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1.
Tetrahedron ; 72(40): 6127-6135, 2016 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-28190898

RESUMEN

Radiolabeled diprenorphine (DPN) and analogs are widely used ligands for non-invasive brain imaging of opioid receptors. To develop complementary radioligands optimized for studies of the peripheral opioid receptors, we prepared a pair of hydrophilic DPN derivatives, conjugated to the macrocyclic chelator DOTA (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid), for complexation with trivalent metals. The non-radioactive indium (III) complexes, tethered to the C6-oxygen position of the DPN scaffold by 6- to 9-atom spacers, displayed high affinities for binding to µ, δ and κ opioid receptors in vitro. Use of the 9-atom linker conferred picomolar affinities equipotent to those of the parent ligand DPN. The [111In]-labeled complexes were prepared in good yield (>70%), with high radiochemical purity (~99%) and high specific radioactivity (>4000 mCi/µmol). Their log D7.4 values were -2.21 to -1.66. In comparison, DPN is lipophilic, with a log D7.4 of +2.25. Further study in vivo is warranted to assess the suitability of these [111In]-labeled DPN-DOTA conjugates for imaging trials.

2.
Curr Drug Res Rev ; 2024 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-38284719

RESUMEN

Osteoarthritis (OA) is a disease characterized by degeneration of cartilage or wear and tear. OA is a cause of disability and health issues. It is a disease that affects more than 500 million adults annually worldwide, of which India accounts for about 22 to 39% of OA patients. The most common type of osteoarthritis is knee OA. Pathogenesis of OA requires evolution in basic science and clinical research to enhance our understanding of the pathogenesis and as well as different treatment options. It is mainly classified as primary and secondary OA. The treatment for OA can only reduce the symptoms and cannot cure the disease itself, including pharmacological treatment, like non-steroidal anti-inflammatory drugs (NSAIDs), acting on COX1 (cyclooxygenase 1) and COX2 (cyclooxygenase 2) enzymes. Non-pharmacological treatments for OA include exercise like walking, and aerobic exercise, diet, weight loss, hot and cold therapy, as well as electrotherapy, which improves muscle strength and decreases joint pain. Surgical treatment is the last treatment option for OA patients, which includes arthroscopy and joint replacement therapy. Thus, necessary precautions should be taken for joints to be healthy and disease-free.

4.
Curr Psychiatry Rep ; 12(6): 522-30, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-20936438

RESUMEN

Although extensive literature supports connections between bipolar disorder and creativity, possible mechanisms underlying such relationships are only beginning to emerge. Herein we review evidence supporting one such possible mechanism, namely that personality/temperament contribute to enhanced creativity in individuals with bipolar disorder, a theory supported by studies showing that certain personality/temperamental traits are not only common to bipolar disorder patients and creative individuals but also correlate with measures of creativity. Thus, we suggest based on studies using three important personality/temperament measures-the Neuroticism, Extraversion, and Openness Personality Inventory (NEO); the Myers-Briggs Type Indicator (MBTI); and the Temperament Evaluation of the Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A)-that changeable (increased TEMPS-A-cyclothymia) and at times negative (increased NEO-neuroticism) affect and open-minded (increased NEO-openness) and intuitive (increased MBTI-intuition) cognition may contribute importantly to enhanced creativity in individuals with bipolar disorder.


Asunto(s)
Trastorno Bipolar/psicología , Creatividad , Personalidad , Afecto , Humanos , Pruebas de Personalidad
5.
J Hazard Mater ; 153(3): 1103-9, 2008 May 30.
Artículo en Inglés | MEDLINE | ID: mdl-17988796

RESUMEN

The current work is related to inorganic species in sludge generated from Common Effluent Treatment Plant contaminated with hazardous wastes at relatively high concentration. The environmental sensitive metals studied in the sludge are Pb, Fe, Ni, Zn and Mn. The solidification/stabilization (S/S) of heavy metals within fly ash-cement-based matrix was conducted for low cost treatment and reuse of sludge. The study examines the strength of the S/S product by predicting the effect of supplementary cementing material from efficiency factor (k) at 60 degrees C curing temperature. The leaching test was performed at two different pH 7 and 4 to determine the efficiency of heavy metal immobilization. It was observed that replacing 76% OPC by 56% fly ash and 20% sludge for 28 days curing period shows increase in strength as well as rate of stabilization for zinc, iron and manganese at pH 7, lead and nickel were stabilized by 79 and 82%, respectively. Environmental stress test was performed to evaluate the tolerance of extreme adverse environmental condition.


Asunto(s)
Carbono , Residuos Peligrosos , Metales Pesados/química , Material Particulado , Eliminación de Residuos/métodos , Contaminantes Químicos del Agua/química , Ceniza del Carbón , Fuerza Compresiva , Residuos Peligrosos/análisis , Concentración de Iones de Hidrógeno , Residuos Industriales/análisis , Temperatura
6.
Mol Cell Biol ; 22(2): 635-43, 2002 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11756558

RESUMEN

Epithelial tumors of the pancreas exhibit a wide spectrum of histologies with varying propensities for metastasis and tissue invasion. The histogenic relationship among these tumor types is not well established; moreover, the specific role of genetic lesions in the progression of these malignancies is largely undefined. Transgenic mice with ectopic expression of transforming growth factor alpha (TGF-alpha) in the pancreatic acinar cells develop tubular metaplasia, a potential premalignant lesion of the pancreatic ductal epithelium. To evaluate the cooperative interactions between TGF-alpha and signature mutations in pancreatic tumor genesis and progression, TGFalpha transgenic mice were crossed onto Ink4a/Arf and/or p53 mutant backgrounds. These compound mutant mice developed a novel pancreatic neoplasm, serous cystadenoma (SCA), presenting as large epithelial tumors bearing conspicuous gross and histological resemblances to their human counterpart. TGFalpha animals heterozygous for both the Ink4a/Arf and the p53 mutation showed a dramatically increased incidence of SCA, indicating synergistic interaction of these alleles. Inactivation of p16(Ink4a) by loss of heterozygosity, intragenic mutation, or promoter hypermethylation was a common feature in these SCAs, and correspondingly, none of the tumors expressed wild-type p16(Ink4a). All tumors sustained loss of p53 or Arf, generally in a mutually exclusive fashion. The tumor incidence data and molecular profiles establish a pathogenic role for the dual inactivation of p16(Ink4a) and p19(Arf)-p53 in the development of SCA in mice, demonstrating that p16(Ink4a) is a murine tumor suppressor. This genetically defined model provides insights into the molecular pathogenesis of SCA and serves as a platform for dissection of cell-specific programs of epithelial tumor suppression.


Asunto(s)
Inhibidor p16 de la Quinasa Dependiente de Ciclina/genética , Cistadenoma Seroso/genética , Genes p53 , Neoplasias Pancreáticas/genética , Proteína p14ARF Supresora de Tumor/genética , Proteínas Supresoras de Tumor , Ubiquitina-Proteína Ligasas , Animales , Cistadenoma Seroso/etiología , Cistadenoma Seroso/metabolismo , Cistadenoma Seroso/patología , Factores de Crecimiento Endotelial/metabolismo , Genes Supresores de Tumor , Humanos , Ligasas/genética , Linfocinas/metabolismo , Ratones , Ratones Endogámicos C57BL , Ratones Endogámicos CBA , Ratones Mutantes , Ratones Transgénicos , Mutación , Neoplasias Pancreáticas/etiología , Neoplasias Pancreáticas/metabolismo , Neoplasias Pancreáticas/patología , Fenotipo , Factor de Crecimiento Transformador alfa/genética , Factor A de Crecimiento Endotelial Vascular , Factores de Crecimiento Endotelial Vascular , Proteína Supresora de Tumores del Síndrome de Von Hippel-Lindau
7.
J Clin Endocrinol Metab ; 89(5): 2281-9, 2004 May.
Artículo en Inglés | MEDLINE | ID: mdl-15126554

RESUMEN

Ionizing radiation is the strongest risk factor known for the development of thyroid neoplasia. Although ret/PTC rearrangements have been identified in both spontaneous and radiation-induced papillary thyroid cancer, they seem more frequent among radiation-associated tumors. We studied the frequency of ret/PTC activation in a group of sporadic and radiation-induced thyroid carcinomas (n = 49) and adenomas (n = 13) among 44 individuals treated for Tinea Capitis with low-dose external irradiation as well as in 18 nonirradiated subjects. Total RNA recovered from paraffin-embedded thyroid cancer surgical specimens was analyzed for ret/PTC 1, 2, and 3 mutations using RT-PCR with Southern blotting to maximize detection sensitivity. Ret/PTC rearrangements were identified in 42.9% of thyroid carcinoma and 46.2% of adenoma subjects. Among the positive carcinoma specimens, three were follicular carcinomas. Ret/PTC 1, the predominant rearrangement, was more prevalent in nonirradiated compared with irradiated carcinomas (66.7 vs. 27.0%; P = 0.04). Ret/PTC activation was associated with male gender. The strengths of this study included analysis of age-, gender-, and ethnicity-matched groups; molecular analysis using two techniques; and a complete blinding of laboratory analysis from clinical features. The differences seen between these and other published results may be related to differences in radiation doses to the thyroid, latency period between time of radiation exposure and development of clinically apparent thyroid cancer, and ethnic background of the study populations.


Asunto(s)
Adenoma/metabolismo , Carcinoma/metabolismo , Neoplasias Inducidas por Radiación/metabolismo , Proteínas de Fusión Oncogénica/metabolismo , Proteínas Oncogénicas/metabolismo , Neoplasias de la Tiroides/metabolismo , Factores de Transcripción/metabolismo , Adulto , Estudios de Casos y Controles , Relación Dosis-Respuesta en la Radiación , Femenino , Reordenamiento Génico , Humanos , Masculino , Persona de Mediana Edad , Coactivadores de Receptor Nuclear , Proteínas Oncogénicas/genética , Proteínas de Fusión Oncogénica/genética , Proteínas Tirosina Quinasas , Método Simple Ciego , Tiña del Cuero Cabelludo/radioterapia , Factores de Transcripción/genética
8.
J Clin Endocrinol Metab ; 89(12): 6010-6, 2004 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-15579752

RESUMEN

The serum thyroglobulin (Tg) level is the most sensitive marker for detecting residual thyroid carcinoma. We hypothesized that the basal and TSH-stimulated Tg levels in patients with metastatic thyroid carcinoma would reflect tumor volume, histological subtype, and location of metastatic lesions. A retrospective review of 417 thyroid cancer survivors undergoing evaluation for residual disease with the assistance of recombinant human TSH (rhTSH) was performed. In 169 patients with metastatic disease, we found that the basal Tg level directly correlated with the number of lesions, and that it was highest in patients with follicular and lowest in those with papillary thyroid carcinoma. The basal Tg level was highest in patients with bone metastases and lowest in those with cervical metastases. The fold increase in the serum Tg after rhTSH treatment was highest in papillary thyroid carcinoma and lowest in Hurthle cell carcinoma. The fold increase in Tg was not influenced by tumor volume or by the site of metastatic lesions. Multivariate analysis showed multiple interactions between factors, but did not identify one factor that significantly influenced basal Tg or fold increase. We conclude that the location and volume of metastases influence basal Tg, but not its responsiveness to rhTSH, whereas the histological type of carcinoma influences both basal Tg and responsiveness to rhTSH.


Asunto(s)
Carcinoma/sangre , Carcinoma/secundario , Tiroglobulina/sangre , Neoplasias de la Tiroides/patología , Tirotropina , Adenocarcinoma Folicular/sangre , Adenoma Oxifílico/sangre , Adulto , Anciano , Carcinoma/diagnóstico , Carcinoma Papilar/sangre , Femenino , Humanos , Radioisótopos de Yodo , Masculino , Persona de Mediana Edad , Análisis Multivariante , Neoplasia Residual/sangre , Proteínas Recombinantes , Estudios Retrospectivos , Neoplasias de la Tiroides/sangre
9.
Indian J Exp Biol ; 41(1): 82-4, 2003 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-15267141

RESUMEN

The predation and searching efficiency of fourth instar of predatory C. septempunctata at various densities of mustard aphid, Lipaphis erysimi (Kaltenbach) and predator was investigated under laboratory conditions. The feeding rate of predatory stage decreased at increased prey- and predator densities. Highest percent (92.80%) prey consumption was observed at initial prey density and lowest percent (40.86%) prey consumption at highest prey density by the fourth instar, though the total prey consumption increased with increase in either prey- or predator densities. Similarly, the individual prey consumption was also highest at initial predator density and lowest at highest predator density owing to the mutual interference between the predators at higher densities. The area of discovery (searching efficiency) also decreased with increase in prey- and predator densities. Handling time of predator was highest at lower prey densities, which decreased with increased prey densities. The highest percentage of prey consumption at the prey density of 50 revealed that 1:50 predator-prey ratio was the best to reduce the pest population.


Asunto(s)
Escarabajos/fisiología , Conducta Predatoria , Animales , Femenino
10.
J Toxicol ; 2014: 910497, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25505908

RESUMEN

Different dilutions, that is, 25, 50, 75, and 100%, of tannery effluent (TE) were chosen for the present study to assess the phytotoxic effects on Vigna mungo L. For amelioration purposes, different levels and combinations of iron and zinc were supplied to the plants along with 50% TE that is chosen on the basis of prior test under Petri dish culture. Cytotoxic and biochemical analysis and plant tolerance index (PTI) of plant were observed. Mitotic index deceased with increase in effluent concentration whereas abnormality % was increased. The pigments (chlorophyll a, total, and carotenoids) were decreased with increasing treatment levels of TE at both growth stages. However, carotenoid content increased significantly at all dilution levels of TE after first growth stage. Chlorophyll b was increased significantly after 35 days of growth but decreased after 70 days. The protein contents were also significantly decreased with increase in all TE treatments and increased significantly in zinc recovery treatments. Activities of catalase and peroxidase enzymes were significantly affected and increased significantly with effluent treatments. PTI showed an enhanced tolerance capacity of plant with treatment of iron and zinc. A negative correlation was found (r = -0.97) between plant height and different dilutions of effluent whereas it was positively correlated (r = 0.95) with iron and zinc treatments. The study represents the ameliorative effect of iron and zinc for phytotoxic damage in V. mungo caused by tannery effluent.

11.
J Affect Disord ; 137(1-3): 139-45, 2012 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-22240084

RESUMEN

OBJECTIVE: Assess quetiapine plus lamotrigine (QTP+LTG) combination maintenance therapy effectiveness in challenging bipolar disorder (BD). METHOD: Outpatients assessed with the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) Affective Disorders Evaluation and followed with the STEP-BD Clinical Monitoring Form were naturalistically prescribed QTP+LTG. RESULTS: Fifty-four outpatients with challenging BD, taking in addition to QTP+LTG, a mean±SD of 2.1±1.6 (in 63.0% at least 2) other psychotropic and 2.3±1.9 non-psychotropic prescription medications, had QTP+LTG maintenance trials. Median(mean±SD) QTP+LTG duration was 401(730±756) days. Final QTP and LTG doses were 87.5(188±211) and 300(287±108) mg/day, respectively. Half (27/54) of patients discontinued QTP (in 19), LTG (in 6), or QTP+LTG (in 2), after 294(415±414) days - due to side-effects in 10, inefficacy in seven, non-adherence in five, and other reasons in five. 42.6%(23/54) had additional pharmacotherapy intervention for emergent mood symptoms, after 175(261±237) days, with at least one psychotropic added (in 16/54) or substantively (by ≥50%) increased (in 7/54). 55.6%(30/54) had recurrent mood episodes, after 126(187±158) days, most often depressive (in 35.2%), although 64.8%(35/54) were euthymic at final visit taking QTP+LTG. Sedation increased significantly during treatment among those with side-effect discontinuations, and 19.2%(10/52, all having QTP added to LTG) had clinically significant (≥7%) weight gain. LIMITATIONS: No placebo comparison group. Small sample of predominantly female Caucasian insured outpatients taking complex concurrent medication regimens. CONCLUSION: Additional studies are warranted to confirm our preliminary observation that QTP+LTG maintenance may be effective in patients with challenging BD.


Asunto(s)
Trastorno Bipolar/tratamiento farmacológico , Dibenzotiazepinas/uso terapéutico , Psicotrópicos/uso terapéutico , Triazinas/uso terapéutico , Adulto , Quimioterapia Combinada , Femenino , Humanos , Lamotrigina , Masculino , Persona de Mediana Edad , Fumarato de Quetiapina
12.
J Psychiatr Res ; 46(7): 920-6, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-22579071

RESUMEN

BACKGROUND: Olanzapine has demonstrated efficacy in acute mania and bipolar I disorder (BDI) maintenance, but efficacy in brief therapy in more diverse populations, including patients with bipolar II disorder (BDII)/bipolar disorder not otherwise specified (BDNOS) with syndromal/subsyndromal depressive/mood elevation symptoms and taking/not taking concurrent medications remains to be established. METHODS: Fifty adult outpatients (24 BD1, 22 BDII, 4 BDNOS, mean ± SD age 40.8 ± 11.5 years, 28.1% female, already taking 1.1 ± 1.2 [median 1] prescription psychotropics) with 17-item Hamilton Depression Rating Scale (HDRS) ≥10 and/or Young Mania Rating Scale (YMRS) ≥10 and ≤24, were randomized to double-blind olanzapine (2.5-20 mg/day) versus placebo for one week. RESULTS: Among 45 patients with post-baseline ratings, olanzapine (9.0 ± 5.8 mg/day, n = 23) compared to placebo (n = 22) tended to yield greater Clinical Global Impressions-Bipolar Version-Overall Severity of Illness (-1.4 ± 0.9 versus -0.8 ± 1.1, p = 0.08) and Hamilton Anxiety Scale (-7.9 ± 6.3 versus -3.8 ± 6.1, p = 0.07) improvements, and YMRS/HDRS remission rate (47.8% versus 22.7%, p = 0.08), but significantly increased median weight (+2 versus -1 lbs, p = 0.001), and rates of excessive appetite (54.2% versus 22.7%, p = 0.04) and tremor (50.0% versus 9.1% p = 0.004). Number Needed to Treat and 95% Confidence Interval for YMRS/HDRS remission were 4 (1-∞). Numbers Needed to Harm for excessive appetite and tremor were 4 (1-21) and 3 (1-6), respectively. CONCLUSIONS: Olanzapine tended to yield affective improvement and significantly increased weight, appetite, and tremor. Larger controlled studies appear feasible and warranted to assess brief olanzapine therapy in heterogeneous symptomatic bipolar disorder patients.


Asunto(s)
Antipsicóticos/uso terapéutico , Benzodiazepinas/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Adulto , Trastorno Bipolar/clasificación , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Olanzapina , Proyectos Piloto , Escalas de Valoración Psiquiátrica , Resultado del Tratamiento
13.
Clin Ther ; 33(12): B40-8, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-22177379

RESUMEN

BACKGROUND: The US Food and Drug Administration (FDA) has approved 10 treatments for acute mania, but only 2 for acute bipolar depression. These agents differ from one another with respect to their efficacy and tolerability profiles, such that certain medications may be optimal for some patients but not others. OBJECTIVE: Our aim was to compare the therapeutic and adverse effects of treatments for acute mania and acute bipolar depression to inform clinical decision making. METHODS: Using data from large, randomized, double-blind, placebo-controlled acute mania and acute bipolar depression trials, we assessed number needed to treat (NNT) for response, number needed to harm (NNH) for sedation/weight gain, and likelihood to help or harm (LHH = NNH ÷ NNT) compared with placebo. RESULTS: For acute mania, lithium compared with other FDA-approved agents yielded substantively less sedation (NNH, 27 vs 5-17) yet broadly similar efficacy (NNT, 4 vs 4-8), and thus a more favorable efficacy:sedation likelihood (LHH, 6.8 vs 0.7-3.4). For acute bipolar depression, lamotrigine compared with FDA-approved treatments yielded substantively less sedation (NNH, 42 vs 6-12), weight gain (NNH, -34 vs 6-19), and efficacy (NNT, 12 vs 4-6), but still more favorable efficacy:sedation likelihood (LHH, 3.5) than quetiapine (LHH, 1.0) and efficacy:weight gain likelihood (LHH, -2.8) than the olanzapine plus fluoxetine combination (LHH, 1.5). CONCLUSIONS: For acute mania, lithium compared with other FDA-approved agents yielded less sedation yet similar efficacy, indicating utility for patients sensitive to sedation. For acute bipolar depression, lamotrigine compared with FDA-approved treatments yielded better tolerability but poorer efficacy, suggesting utility in patients sensitive to sedation/weight gain with milder episodes, whereas the FDA-approved treatments might have utility in patients with more severe episodes.


Asunto(s)
Antimaníacos/uso terapéutico , Antipsicóticos/uso terapéutico , Trastorno Bipolar/tratamiento farmacológico , Medicina Basada en la Evidencia , Enfermedad Aguda , Afecto/efectos de los fármacos , Antimaníacos/efectos adversos , Antipsicóticos/efectos adversos , Trastorno Bipolar/diagnóstico , Trastorno Bipolar/psicología , Determinación de Punto Final , Humanos , Selección de Paciente , Proyectos de Investigación , Medición de Riesgo , Sueño/efectos de los fármacos , Resultado del Tratamiento , Aumento de Peso/efectos de los fármacos
14.
J Affect Disord ; 125(1-3): 27-34, 2010 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-20085848

RESUMEN

BACKGROUND: Enhanced creativity in bipolar disorder patients may be related to affective and cognitive phenomena. METHODS: 32 bipolar disorder patients (BP), 21 unipolar major depressive disorder patients (MDD), 22 creative controls (CC), and 42 healthy controls (HC) (all euthymic) completed the Revised Neuroticism Extraversion Openness Personality Inventory (NEO), the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A), the Myers-Briggs Type Inventory (MBTI); the Barron-Welsh Art Scale (BWAS), the Adjective Check List Creative Personality Scale, and the Figural and Verbal Torrance Tests of Creative Thinking. Mean scores were compared across groups, and relationships between temperament/personality and creativity were assessed with bivariate correlation and hierarchical multiple linear regression. RESULTS: BP and CC (but not MDD) compared to HC had higher BWAS-Total (46% and 42% higher, respectively, p<0.05) and BWAS-Dislike (83% and 93% higher, p<0.02) scores, and higher MBTI-Intuition preference type rates (78% vs. 50% and 96% vs. 50%, p<0.05). BP, MDD, and CC, compared to HC, had increased TEMPS-A-Cyclothymia scores (666%, 451% and 434% higher, respectively, p<0.0001), and NEO-Neuroticism scores (60%, 57% and 51% higher, p<0.0001). NEO-Neuroticism and TEMPS-A Cyclothymia correlated with BWAS-Dislike (and BWAS-Total), while MBTI-Intuition continuous scores and NEO-Openness correlated with BWAS-Like (and BWAS-Total). LIMITATIONS: Relatively small sample size. CONCLUSIONS: We replicate the role of cyclothymic and related temperaments in creativity, as well as that of intuitive processes. Further studies are needed to clarify relationships between creativity and affective and cognitive processes in bipolar disorder patients.


Asunto(s)
Afecto , Trastorno Bipolar/psicología , Cognición , Creatividad , Adulto , Trastorno Bipolar/diagnóstico , Estudios de Cohortes , Comorbilidad , Trastorno Ciclotímico/diagnóstico , Trastorno Ciclotímico/psicología , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/psicología , Femenino , Humanos , Modelos Lineales , Masculino , Persona de Mediana Edad , Modelos Psicológicos , Inventario de Personalidad/estadística & datos numéricos , Psicometría , Estadística como Asunto , Temperamento , Adulto Joven
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