[Treatment of attention deficit hyperactivity disorder in adults using virtual reality through a mindfulness programme]. / Tratamiento del trastorno por deficit de atencion/hiperactividad en la edad adulta a traves de la realidad virtual mediante un programa de mindfulness.

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder, which presents a high comorbidity with anxiety and affective signs and symptoms. It has repercussions on the functioning of those suffering from it, who also have low therapy compliance and generate a significant cost both at a personal level and for society. Mindfulness is a psychological treatment that has proved to be effective for ADHD. Virtual reality is widely used as treatment in cases of phobias and other pathologies, with positive results. AIMS: To develop the first treatment for ADHD in adults based on virtual reality and mindfulness, while also resulting in increased treatment adherence and reduced costs. PATIENTS AND METHODS: We conducted a pilot study with 25 patients treated by means of virtual reality, in four 30-minute sessions, and 25 treated with psychostimulants. Measures will be taken pre-treatment, post-treatment and at 3 and 12 months post-treatment, to evaluate both ADHD and also depression, anxiety, functionality and quality of life. Data will be later analysed with the SPSS v. 20 statistical program. An ANOVA of independent groups will be performed to see the differences between treatments and also a test-retest to detect whether the changes will be maintained. RESULTS AND CONCLUSIONS: It is necessary to use treatments that are effective, reduce costs and increase therapy adherence. Treatment with virtual reality is an interesting alternative to the classical treatments, and is shorter and more attractive for patients.

TITLE: Tratamiento del trastorno por deficit de atencion/hiperactividad en la edad adulta a traves de la realidad virtual mediante un programa de mindfulness.Introduccion. El trastorno por deficit de atencion/hiperactividad (TDAH) es un trastorno del neurodesarrollo altamente prevalente, presenta una elevada comorbilidad con sintomatologia afectiva y ansiosa, afecta a la funcionalidad de la persona que lo padece, tienen una baja adhesion terapeutica y genera unos costes sociales y personales elevados. El mindfulness es un tratamiento psicologico que ha demostrado ser eficaz para el TDAH. La realidad virtual es un tratamiento altamente utilizado en fobias y extendido a otras patologias con resultados positivos. Objetivo. Desarrollar el primer tratamiento con realidad virtual y mindfulness para el TDAH en la edad adulta, que suponga un aumento en la adhesion terapeutica y reduzca costes. Pacientes y metodos. Estudio piloto de 25 pacientes tratados con realidad virtual, mediante cuatro sesiones de 30 minutos, y 25 mediante psicoestimulantes. Se tomaran medidas de evaluacion pretratamiento, postratamiento y postratamiento a los 3 y 12 meses, tanto de TDAH como de depresion, ansiedad, funcionalidad y calidad de vida. Se analizaran posteriormente con el programa SPSS v. 20 y se realizara un ANOVA de grupos independientes para ver las diferencias entre tratamientos y un test-retest para detectar el mantenimiento de los cambios. Resultados y conclusiones. Es necesaria la utilizacion de tratamientos que sean efectivos, supongan una reduccion en los costes y un aumento en la adhesion terapeutica. El tratamiento con realidad virtual se plantea como una alternativa a los tratamientos clasicos, que sea mas breve y atractiva para los pacientes.

Metabolic adaptation of colonic microbiota to galactooligosaccharides: a proof-of-concept-study.

BACKGROUND: Prebiotics have been shown to reduce abdominal symptoms in patients with functional gut disorders, despite that they are fermented by colonic bacteria and may induce gas-related symptoms. AIM: To investigate changes in the metabolic activity of gut microbiota induced by a recognised prebiotic. METHODS: Healthy subjects (n = 20) were given a prebiotic (2.8 g/day HOST-G904, HOST Therabiomics, Jersey, Channel Islands) for 3 weeks. During 3-day periods immediately before, at the beginning and at the end of the administration subjects were put on a standard diet (low fibre diet supplemented with one portion of high fibre foods) and the following outcomes were measured: (i) number of daytime gas evacuations for 2 days by means of an event marker; (ii) volume of gas evacuated via a rectal tube during 4 h after a test meal; and (iii) microbiota composition by faecal Illumina MiSeq sequencing. RESULTS: At the beginning of administration, HOST-G904 significantly increased the number of daily anal gas evacuations (18 ± 2 vs. 12 ± 1 pre-administration; P < 0.001) and the volume of gas evacuated after the test meal (236 ± 23 mL vs. 160 ± 17 mL pre-administration; P = 0.006). However, after 3 weeks of administration, these effects diminished (11 ± 2 daily evacuations, 169 ± 23 mL gas evacuation). At day 21, relative abundance of butyrate producers (Lachnospiraceae) correlated inversely with the volume of gas evacuated (r = -0.52; P = 0.02). CONCLUSION: The availability of substrates induces an adaptation of the colonic microbiota activity in bacterial metabolism, which produces less gas and associated issues. Clinical trials.gov NCT02618239.

Preliminary analysis of the concurrent validity of the Spanish translation of the BEARS sleep screening tool for children.

WHAT IS KNOWN ON THE SUBJECT?: Paediatric sleep problems are clinical conditions that often coexist with other mental health problems and meet criteria that warrant the implementation of screening procedures, including high prevalence, and significant clinical impact. Researchers have designed the BEARS, a user-friendly paediatric sleep screening tool that seems to increase the amount of sleep information recorded, as well as the likelihood of identifying sleep problems during routine health encounters. Nonetheless, there are no studies using the BEARS in Spanish-speaking samples. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Using a sample of children with mental health problems, this study provides support for the use of the Spanish version of the BEARS to identify the most common sleep problems seen in paediatric populations. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Considering how frequent sleep problems are, it is especially important for health professionals working with children in general, and with children with mental health problems in particular, to be aware of and be encouraged to use simple brief screening tools for paediatric sleep problems. ABSTRACT: Objective Research studies describe a high prevalence of sleep problems in children with mental health problems, up to 50%, and its role as a risk factor in the development of psychopathology. These often go unnoticed and are not evaluated in the clinical field. Our objective was to assess the concurrent validity of the BEARS, a brief paediatric sleep screening instrument, using the Children Sleep Habits Questionnaire (CSHQ) as the comparison instrument. Methods In this cross-sectional descriptive study, the BEARS was applied by a registered nurse to a sample of parents of children aged 2-16 years (n = 60, 71.7% male) who attended a mental healthcare facility (located in Murcia, Spain) for the first time to receive a group psychoeducational intervention. The association between the information collected with the BEARS and scores on the related subscales of the CSHQ was assessed by Mann-Whitney U tests. Results Children who, according to the BEARS, had a sleep problem obtained scores on the CSHQ-related subscales significantly higher than children who did not have a sleep problem (all Ps  < 0.05). Conclusion Our results support the concurrent validity of the Spanish translation of the BEARS to detect sleep problems in paediatric nursing assessments. Further studies, with bigger and more heterogeneous samples, are warranted.

Vectorial role of Acanthamoeba in Legionella propagation in water for human use.

Legionella spp. is the causative agent of Legionnaires' disease and is transmitted through aerosols emanating from man-made water systems. Legionella resistance to water treatments has been related to its association with environmental amoebae such as Acanthamoeba. Due to the high presence of this protozoon in Spain and the high rate of notification of Legionnaires' disease of this country, the aims of this work were to study the coexistence of these bacteria and protozoa in water as well as their interaction. The usefulness of Acanthamoeba co-culture for the isolation of environmental Legionella was also studied. For this purpose, 70 water samples were collected in 2011 from three Drinking Water Treatment Plants, three Wastewater Treatment Plants and five Natural Pools in Spain. Acanthamoeba was found by PCR in 87.1% (61/70) samples and, by culture in 85.7% (60/70) samples. Legionella was detected by PCR in 58.6% (41/70) of water samples, in 5.7% (4/70) by agar culture and 75.7% (53/70) by Acanthamoeba co-culture. From the 54 Acanthamoeba water isolates, Legionella was detected in 43 of them independently of Acanthamoeba's genotype (T3, T4 and T11). Legionella feeleii, Legionella birminghamiensis, Legionella gresilensis/berliardensis, Legionella fairfieldensis, Legionella drozanski and Legionella falloni were identified. In conclusion, our results showed that environmental Acanthamoeba is infected by Legionella to a high percentage, and due to its ubiquity, high resistance and its pathogenic potential per se, new methods for its elimination should be studied. Also, the high effectivity of Acanthamoeba co-culture for Legionella detection has been shown.

Distribution and inventories of fallout radionuclides (239+240Pu, 137Cs) and 210Pb to study the filling velocity of salt marshes in Doñana National Park (Spain).

Within an extensive multinational and multidisciplinary project carried out in Doñana National Park (Spain) to investigate its preservation and regeneration, the filling velocity of the salt marshes has been evaluated through the calculation of their average sediment accumulation rates. (239+240)Pu and (137)Cs from weapons testing fallout and total (210)Pb distribution profiles and inventories have been determined in some of the most characteristic zones of the park, namely, the ponds (or "lucios") and the waterjets (or "caños"). Plutonium inventories range from 16 to 101 Bq m(-2), (137)Cs values fluctuate between 514 and 3,758 Bq m(-2) and unsupported (210)Pb values comprise between 124 and 9398 Bq m(-2). Average sedimentation rates range from 3 to 5 mm y(-1) (1952-2002). These data are higher than those obtained by carbon dating for the period 6,500 AD-present, estimated as 1.5-2 mm y(-1), suggesting an increase in the accumulation of sediments and the alteration of the park's hydrodynamics caused by the re-channeling of the major rivers feeding the salt marshes.

Distributions of Pu, Am and Cs in margin sediments from the western Mediterranean (Spanish coast).

Continental margins are important areas to be considered when studying the distributions and depositions of pollutants, both conventional and radioactive. Coastal sediments accumulate most of those contaminants which can be introduced following atmospheric and/or fluvial pathways. Moreover, their residence times within the water column are usually shortened due to their affinity to associate with the downward falling particulate matter, more abundant at shallower depths. In this paper the distribution profiles and inventories of plutonium, americium and cesium are detailed, providing useful information about recent sedimentation phenomena such as sediment mixing, slumping processes and bioturbation. Unsupported 210Pb data are used as reliable indicators of enhanced/reduced deposition events. Also, the calculated inventories have enabled the estimation of the radiological contribution of the Spanish Mediterranean margin to the total radioactivity deposited onto the Mediterranean sea floor.

Choline-binding domain as a novel affinity tag for purification of fusion proteins produced in Pichia pastoris.

The choline-binding domain (ChoBD) of the carboxy-terminal region of the Streptococcus pneumoniae amidase LYTA (C-LYTA) presents a strong affinity for tertiary amines. We report a method for single-step purification of proteins expressed in the methylotrophic yeast Pichia pastoris based on the fusion of C-LYTA to the protein of interest. We show that C-LYTA can be efficiently expressed and secreted in this host. Tagged proteins fused to this binding domain can be purified on inexpensive DEAE matrices. It therefore provides a useful system for the purification of recombinant proteins with high specificity suitable for industrial purposes.

Cytosolic glutamine synthetase and not nitrate reductase from the green alga Chlamydomonas reinhardtii is phosphorylated and binds 14-3-3 proteins.

The nitrate reductase activity from Chlamydomonas reinhardtii was not altered when extracts were incubated with yeast 14-3-3 proteins in the presence of Mg-ATP. However, the C. reinhardtii extracts contained 14-3-3 proteins capable of inhibiting the spinach nitrate reductase, raising the question of their physiological substrates. Two C. reinhardtii proteins of about 48 and 35 kDa were eluted from 14-3-3 affinity chromatography columns and bound to 14-3-3s in overlay assays. The 48-kDa protein corresponded to the cytosolic isoform of glutamine synthetase (GS1). The GSI was phosphorylated by a Ca2+-and calmodulin-dependent protein kinase partially purified from the alga. However, neither phosphorylation nor 14-3-3 binding seemed to change GS catalytic activity.

The negative effect of nitrate on gametogenesis is independent of nitrate assimilation in Chlamydomonas reinhardtii.

The effect of nitrate on gamete differentiation as well as on the expression of genes involved in gametogenesis, nitrogen scavenging, and nitrate assimilation has been analyzed in wild-type and mutant strains of Chlamydomonas reinhardtii. Nitrate prevented gamete formation from wild-type strains and caused a strong reduction in the number of zygotes recovered in genetic crosses between nitrate-assimilation-deficient mutants, thus suggesting that nitrate by itself is providing a negative regulatory signal for the sexual differentiation of the alga. Addition of nitrate at low concentrations to wild-type cells, after an initial period of nitrogen starvation, resulted in a drastic decrease in transcript levels of both nitrate-assimilation genes (NIA1 and NRT2;1) and genes induced after N-starvation (NCG2 and NCG4). This strong effect of nitrate was due to its assimilation products since it was not evident in nitrate-assimilation mutants. A slight negative effect of nitrate on NCG4 expression was only observed in the mutant. Nitrate by itself was also found to provide a negative signal for the expression of gamete-specific genes (GAS3 and GAS18) in mutants incapable of assimilating nitrate.

Determination of dexamethasone in feed by TLC and HPLC.

Two detection methods are described for the determination of dexamethasone in feed, which may be used as screening and confirmatory methods. The procedures were developed after studying different extraction and clean-up procedures: feed extraction was optimized using methylene chloride and hexane followed by a tandem solid-phase clean-up step with silica and C18 cartridges. The confirmatory method presented is based on normal-phase high-performance liquid chromatography on a Diol 5 microns column, with hexane-propan-2-ol (90:10 v/v) as mobile phase, followed by diode array detection and confirmation. All parameters are discussed, especially the extraction and clean-up steps. Recovery studies after application of the proposed method to different kinds of feed samples spiked with dexamethasone at levels between 120 and 1600 ng g-1 yielded a mean value of 55.4% with an overall standard deviation of 15.6%. The proposed procedure allows the determination of dexamethasone in feed at levels lower than 50 ng g-1.

The effect of age and sex on metabolism and urinary excretion of antipyrine.

BACKGROUND: Drug-metabolizing capacity is generally reduced in the elderly. The purpose of this investigation was to study antipyrine clearance and metabolite excretion in old subjects of both sexes. METHODS: Saliva clearance of antipyrine and the production clearances of antipyrine metabolites were studied in young and elderly volunteers of both sexes. Seventy-six elderly subjects (mean age 81 years) were compared with a group of 24 young subjects (mean age 29 years). RESULTS: After oral administration, salivary antipyrine clearance declined with age in both males and females, whether or not this variable was corrected for weight, and antipyrine half-life was significantly prolonged in elderly groups of either sex. The percentage urinary excretion of the antipyrine metabolites (hydroxymethylantipyrine, HMA; norantipyrine, NORA; and 4-hydroxyantipyrine, OHA) was reduced at 48 h in the elderly compared to young subjects by 23%, 31%, and 10%, respectively, in males, and by 41%, 41%, and 24%, respectively, in females. The formation clearance of HMA was reduced by 47% in males and by 52% in females. NORA clearance declined by 42 and 56%, respectively, in males and females. A decrease of 30% in males and 44% in females was observed in OHA clearance. CONCLUSIONS: The findings suggest that aging leads to altered disposition of antipyrine in both males and females and that the main metabolic pathways of the compound are not different in the elderly.

Effects of aging on antipyrine clearance: predictive factors of metabolizing capacity.

The purpose of this study was to identify variables that can account for the decline of antipyrine clearance (CLAP) in elderly adults and that may help predict a reduction in metabolizing capacity. For comparison, ClAP was determined in 177 elderly (mean age 82 years) and 25 young (mean age 29 years) volunteers. Antipyrine (1 g) was administered orally and ClAP was determined by the one-sample saliva method. Mean ClAP was reduced by 38% and antipyrine half-life increased by 64% in old subjects. Multiple regression analysis of ClAP revealed an independent value for age, serum aspartate transaminase (AST), and height in the elderly. The independent variables collectively accounted for 27% of the variance explained. Age, high serum AST, use of diuretics, and no consumption of drugs known to stimulate oxidative metabolism were selected by multivariate analysis (logistic model) as independent predictors of a low metabolizing capacity. The findings indicate that factors other than age may contribute to impaired hepatic oxidative metabolism in the elderly.

Determination of the concentrations of 5-fluorouracil and its metabolites in rabbit plasma and tissues by high-performance liquid chromatography.

The concentrations of 5-fluorouracil, 5-fluoro-5,6-dihydrouracil, 5-fluorouridine and 5-fluoro-2'-deoxyuridine in plasma, liver, kidney, lung and heart of rabbits were determined by high-performance liquid chromatography (HPLC) after drug administration by two different routes. HPLC was carried out by using a Spherisorb 5 ODS 2 column and 0.05 M phosphate buffer as the mobile phase with UV detection at 200 nm. The pH of the mobile phase, organic modifier content and column temperature were found to have a profound influence on the results, hence it was necessary to optimize a procedure for each matrix. A comparison of the efficiency of intravenous and peritoneal administration revealed that the latter provides higher drug concentrations in the liver and minimal contents in plasma and all other tissues studied.

[Detection of serum IgG (ELISA) against Helicobacter pylori: relationship with age and gastroduodenal disease]. / Detección de IgG sérica (ELISA) frente a Helicobacter pylori: relación con la edad y patología gastroduodenal.

OBJECTIVE: An attempt was made to investigate the serological response against Helicobacter pylori by using a IgG serum detection technique (ELISA Biometra) to establish a relationship with age and gastroduodenal pathology. The serological response was compared with the microbiologic and histologic studies of biopsy samples from 4 locations in each patient: duodenal bulb, gastric antrum, corpus and fundus. PATIENTS: A total of 309 patients with gastrointestinal symptoms who underwent an upper digestive endoscopy were included. RESULTS: The overall sensitivity of the serological technique (cut-off value 15 U/ml) was 89.3%, the specificity 75.7%, the positive predictive value 96.9% and the negative predictive value 45.4%. The mean titer in patients with a negative microbiology increased with age: 13.5 U/ml, 14-30 years; 10.0 U/ml, 31-50 years; 18.5 U/nl, 51-65 years and 29.2 U/ml, > 65 years. By increasing the cut-off value to 20 and 30 U/ml in the last two age groups, the specificity increased without a significant decrease in the sensitivity. Patients without abnormal findings at endoscopy had mean titers considerably lower (64.7 U/ml) than those with the stomach resected -Billroth I or II- (99.6 U/ml) and those with gastritis, duodenitis and ulcus (86.7-83.1 U/ml), Patients with gastritis but without acute inflammatory activity had mean titers (62.5 U/ml) lower than those observed in patients with active gastritis (p < 0.01) and increased in parallel with the increasing activity of gastritis. In contrast, patients with atrophic gastritis had the lowest mean titers (54 U/ml). CONCLUSIONS: Our results suggest that the cut-off value in the serological technique should be increased according to the patient's age. Moreover, there is a clear relationship between the serum levels of IgG and the activity of gastritis.

[Evaluation of a selective medium for the isolation of Moraxella catarrhalis]. / Evaluación de un medio selectivo para aislamiento de Moraxella catarrhalis.

The recovery rate of Moraxella catarrhalis in a selective culture medium with acetazolamide and in a conventional blood-agar medium was compared from 1291 samples from the respiratory tract and conjunctivae of children and adults with respiratory and ocular symptomatology. M. catarrhalis was recovered in 215 samples on the acetazolamide medium, and only. 18 cases in the blood agar medium (p < 0.001). The highest recovery of M. catarrhalis was in samples with an accompanying flora, either pathogenic or commensal, such as pharyngeal and nasal exudates. The prevalence of M. catarrhalis in adults and children was 2% and 28%, respectively. We therefore, recommend the use of the acetazolamide medium for the recovery of M. catarrhalis in samples where M. catarrhalis is expected to be present with an accompanying flora.