[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.

Region-specific regulation of 5-HT1B receptors in the rat brain by chronic venlafaxine treatment.

RATIONALE: Venlafaxine is a non-selective serotonin and noradrenaline reuptake inhibitor antidepressant drug for which clinical studies have suggested a high level efficacy and a possible early action onset compared to the classical antidepressants. Its therapeutic effects might be due, at least in part, to adaptive changes in serotonergic neurotransmission, through the activation of the different 5-HT receptor subtypes. 5-HT(1B) receptors are located in the axon terminals of both serotonergic and non-serotonergic neurons, where they act as inhibitory autoreceptors or heteroreceptors, respectively. However, the information about the involvement of this subtype in the mechanism of action of antidepressants is limited and quite controversial. OBJECTIVES: The aim of this study was to evaluate the effect of venlafaxine (10 mg kg⁻¹ day⁻¹, p.o.) after 21 days of treatment on the density of 5-HT(1B) receptors and their functionality in rat brain. METHODS: Effects of chronic venlafaxine were evaluated at different levels of 5-HT(1B) receptor by using receptor autoradiography, [³5S]GTPγS binding, and the regulation of body temperature induced by selective 5-HT(1B) agonist. RESULTS: Our results show that venlafaxine induced an increase in sensitivity of 5-HT(1B) receptors in hypothalamus both at G-protein level and the control of core temperature without affecting the receptor density. CONCLUSIONS: These results demonstrate that adaptive changes on 5-HT(1B) receptors induced by chronic administration of venlafaxine exhibit regional differences suggesting that the hypothalamus might be an important site of drug action.

Avaliação preliminar da atividade antimicrobiana do extrato de erva-mate (Ilex paraguariensis A. St. - Hil.) obtido por extração com CO2 supercrítico / Preliminary evaluation of the antimicrobial activity of "erva mate" (Ilex paraguariensis A. St. - Hil.) extract obtained by using supercritical CO2

Ilex paraguariensis A. St. - Hil. (erva-mate) é uma árvore pertencente à família Aquifoleaceae, nativa da região sul da América do Sul e de grande importância cultural e econômica para os três estados da região sul do Brasil. O presente trabalho determinou o potencial antimicrobiano do extrato de erva-mate obtido por fluido supercrítico, frente a alguns microrganismos. As folhas de Ilex paraguariensis foram coletadas na região norte do RS. O extrato bruto da planta desidratada foi obtido pelo método de extração com fluido supercrítico, utilizando dióxido de carbono (CO2) como solvente. Foi obtida a solução mãe desse extrato (100 mg mL-1) que a seguir foi diluído (50; 25; 12,5; 6,25 mg mL-1) para avaliação da atividade antimicrobiana por meio da técnica de difusão do disco em ágar Müeller Hinton, sobre cepas de Acinetobacter baumannii (ATCC 19606), Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27853), Staphylococcus aureus (ATCC 25923) e Enterococcus faecalis (ATCC 29212). As análises foram efetuadas em triplicata, utilizando como controle negativo disco estéril sem impregnação e como controle positivo discos de antibióticos comerciais variáveis de acordo com a espécie bacteriana. Após 16 a 24h de incubação a 35ºC os halos com significância foram medidos. Observou-se atividade antimicrobiana frente a S. aureus (halos de inibição variaram entre 7 e 18 mm) e para P. aeruginosa (halos entre 6 e 11 mm), ambos nas concentrações de 100 até 25 mg mL-1. O extrato obtido por extração em fluido supercrítico de Ilex paraguariensis apresentou atividade antimicrobiana frente a S. aureus e P. aeruginosa.

Ilex paraguariensis A. St. - Hil. ("erva mate") is a tree of the Aquifoliaceae family, native to the south region of South America and of great cultural and economic importance for the three states of the south region of Brazil. The present study aimed to determine the antimicrobial potential of "erva mate" extract obtained by supercritical fluid against some microorganism strains. The leaves of Ilex paraguariensis were collected in the north region of Rio Grande do Sul State. The crude extract of dehydrated plant was obtained by supercritical fluid extraction, using carbon dioxide (CO2) as solvent. The extract mother solution (100 mg mL-1) was diluted (50; 25; 12, 5; 6.25 mg mL-1) for antimicrobial activity evaluation, by means of disk diffusion method on Müeller-Hinton agar, against strains of Acinetobacter baumannii (ATCC 19606), Escherichia coli (ATCC 25922), Pseudomonas aeruginosa (ATCC 27853), Staphylococcus aureus (ATCC 25923) and Enterococcus faecalis (ATCC 29212). The analyses were done in triplicate, using as negative control sterile disk without impregnation and as positive control, commercial antibiotic disks according to the bacterial species. After 16-24h incubation at 35ºC, the diameters of inhibition zones were measured. Antimicrobial activity was observed against S. aureus (inhibition zones between 7 and 18 mm) and P. aeruginosa (inhibition zones between 6 and 11 mm), both at the concentrations of 100 mg mL-1 to 25 mg mL-1. The extract of Ilex paraguariensis obtained by supercritical fluid presented antimicrobial activity against S. aureus and P. aeruginosa.

Simple DNA extraction protocol for a 16S rDNA study of bacterial diversity in tropical landfarm soil used for bioremediation of oil waste.

Landfarm soil is used to bioremediate oil wastes from petrochemical industries. We developed a simplified protocol for microbial DNA extraction of tropical landfarm soil using only direct lysis of macerated material. Two samples of tropical landfarm soil from a Brazilian refinery were analyzed by this protocol (one consisted of crude oil-contaminated soil; the other was continuously enriched for nine months with petroleum). The soil samples were lysed by maceration with liquid nitrogen, eliminating the need for detergents, organic solvents and enzymatic cell lysis. Then, the DNA from the lysed soil sample was extracted using phenol-chloroform-isoamyl alcohol or guanidium isothiocyanate, giving high DNA yields (more than 1 micro g DNA/g soil) from both soil types. This protocol compared favorably with an established method of DNA template preparation that included mechanical, chemical and enzymatic treatment for cell lysis. The efficiency of this extraction protocol was confirmed by polymerase chain reaction amplification of the 16S rRNA gene, denaturing gradient gel electrophoresis and cloning assays. Fifty-one different clones were obtained; their sequences were classified into at least seven different phyla of the Eubacteria group (Proteobacteria - alpha, gamma and delta, Chloroflexi, Actinobacteria, Acidobac teria, Planctomycetes, Bacteroidetes, and Firmicutes). Forty percent of the sequences could not be classified into these phyla, demonstrating the genetic diversity of this microbial community. Only eight isolates had sequences similar to known sequences of 16S rRNA of cultivable organisms or of known environmental isolates and therefore could be identified to the genus level. This method of DNA extraction is a useful tool for analysis of the bacteria responsible for petroleum degradation in contaminated environments.

Intoxicación por Atropa bella donna / Intoxication for Atropa belladona

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Life-threatening toxicity of oral tegafur-uracil (UFT) plus leucovorin.

UFT. a a combination of tegafur and uracil, is increasingly used in the treatment of gastrointestinal malignancies. We report on a life-threatening toxicity observed in a 74-year-old female while undergoing adjuvant treatment with oral UFT plus leucovorm for adenocarcinoma of the rectum. The patient developed grade 4 thrombocytopenia, grade 4 neutropenia, grade 3 infection, grade 3 neurotoxicity and grade 2 cutaneous toxicity. This oral double-agent regimen should be used with caution in the adjuvant treatment of elderly patients with gastro-intestinal malignancies.

[Atypical fibrous histiocytoma of the seminal vesicle]. / Fibrihistiocitoma atípico de las vesículas seminales.

OBJECTIVES: To describe a rare case of fibrous histiocytoma of the seminal vesicles. METHODS: A tumor occupying the entire hypogastrium, extending beyond the umbilical region were the only remarkable findings in our 47-year-old male patient that prompted us to perform complementary studies such as US, contrast-enhanced radiological evaluation (urography, cystography, colon enema and intestinal transit time) and laparoscopy that disclosed an extraperitoneal tumor with no precise location. A large tumor involving the seminal vesicles was found at surgery and resected. The histological analyses disclosed an atypical fibrous histiocytoma of the seminal vesicles. RESULTS: Patient outcome was satisfactory. CONCLUSIONS: Because tumors of the seminal vesicles are uncommon, it is practically impossible to diagnose this tumor type preoperatively.

Five-day course of granulocyte colony-stimulating factor in patients with prolonged neutropenia after adjuvant chemotherapy for breast cancer is a safe and cost-effective schedule to maintain dose-intensity.

PURPOSE: To analyze the safety and efficacy of a short course of granulocyte colony-stimulating factor (G-CSF) to maintain dose-intensity of subsequent cycles of chemotherapy after a prior episode of prolonged neutropenia, without febrile complications, in patients receiving adjuvant treatment for breast cancer. PATIENTS AND METHODS: Thirty-two patients undergoing adjuvant cyclophosphamide, methotrexate, and fluorouracil (CMF) or doxorubicin-CMF for stages I to II breast cancer were included after having chemotherapy delays due to neutropenia (absolute neutrophil count [ANC] < 1.5 x 10(9)/L) on day 22. G-CSF was administered subcutaneously on days 15 to 19 of each subsequent cycle. RESULTS: None of the patients included in this study had to be admitted to the hospital for fever and neutropenia. The median percentage of the projected dose-intensity for CMF or doxorubicin-CMF on an intent-to-treat basis was 0.994, which was significantly higher than the delivered dose-intensity before the start of G-CSF treatment (P < .0001). Patients who received concomitant G-CSF and radiotherapy achieved a similar dose-intensity as patients who did not undergo radiotherapy. Seven patients discontinued G-CSF treatment due to musculoskeletal pain. These patients had more subsequent cycle delays because of day 22 neutropenia than the 25 patients who followed the G-CSF schedule (P = .0028). CONCLUSION: A 5-day course of G-CSF in patients with prior chemotherapy delays due to prolonged neutropenia seems to be a safe and cost-effective schedule to maintain CMF or doxorubicin-CMF dose-intensity in the adjuvant treatment of breast cancer.

Docosahexaenoic acid--a new therapeutic approach to peroxisomal-disorder patients: experience with two cases.

Docosahexaenoic acid (DHA, 22:6 omega 3) is a major constituent of brain membrane phospholipids and photoreceptor cells. Patients with generalized peroxisomal disorders have extremely low levels of DHA in the brain and other tissues. Since a DHA deficiency could explain some basic symptoms in peroxisomal-disorder patients, we tested the possible beneficial effects of DHA in two patients with neonatal adrenoleukodystrophy (NALD). Before the treatment, both patients had very low DHA levels in plasma and erythrocytes. We first gave DHA in the form of fish oil and, in both patients, the rapid increase in red-cell DHA levels indicated that this fatty acid was being absorbed and incorporated into membrane phospholipids very fast. However, a low ratio 22:6 omega 3/22:5 omega 3 was still present in erythrocyte membranes, and the content of 20:5 omega 3 (eicosapentaenoic acid) was too high with the fish oil diet. We then began treatment with pure DHA ethyl ester and, after a few weeks, erythrocyte omega 3 polyunsaturated fatty acids were normal. There was an increase in the 18:0 molecular species of plasmalogens in both patients, most significantly in the child with affected plasmalogen biosynthesis in cultured fibroblasts. In the less severely affected NALD patient, treatment with DHA produced a very significant decrease in the ratios 24:1/22:0 and 26:1/22:0, and this child improved neurologically. The present data suggest that DHA deficiency may be the cause for some of the most characteristic abnormalities in peroxisomal-disorder patients and open new therapeutic possibilities for these patients.