six subjects who had suffered stroke took part in a randomised clinical trial. The treatment was applied through either collective or individual modalities for three hours per day for a period of ten days. Participant's functional independence was assessed using the Functional Independence Measure (FIM) scale at the before and after of the intervention. RESULTS: An analysis of covariance carried out on the pre-test assessments indicates that the dependent variable presents significant differences (F1.31 = 42.78, p < 0.001, η2p = 0.72) in favour of the collective intervention modality. CONCLUSION: Both modalities of CIMTm intervention promote functional independence. However, the greatest improvements were observed in participants in the collective modality. Improvements in functional independence pursue a reduction in learned non-use behaviours through greater use of the paretic upper extremity in everyday activities.

[Expectations of relatives of critically ill patients regarding medical information. Qualitative research study]. / Expectativas de los familiares de pacientes críticos respecto a la información médica. Estudio de investigación cualitativa.

OBJECTIVE: To determine and analyse the expectations, needs and experiences of relatives of critically ill patients as regards medical information and the level of their understanding. To find keys for improving communication and to draw up best practices in clinical information. MATERIAL AND METHODS: Qualitative research study through semi-structured interviews carried out in a polyvalent adult intensive care unit (ICU) in a University Hospital. PARTICIPANTS: relatives of patients who were admitted to the ICU and who were discharged alive from the Unit. Ten interviews were performed taking into account diversification variables such as, type of family relationship with patients, patient age, length of ICU stay, origin, and location at the time of the interview. RESULTS: The results of the analysis of 10 interviews focused on: the subjective position of the family in the ICU (the agonizing wait), what the ICU represents for the family (surveillance and monitoring of a situation between life and death), perceived care (complete delegation of care), and medical information (what and how they expect and what and how they receive it), as much in the first information (sincerity, hope, delicacy) as in the successive. CONCLUSIONS: There is divergence between what families expect and what they get as regards medical information. To know the expectations of the families will help to provide higher quality care and more humane treatment in the ICU.

Disentangling the role of psychopathic traits and externalizing behaviour in predicting conduct problems from childhood to adolescence.

Child and youth conduct problems are known to be a heterogeneous category that implies different factors and processes. The current study aims to analyze whether the early manifestation of psychopathic traits designates a group of children with severe, pervasive and persistent conduct problems. To this end, cluster analysis was conducted in a sample of 138 children (27.6 % female), aged 6-11 at the first wave of the study (T1) and 12-17 in a follow-up carried out 6 years later (T2). Results allowed the identification of four distinctive clusters: Primarily externalizing, Externalizing-psychopathic, Primarily psychopathic and Non-problematic. As was expected, the Externalizing-psychopathic cluster showed the most severe and persistent pattern of behavioral, temperamental and social disruptions across the 6 years of the study. Early psychopathic traits seemed also to be relevant in predicting higher levels of conduct problems in T2, even when conduct disorders had not manifested in T1. These results highlight the role of psychopathic traits in predicting adolescent psychosocial disorders and the relevance to analyze them at early developmental stages.

Síndrome de Down y transplaste de médula ósea: un análisis desde la ética / Down syndrome and bone marrow transplantation: an analysis from ethics

En Chile, el cáncer infantil ocupa el 2° lugar en mortalidad en niños mayores de 5 años. Dentro del cáncer infantil, el más incidente es la Leucemia Linfoblástica Aguda. En relación al tratamiento de la Leucemia, el Trasplante de Médula Ósea puede ser indicación en determinados casos de Leucemia como última opción terapéutica. Al trabajar en el área de la salud, podemos atender a niños con cáncer con condiciones especiales. Dentro de ellos, tenemos a los niños con Síndrome de Down (SD), que por ser portadores de la Trisomía 21, tienen mayor riesgo de desarrollar Leucemia. En el siguiente artículo analizaremos el caso de una adolescente con Síndrome de Down, que al tener una Leucemia de alto riesgo deberá ser trasplantada de médula ósea, este procedimiento es de alto riesgo, única opción curativa para la paciente. Por ser el trasplante un tratamiento que puede conllevar graves complicaciones y ser los niños con Síndrome de Down particularmente frágiles al tratamiento previo al trasplante, analizaremos el caso desde una perspectiva bioética en base a un modelo de toma de decisiones en salud del Hastings Center de Filadelfia, a partir del siguiente problema ético: Dadas las consecuencias nocivas que podría conllevar el trasplante de médula para la paciente, considerando su condición de Síndrome de Down, ¿la paciente tendrá una mejor calidad de vida postrasplante? ¿es éticamente correcto no trasplantar a la paciente?

In Chile, cancer is the second cause of mortality in children with more than 5 year old. Inside this group of patients, Acute Linfoblastic Leukemia (ALL) is the most incidence type of cancer. For his treatment, the bone-marrow transplant is considered suitable as last option of therapy. Some special systemic conditions or certain previous diseases in children can increases the risk of develop ALL and, in the same time, represent a important risk-factor must be considered in the prognosis of ALL therapy. Down Syndrome (DS) is an example of this situation, because patients with DS are more susceptible of develop ALL, and the risks of treatment previous to transplant are higher in this group of patients than patients without DS. In this study we analyze the case of an adolescent with DS and ALL, with indication of bone-marrow transplant as the only option of treatment. For the high risk of this procedure, specially in patients with DS, we analyze the bioethics in relationship with this case using the Hasting Center of Philadelphia model designed for the make of decisions in health, with the next bioethics problem to analyze: in view of the potentially harmful consequences of bone-marrow transplant considering his DS condition, ¿his quality of life will be better after the treatment? ¿May be an ethic decision the choice of no realizes the transplant?

[Attitudes of Spanish doctors towards immigrant patients: an opinion survey]. / Actitudes de los médicos españoles hacia los pacientes inmigrantes: una encuesta de opinión.

INTRODUCTION: We assess the attitudes of Spanish doctors towards immigrant patients. DESIGN: cross-sectional descriptive study carried out in January-June 2003. SAMPLE AND SETTING: Family doctors and third-year residents of 15 health care centers in Zaragoza, Spain. INSTRUMENT: specifically designed interview answered in anonymously and on a voluntary basis. RESULTS: A total of 62.3 % of the sample responded. Nearly 75 % of the doctors had received training on immigration, mainly from a theoretical point of view. Almost 25 % of immigrant consultations are not related to health matters. Doctors think that immigrant patients somatize more than Spanish ones but they do not suffer from more psychiatric illness. They also think immigrants show less treatment compliance and are more demanding. They disagree about possible racial biases in diagnosis or treatment of these patients. Spanish doctors consider that the different ethnic groups present similar management difficulties. The group with the most negative stereotype was the patients from Muslim North African countries. DISCUSSION: These findings are discussed from a psychological and anthropological perspective.

[Epidemic outbreak of tuberculosis in a primary and secondary school in Granada (Spain)]. / Brote epidémico de tuberculosis en un colegio de Granada.

OBJECTIVE: To describe the diagnosis and early treatment of an epidemic outbreak of tuberculosis and determine the utility of polymerase chain reaction (PCR) compared with routine culture in gastric juice. MATERIAL AND METHODS: A computer studies teacher, with clinical features suggestive of tuberculosis and caverns on X-ray, was diagnosed with bacilliferous tuberculosis. Primary health care services carried out a Mantoux test on the school's 387 students as well as on teachers and other staff. The children with a positive Mantoux test underwent laboratory, radiological, and microbiological investigations for one week in the Pediatric Respiratory Unit of Hospital Clínico in Granada. In the teaching and non-teaching staff, active tuberculosis was ruled out through bacilloscopy of sputum samples, Mantoux test, and chest X-ray. RESULTS: In the first screening, the Mantoux test was positive in 67 children. Of these, 7 children were diagnosed with tuberculosis and 60 were found to be infected. Of the 7 children with tuberculosis, five presented positive gastric juice culture in Lowenstein medium while Roche COBAS PCR was negative. In the second screening, 9 children became tuberculin positive. Of these, 8 were diagnosed with tuberculosis and one was infected. Cultures were positive in 3 and PCR was negative. In 77.6 % of the children (59/76), the Mantoux induration was equal to or higher than 18 mm. All of the 15 children with tuberculosis were aged between 9 and 14 years old, except one who was 5 years old. CONCLUSIONS: The Mantoux test remains a basic screening method in diagnosis and epidemiological research, whereas the results of microbiological investigation remain poor and in our study the results DNA were disappointing. The screening of tuberculosis and of other infectious diseases should be more closely monitored in professional groups, such as teachers, that are in contact with large numbers of children. This would identify infected adults and prevent epidemics such as that described in the present study.

[Seroprevalence of three types of hepatotropic virus in a population of adolescents of the province of Guadalajara]. / Seroprevalencia de tres tipos de virus hepatotropos en población adolescente de la provincia de Guadalajara.

BACKGROUND: Viral forms of hepatitis are one of the most infectious disease groups most often encountered in human pathology, and although most are benign, some can evolve into chronic forms. The purpose of this study is that of ascertaining the prevalence of hepatitis C, Epstein-Barr and human herpesvirus-6 infections among eighth-graders (13-14 years of age) and to related the same to variables regarding the gender and environment (rural or urban) in which they were living. METHODS: Descriptive, transversal study of a representative sample of the eighth-grade population in the province of Guadalajara during the 1998-1999 period. Systematic random sampling layered by gender and school (multi-stage sample format). The rate of specific IgG antibodies was determined using the ELISA technique. RESULTS: A study was conducted of 268 school-age children (46.6% males). The prevalence of Epstein-Barr antibodies was of 73.5% (CI: 67.9%-78.5%); 72% (CI: 64%-80%) among the males and of 74.8% (CI: 67.7%-81.9%) among the females (NS); 65.6% (CI: 57.4%-73.8%) residing in an urban environment and 80.7% in a rural environment (p < 0.05). The prevalence of those who tested positive for the hepatitis virus was that of 0.7%--two individuals, both females, one of whom resided in an urban environment and the other in a rural environment. For herpesvirus-6, the prevalence was of 82.4% (CI: 77.9%-86.9%); 81.5% (CI: 74.7%-88.3%) among the males and of 83.2% (CI: 77.1%-89.3%) among the females (NS), 86.7% (CI: 80.4%-92.2%) residing in an urban environment and 78.5% (CI: 73.1%-86.5%) in a rural environment (p < 0.05). CONCLUSIONS: The prevalence of Epstein-Barr and human herpesvirus-6 and low degree as regards VHC is high, which tallies with the characteristics of the environment and age of the individuals under study.

Values and antisocial behavior among Spanish adolescents.

A number of studies have indicated that delinquent adolescents have characteristic value systems. However, most of these studies have adopted a "known-groups" design--that is, they have compared institutionalized delinquents and non-institutionalized adolescents, assuming those adolescents to be non-delinquent. Designs of this type do not distinguish effectively between the statistical effects of delinquency and of institutionalization. In this study, the authors investigated relationships between values and self-reported antisocial behavior in three adolescent groups: 435 school-attending boys, 529 school-attending girls, and 95 delinquent boys in juvenile rehabilitation centers or prisons. The results indicate that antisocial behavior is associated with hedonistic values and a lack of interest in conventional values and social values. These relationships cannot be explained by the institutionalization effects.

[Coverage and immune response to hepatitis B vaccine in adolescents of the Guadalajara province]. / Cobertura e inmunorrespuesta a la vacunación frente al virus de la hepatitis B en adolescentes de la provincia de Guadalajara.

BACKGROUND: Hepatitis B comprises one of the major health problems worldwide. One of the measures for the prevention thereof is the massive vaccination of adolescents. The purpose of our study is that of assessing the degree of coverage of the systematic hepatitis B prevention campaign among the 8th-grade population in the province of Guadalajara in addition to studying the immune response of said population, relating said response to other variables. METHODS: Cross-sectional study. The degree of coverage of the vaccination campaign was studied throughout the entire target population in the province in question. For the study of the immune response, a sample of 338 students was taken by systematic random sampling. The titres of anti-HB's were quantified 6 months following the third dosage, levels of 10 mU/ml or above being considered as being levels providing protection. RESULTS: The percentage of students properly vaccinated totaled 82.7%. The overall serum protection rate was 97.5%, and 46.7% of the sample responded showing titres of over 100 mU/ml. A statistically significant inverse relationship (p < 0.001) existed between the level of anti-HB's and the Quetelet level, we not having found any significant differences between the two sexes on comparing the postvaccination titres of anti-HB's. CONCLUSIONS: We consider the degree of coverage provided to be satisfactory and the immunogenic aspect of the vaccine to be good. Obesity is a factor providing a prior indication of a minor response to the same. This response is not influenced by the subject's sex.

Bone mineral density in asthmatic patients treated with inhaled corticosteroids: a case-control study.

Recent studies suggest that inhaled corticosteroids can adversely affect bone metabolism. The objective of this study was to evaluate the importance of these adverse effects in a case-control study. Bone mineral density (BMD) was measured in 48 asthmatic adults (15 males and 33 females) treated with inhaled steroids (beclomethasone or budesonide) and in 48 gender and age-matched healthy subjects at baseline and at 2 yrs. Vertebral BMD was measured by dual energy X-ray densitometry. Patients had been treated with a dose of 662 +/- 278 micrograms (range 300-1,000 micrograms) of beclomethasone dipropionate or budesonide for more than 1 yr (mean duration of treatment 10.6 yrs, range 1-16 yrs). Twenty four patients had needed 1-6 short courses of oral steroids and seven had received oral corticosteroids (mean daily dose 6.2 mg prednisone) for 2-15 yrs more than 4 yrs prior to the BMD measurements. During the follow-up, 14 patients required 1-3 short courses of oral steroids. There was no correlation either between inhaled corticosteroid doses or duration of treatment and BMD values. There were no significant differences in BMD baseline values between patients and healthy controls. BMD significantly decreased in both groups at 2 yrs, from 1.08 +/- 0.19 to 1.05 +/- 0.19 g.cm-2 (p = 0.002) in asthmatics versus 1.12 +/- 0.17 to 1.09 +/- 0.18 g.cm-2 (p = 0.008) in controls. There were no significant differences in BMD loss between patients and healthy controls. Furthermore, no differences were found in bone loss when pre- and postmenopausal women were compared with their healthy control counterparts. No differences in baseline BMD were found between patients who had received regular oral corticosteroid therapy or booster courses of oral corticosteroids and those who had not. Inhaled corticosteroid treatment at a mean dose of 662 micrograms.day-1 and sporadic booster courses of oral corticosteroids do not further increase bone mass loss with respect to that expected from natural bone mass loss.

Corticosteroid-induced bone loss. Prevention and management.

Osteoporosis is one of the most serious adverse effects experienced by patients receiving long term corticosteroid therapy. Bone loss occurs soon after corticosteroid therapy is initiated and results from a complex mechanism involving osteoblastic suppression and increased bone resorption. There are a number of factors that may increase the risk of corticosteroid-induced osteoporosis [smoking, excessive alcohol (ethanol) consumption, amenorrhoea, relative immobilisation, chronic obstructive pulmonary disease, inflammatory bowel disease, hypogonadism in men, organ transplantation]. The initial assessment of patients about to start taking corticosteroids should include measurement of spinal bone density, urinary calcium level and plasma calcifediol (25-hydroxycholecalciferol) level; serum testosterone levels should also be measured when hypogonadism is suspected. Many different drugs have been used to prevent osteoporosis in patients receiving long-term corticosteroid therapy, including thiazide diuretics, cholecalciferol (vitamin D) metabolites, bisphosphonates, calcitonin, fluoride, estrogens, anabolic steroids and progesterone. At present, however, published studies have failed to demonstrate a reduction in the rate of fracture using different preventive pharmacological therapies in patients being treated with corticosteroids on a continuous basis. Among the drugs studied, bisphosphonates (pamidronic acid and etidronic acid) and calcitonin appear to be effective in increasing bone density. Cholecalciferol preparations have been reported to be effective in some, but not all, studies. Limited data have shown positive results with thiazide diuretics, estrogen, progesterone and nandrolone. When treating patients with corticosteroids, the lowest effective dose should be used, with topical corticosteroids used whenever possible. Auranofin may be considered in patients with corticosteroid-dependent asthma. Patients should take as much physical activity as possible, maintain an adequate daily intake of calcium (1000 mg/day0 and cholecalciferol (400 to 800 U/day), stop smoking and avoid excessive alcohol intake. It is important to detect and treat hypogonadism in men, if present, and to replace gonadal hormones in postmenopausal women or amenorrhoeic premenopausal women, and to detect and correct cholecalciferol deficiency. A thiazide diuretic should be considered if hypercalciuria is present (urinary calcium excretion in excess of 4 mg/kg/day). High-risk patients and those with established osteoporosis should be treated with bisphosphonates (cyclical etidronic acid or intravenous pamidronic acid), nasal calcitonin, or calcifediol or calcitriol. Patients receiving cholecalciferol preparations should be carefully monitored for hypercalciuria and hypecalcaemia.

Variations in magnesium and zinc in hypertensive patients receiving different treatments.

We studied the influence of captopril, atenolol, and verapamil on serum and intraerythrocyte concentrations of magnesium and zinc in 30 normotensive control subjects (12 men and 18 women, aged 30 to 65 years, mean +/- SD 45.76 +/- 12.15 years) and 30 patients with untreated mild or moderate essential hypertension (14 men and 16 women, aged 30 to 65 years, mean +/- SD 49.50 +/- 13.58 years). Ten each of the hypertensive patients were treated with captopril, atenolol, or verapamil. Physical examination and biochemical analyses (serum Mg and Zn) were done in all participants at baseline, and in patients after 3 and 6 months of treatment. The results were compared according to a nested design with Neumann-Keuls test. We found no significant differences between controls and patients in serum and intraerythrocyte concentrations of Zn at the start of the study, although there was a significant decrease in serum Zn in patients after 3 (P < .01) and 6 months (P < .001) of treatment, regardless of the drug used. This decrease was thought to be attributable to the zincuric effect of captopril or to dietary measures, or both. Intraerythrocyte Zn was not significantly affected by antihypertensive treatment. Serum and intraerythrocyte concentrations of Mg were significantly lower (P < .001) in hypertensive than in normotensive subjects, and serum Mg in patients treated with verapamil was significantly lower (P < .05) than after treatment with captopril or atenolol. Serum Mg concentration was related directly with serum concentrations of high density lipoprotein cholesterol (r = 0.4043, P < .05). We conclude that supplementation with Mg may benefit patients with hypertension.

[Does the diuretic effect of calcium inhibitors play an important role in the hypertensive efficacy?]. / L'effet diurétique des inhibiteurs calciques joue-t-il un rôle important dans l'efficacité antihypertensive?

Calcium ions play an important role in the pathophysiology of hypertension. Calcium antagonists, a group of first line drugs in the treatment of hypertension, reduce the intracellular content of calcium in vascular smooth muscle cells, and decrease the peripheral vascular resistance and blood pressure. These drugs differ from other vasodilators in that they also have natriuretic effects; thus they can affect the kidney on three levels: Renal haemodynamics are affected by increased renal blood flow, and increased glomerular filtration rate. Changes in the renin-angiotensin system can decrease aldosterone secretion. Finally, they affect sodium management by acting directly on the renal tubule, increasing sodium excretion and inhibiting tubular reabsorption of this ion. The natriuretic effect of calcium antagonists is independent of the subject's sodium balance. The vasodilating action of these drugs is therefore accompanied by a natriuretic effect that makes satisfactory control of hypertension possible without placing the patient on a low-salt or salt-free diet.

Time estimation and juvenile delinquency.

Certain empirical evidence suggests that subjects prone to delinquent activity may have faster internal clocks than others. To investigate the relationship between antisocial behavior and time perception and its dependence on the experimental time interval and method and on whether the subject is institutionalized we obtained verbal and production estimates of 5-, 15-, 30-, and 60-sec. intervals from 249 adolescents (156 school attenders and 93 institutionalized subjects) classified into 3 groups according to the intensity of their antisocial activity. Results provide no support for the hypothesis that overestimation of short time intervals is associated with either juvenile delinquency or institutionalization.

Prevention of further bone mass loss by nasal calcitonin in patients on long term glucocorticoid therapy for asthma: a two year follow up study.

BACKGROUND: Injectable calcitonin is effective in reducing spinal bone loss in steroid-dependent asthma but side effects are frequent. In contrast, a nasal spray presentation has been shown to be effective and well tolerated in involutional osteoporosis. To test the efficacy of nasal calcitonin a two year prospective trial was conducted in 44 steroid-dependent asthmatic patients. METHODS: All patients received a calcium supplement of 1000 mg and were allocated randomly into two groups treated with either salmon calcitonin nasal spray (200 IU every other day, n = 22) or calcium alone (n = 22) for two years. All patients completed the first year of the study. Five patients in each group dropped out during the second year. In the calcitonin group one patient developed generalised pruritus and four lost steroid dependence, and in the calcium alone group five were no longer dependent on steroids. The efficacy of treatment was evaluated as follows: bone turnover assessed by biochemical markers, bone loss assessed by serial measurement of lumbar spine density, and rates of bone fractures. RESULTS: The bone mass in the calcitonin group increased by 2.7% in the first year while in the group receiving calcium alone it decreased by 2.8%; this difference was significant. Calcitonin prevented more bone loss during the second year while the calcium alone group continued losing bone mass (-7.8%). The difference between means was 0.1077 (95% CI 0.0381 to 0.1773). Three new fractures occurred in both groups. No changes in biochemical parameters were detected in either group. CONCLUSIONS: Calcitonin given intranasally increased spinal bone mass during the first year of treatment and maintained bone mass in a steady state during the second year. These results suggest that calcitonin may be a useful agent to prevent steroid-induced osteoporosis. However, the lack of effect of calcitonin on the rate of vertebral fractures does not permit its recommendation for routine use in preventing steroid-induced osteoporosis.