Oral health-related quality of life after dental treatment in patients with intellectual disability.

BACKGROUND: The influence of dental treatment on oral health-related quality of life (OHRQOL) has rarely been evaluated in patients with intellectual disability (ID) through validated questionnaires. The aim of this study was to estimate the changes on OHRQOL in patients with ID after the implementation of an institutional dental treatment program under general anesthesia using the Franciscan Hospital for Children Oral Health-Related Quality of Life questionnaire (FHCOHRQOL-Q). MATERIAL AND METHODS: A prospective longitudinal study was conducted on 85 patients (mean age=24.85 years) classified according to DSM-V whose parents/caregivers completed the FHC-OHRQOL-Q. We analyzed the changes in the questionnaire's overall score and its dimensions from pre-treatment to 12-months of follow-up, considering effect sizes and minimal important differences estimated by the standard measurement error. The impact of clinical and therapeutic factors was evaluated using univariate and multiple linear regression analysis (p<0.05). RESULTS: Significant improvement of OHRQOL was found after dental treatment in oral symptoms (p0.001), daily life problems (p=0.018), parent's perceptions (p=0.013) and FHCOHRQOL-Q´s overall score (p=0.001). OHRQOL changes exhibited an intermediate magnitude (0.38-0.21) as estimated by effect sizes. Changes in oral symptoms showed positive correlation with DMFT index (r=0.375, p=0.002), decayed teeth (r=0.244, p=0.036), dental extractions (r=0.424, p<0.001) and number of treatments (r=0.255, p=0.019). The improvement was greater in patients with 4 decayed teeth (p=0.049) and undergoing 2 dental extractions (p=0.002). Multiple regression analysis demonstrated that dental extractions (p<0.001) and DMFT index (p=0.028) were significantly related to oral symptom improvement. CONCLUSIONS: Dental treatment under general anesthesia showed a positive effect on the overall FHC-OHRQOL-Q score and most of its dimensions. At 12-months of follow-up, the improvement of oral symptoms was significantly associated with DMFT index, decayed teeth, dental extractions and number of treatments. In our clinical setting, the implementation of a dental treatment program enhanced the OHRQOL of patients with ID.

Nanoparticle rearrangement under stress in networks of cellulose nanofibrils using in situ SAXS during tensile testing.

This study aims to describe and evaluate the mechanism for increased strain-at-break of composites made of cellulose nanofibrils (CNFs) reinforced with nanoscopic latex particles (<200 nm) stabilized by a cationic polyelectrolyte as corona. The applied latex nanoparticles (NPs), synthesized by polymerization-induced self-assembly (PISA), are composed of a neutral core polymer, either poly(butyl methacrylate) (PBMA) or poly(methyl methacrylate) (PMMA). At room temperature, PBMA is close to its glass transition (Tg), while PMMA is below its Tg. Nanocomposites with 75 wt% CNFs and 25 wt% NPs were analyzed using in situ small angle X-ray scattering during tensile testing, monitoring the structural evolution of the NPs under strain. The scattering of the spherical PMMA NPs, which do not coalesce like the PBMA NPs, shows changes to the organization of the NPs in the CNF-network. The observations are corroborated by cross-sectional transmission and scanning electron microscopy. No distinct change from spherical to ellipsoidal shape is evidenced for the PMMA NP cores during tensile strain. Changes in anisotropic scattering produced by the three-dimensional NP structure appear to be very different between nanocomposites loaded with PMMA or PBMA NPs, contrasting commonly described two-dimensional CNF networks. The discrete PMMA NPs can reorganize within the CNF-NP double network under strain, resulting in maintained strength and increased strain-at-break. Increasing the humidity (20, 50 and 80% RH) during in situ measurements further emphasizes this effect in the PMMA composite, relative to the PBMA composite and CNF reference films. The onset of deformation occurs at strain values beyond the fracture of the more brittle films, indicating the effect of secondary nanoscale interaction available only for the PMMA composite, extending the plastic deformation and increasing the ductility. These results provide key insights into the deformation mechanism occurring during tensile testing in the CNF composites loaded with PMMA NPs.

Validation of the Spanish version of the Franciscan Hospital for Children Oral Health-Related Quality of Life questionnaire.

BACKGROUND: The Franciscan Hospital for Children Oral Health-Related Quality of Life questionnaire (FHC-OHRQOL-Q) is an instrument designed specifically for parents and caregivers of patients with special needs that has not yet been applied in Spain. The aim of this study was to adapt it to Spanish and evaluate its reliability and validity in patients with intellectual disability (ID) treated under general anesthesia. MATERIAL AND METHODS: The study was conducted in two different stages: a) cross-cultural adaptation of the original questionnaire, and b) cross-sectional study on 100 parents and caregivers who completed the piloted FHC-OHRQOL-Q. The patients were examined according to the WHO methodology. Dental treatments performed were recorded. Statistical tests were used to evaluate reliability (internal consistency) and validity (content, criterion, construct and discriminant) of the instrument. RESULTS: The mean age was 24 years (range=4-71 years). The most frequent causes of ID were psychomotor retardation (25%) and cerebral palsy (24%). The items most frequently answered by parents and caregivers were eating and nutrition problems (80%) and bad breath/taste (57%). Reliability (Cronbach's alpha coefficient) was considered excellent (alpha=0.80-0.95). The analysis of the factorial validity yielded similar results to the original questionnaire. The high response rate of items (>96%) allowed content validity. Criterion validity was confirmed by a significant correlation with questions on oral health and oral well-being. Discriminant validity was demonstrated by the significant association of ≥21.5 years of age with worse oral symptoms (p=0.034) and parental concerns (p=0.005), DMFT index ≥3 with daily life problems (p=0.02), ≥4 decayed teeth with daily life problems (p=0.001), and >2 dental extractions with oral symptoms (p=0.000), daily life problems (p=0.002) and parent's perceptions (p=0.043). CONCLUSIONS: The FHC-OHRQOL-Q in Spanish is a reliable and valid instrument to apply in clinical practice to evaluate the impact of OHRQOL in mostly adult patients with ID, accessible to Spanish-speaking parents and caregivers.

An Exploration of the Reliability and Validity of the Spanish Version of the 'Voice and You' (VAY): A Scale for Measuring the Relationship with Voices.

UNLABELLED: The purpose of this study was to adapt the 'Voice and You' Scale (VAY) (Hayward, Denney, Vaughan, & Fowler, 2008) to Spanish and explore its psychometric properties for measuring the perceived relationship with voices. A sample of 50 psychiatric patients with verbal auditory hallucinations (48 had a psychotic disorder and two a borderline personality disorder) was used. Its reliability was calculated using the Cronbach's α and test-retest, and concurrent validity by the Pearson correlation coefficient of the VAY with the Beliefs About Voices Questionnaire and the Psychotic Symptom Rating Scales. The results showed that internal consistency of the Spanish version of the VAY ranged from 0.74 to 0.84 on the various subscales, and test-retest reliability varied from 0.74 to 0.83 on three subscales (voice 'dominance', 'intrusiveness' and hearer 'dependence'), and was lower (0.68) on the hearer 'distance' subscale. Concurrent validity was acceptable as significant associations were found with the Beliefs About Voices Questionnaire and the Psychotic Symptom Rating Scales subscales. It is concluded that the Spanish version of the VAY is a reliable and valid instrument that can assist the exploration of voices within relational frameworks across research and clinical domains. KEY PRACTITIONER MESSAGE: The Spanish version of the VAY is a reliable, valid instrument for evaluating the perception a person can have about his or her relationship with the voices and how the person relates to them. Voices that are perceived as relating dominantly and intrusively, and from whom distance is sought, seem to be distressing and cause disturbance. Voices that are related to dependently are perceived as having benevolent intent and are engaged with. Benevolent or neutral voices may be considered as intrusive because of the intensity and frequency with which they are experienced.

Relationship between self-focused attention, mindfulness and distress in individuals with auditory verbal hallucinations.

INTRODUCTION: The purpose of this study was to investigate the relationships among self-focused attention, mindfulness and distress caused by the voices in psychiatric patients. METHODS: Fifty-one individuals with a psychiatric diagnosis participated in this study. The Psychotic Symptom Rating Scale (PSYRATS) emotional factor was applied to measure the distress caused by the voices, the Self-Absorption Scale (SAS) was given for measuring the levels of self-focused attention, and the Mindful Attention Awareness Scale (MAAS) was used to measure mindfulness. RESULTS: The results showed that distress caused by the voices correlated positively with self-focused attention (private and public) and negatively with mindfulness. A negative correlation was also found between mindfulness and self-focused attention (private and public). Finally, multiple linear regression analysis showed that public self-focus was the only factor predicting distress caused by the voices. CONCLUSIONS: Intervention directed at diminishing public self-focused attention and increasing mindfulness could improve distress caused by the voices.

Gene expression differences in primary colorectal tumors and matched liver metastases: chemotherapy related or tumoral heterogeneity?

BACKGROUND: Treatment of metastatic colorectal cancer (mCRC) is generally based on genetic testing performed in primary tumor biopsies, but whether the genomic status of primary tumors is identical to that of metastases is not well known. We compared the gene expression profiles of formalin-fixed paraffin-embedded (FFPE) biopsies of colorectal primary tumors and matched liver metastases. PATIENTS AND METHODS: We compared the expression of 18 genes in FFPE CRC tumors and their matched liver metastases from 32 patients. The expression of each gene in CRC primary tumors and their matched liver metastases was tested using Student's t test for paired samples. Pairwise correlations of each gene in the primary tumors and matched liver metastases were evaluated by Pearson's correlation coefficient. RESULTS: The expression of six genes was significantly different in primary tumors compared with their matched liver metastases [CXCR4 (p < 0.001), THBS1 (p = 0.007), MMP 9 (p = 0.048), GST Pi (p = 0.050), TYMP (p = 0.042) and DPYD (p < 0.001)]. For the remaining genes, where no significant differences were observed, only SMAD4 (r s = 0.447, p = 0.010), ERCC1 (r s = 0.423, p = 0.016) and VEGF A (r s = 0.453, p = 0.009) showed significant correlation in expression between the two tissues. Therefore, we only detected similar gene expression levels between the tumor and the metastases in these three markers. CONCLUSIONS: We only found similar gene expression levels between the tumor and the metastases in three genes (SMAD4, ERCC1, and VEGF A). However, our study could not assess whether the differences in gene expression were secondary to tumoral heterogeneity or to molecular changes induced by previous chemotherapy.

[Does medication abuse in patients with chronic migraine influence the effectiveness of preventive treatment with topiramate?]. / ¿El abuso de farmacos en pacientes con migraña cronica influye en la efectividad del tratamiento preventivo con topiramato?

INTRODUCTION: Patients with chronic migraine (CM) and medication abuse are difficult to treat, and have a greater tendency towards chronification and a poorer quality of life than those with other types of headache. AIM: To evaluate whether the presence of medication abuse lowers the effectiveness of topiramate. PATIENTS AND METHODS: A series of patients with CM were grouped according to whether they met abuse criteria or not. They were advised to stop taking the drug that they were abusing. Treatment was adjusted to match their crises and preventive treatment with topiramate was established from the beginning. The number of days with headache and intense migraine in the previous month and at four months of treatment was evaluated. RESULTS: In all, 262 patients with CM criteria were selected and 167 (63.7%) of them fulfilled abuse criteria. In both groups there was a significant reduction in the number of days with headache/month and number of migraine attacks/month at the fourth month of treatment with topiramate. The percentage of reduction in the number of days with headache/month in CM without abuse was 59.3 ± 36.1%, and with abuse, 48.7 ± 41.7% (p = 0.0574). The percentage of reduction in the number of days with intense migraine/month in CM without abuse was 61.2%, and with abuse, 50% (p = 0.0224). Response rate according to the number of days with headache/month in CM without abuse was 69%, and with abuse, 57%. Response rate according to the number of intense migraines/month in CM without abuse was 76.8%, and in CM with abuse, 61% (p = 0.0097). CONCLUSIONS: Topiramate was effective in patients with CM with and without medication abuse, although effectiveness is lower in the latter case.

TITLE: El abuso de farmacos en pacientes con migraña cronica influye en la efectividad del tratamiento preventivo con topiramato?Introduccion. Los pacientes con migraña cronica (MC) y abuso de medicacion son dificiles de tratar y tienen peor calidad de vida que otros pacientes con migrañas. Objetivo. Valorar si la presencia de abuso de farmacos disminuye la efectividad del topiramato. Pacientes y metodos. Una serie de pacientes con MC fueron agrupados segun presentasen criterios de abuso o no abuso de farmacos. Se les aconsejo la supresion del farmaco del cual abusaban. Se ajusto el tratamiento de sus crisis y se inicio tratamiento preventivo desde el principio con topiramato. Se valoro el numero dias con cefalea y migrañas intensas en el mes previo y al cuarto mes de tratamiento. Resultados. Fueron seleccionados 262 pacientes con criterios de MC, y de ellos 167 (63,7%) cumplieron criterios de abuso. En ambos grupos hubo una reduccion significativa del numero de dias con cefalea/mes y numero de crisis de migraña/mes al cuarto mes de tratamiento con topiramato. Porcentaje de reduccion de dias con cefalea/mes en MC sin abuso, 59,3 ± 36,1%; y con abuso, 48,7 ± 41,7% (p = 0,0574). Porcentaje de reduccion de migrañas intensas/mes en MC sin abuso, 61,2%; y con abuso, 50% (p = 0,0224). Tasa de respondedores segun numero de dias con cefalea/mes en MC sin abuso, 69%; y con abuso, 57%. Tasa de respondedores segun numero de migrañas intensas/mes en MC sin abuso, 76,8%; y en MC con abuso, 61% (p = 0,0097). Conclusiones. El topiramato fue efectivo en pacientes con MC sin y con abuso de farmacos, aunque con menor efectividad en estos ultimos.

Assessment of two-phase olive mill solid waste and microalgae co-digestion to improve methane production and process kinetics.

Olive mill solid waste (OMSW) is a pollutant waste coming from olive oil elaboration by the two-phase centrifugation system. OMSW has a high organic matter content and unbalanced carbon to nitrogen (C/N) ratio, 31/1, which avoids obtaining high methane yields in the anaerobic digestion of this waste. In the present study a microalgae, Dunaliella salina, was employed as co-substrate for the OMSW anaerobic digestion in order to decrease the C/N ratio and increase its biodegradability. Different co-digestion mixtures (C/N ratios) were studied. The increase of D. salina from 25% to 50% in the co-digestion mixture clearly increased the biodegradability of the sole substrates. The highest biodegradability was found for the co-digestion mixture 50% OMSW-50% D. salina. Nevertheless, the maximum methane production, 330mLCH4/gVSadded, and the highest methane production rate were obtained for the co-digestion mixture 75% OMSW-25% D. salina, keeping a C/N ratio near to 26.7/1.

Biological traits and growth patterns of pejerrey Odontesthes argentinensis.

This study assesses for the first time the relationship between annual cycles of different biological indices with growth patterns of a marine pejerrey Odontesthes argentinensis population near its southern-distribution boundary in North Patagonia. The reproductive period is between September and November evidenced by an increase in the gonado-somatic index with a peak in October corresponding to spawning. The reproductive cycle was also coupled with metabolic processes related to energy allocation as shown by changes in the hepato-somatic index and body condition. Total length (L(T) ) at maturity was 270 for females and 282 mm for males, whereas fecundity was estimated at mean ±s.d. = 9380 ± 1797 mature oocytes. Based on the marginal increment analysis, most of the scales showed a maximum value during summer, with a sharp decline thereafter during autumn and winter, indicating that scale rings are formed during the latter period and only once a year. Growth fitted by the von Bertalanffy model for both males and females did not show significant differences and showed a rapid growth during the first 2 years. The shorter reproductive period compared with that of the northern O. argentinensis populations inhabiting tropical and subtropical areas was interpreted as an adjustment to temperate environmental conditions. The larger maximum L(T) and L(T) at first maturity are in agreement with the counter-gradient hypothesis and could be related to the selective effects of low temperature and a shorter growing season. This latitude dependency argues strongly against the application of the same fishing regulations for different O. argentinensis populations as a whole and reinforces the need to assess basic biological features at a population scale to promote local sustainable fisheries management.

Narrow band quantitative and multivariate electroencephalogram analysis of peri-adolescent period.

BACKGROUND: The peri-adolescent period is a crucial developmental moment of transition from childhood to emergent adulthood. The present report analyses the differences in Power Spectrum (PS) of the Electroencephalogram (EEG) between late childhood (24 children between 8 and 13 years old) and young adulthood (24 young adults between 18 and 23 years old). RESULTS: The narrow band analysis of the Electroencephalogram was computed in the frequency range of 0-20 Hz. The analysis of mean and variance suggested that six frequency ranges presented a different rate of maturation at these ages, namely: low delta, delta-theta, low alpha, high alpha, low beta and high beta. For most of these bands the maturation seems to occur later in anterior sites than posterior sites. Correlational analysis showed a lower pattern of correlation between different frequencies in children than in young adults, suggesting a certain asynchrony in the maturation of different rhythms. The topographical analysis revealed similar topographies of the different rhythms in children and young adults. Principal Component Analysis (PCA) demonstrated the same internal structure for the Electroencephalogram of both age groups. Principal Component Analysis allowed to separate four subcomponents in the alpha range. All these subcomponents peaked at a lower frequency in children than in young adults. CONCLUSIONS: The present approaches complement and solve some of the incertitudes when the classical brain broad rhythm analysis is applied. Children have a higher absolute power than young adults for frequency ranges between 0-20 Hz, the correlation of Power Spectrum (PS) with age and the variance age comparison showed that there are six ranges of frequencies that can distinguish the level of EEG maturation in children and adults. The establishment of maturational order of different frequencies and its possible maturational interdependence would require a complete series including all the different ages.

Human biomarkers in breath by photoacoustic spectroscopy.

Photoacoustic spectrometry provides a novel approach to the analysis of human breath biomarkers. This unique methodology has specific applications for determination of ethylene oxide, nitrous oxide, ammonia as well as other compounds of interest including sevoflurane, halothane, isoflurane, methane, ethane and propofol. The advantages and disadvantages of photoacoustic spectrometry for this purpose are evaluated.

[A study to compare independent groups of patients with episodic migraine who were treated preventively with flunarizine or nadolol]. / Estudio comparativo de grupos independientes de pacientes con migrana episodica tratados preventivamente con flunaricina o nadolol.

INTRODUCTION. Flunarizine, with level of evidence A, and nadolol, with evidence level C, would be indicated as preventive treatment of migraine. Yet, no previous studies have been conducted to compare the effectiveness of the two drugs. AIM. To compare the effectiveness parameters in independent groups of patients treated preventively with one of the pharmaceuticals from the study, the same protocol being applied in both cases. PATIENTS AND METHODS. The subjects selected for the study were patients with episodic migraine (according to 2004 International Headache Society criteria) who had undergone preventive treatment for the first time, with flunarizine (5 mg/day) or nadolol (20-40 mg/day). The main effectiveness variables (reduction in the number of seizures at four months of treatment and responder rates) were analysed. RESULTS. The study included 227 patients who intended to receive treatment: 155 with flunarizine (80.5% females; mean age: 38.3 ± 12.1 years) and 72 with nadolol (63.8% females; mean age: 37.1 ± 12.0 years). The mean number of seizures prior to treatment was 6.09 ± 2.6 in the flunarizine group and 5.1 ± 1.7 in the nadolol group (p = 0.0079); at four months of treatment it was 2.61 ± 2.4 in the flunarizine group and 2.77 ± 2.4 in the nadolol group (p = NS). Percentage of reduction of migraines: 55.2% with flunarizine and 50.4% with nadolol (p = NS). The responder rate was 69% with flunarizine and 67% with nadolol (p = NS). The excellent response rate (reduction in the number of seizures by 75% or more) was 52.2% with flunarizine and 36.1% with nadolol (p = 0.0077). Percentage of adverse side effects: 48.3% with flunarizine and 25% with nadolol (p = 0.0009). The satisfaction rate was similar in both groups, 68%. CONCLUSIONS. Both flunarizine and nadolol proved to be effective in the preventive treatment of episodic migraine. Flunarizine is used more often in our milieu and was less well tolerated.

Towards high throughput production of artificial egg oocytes using microfluidics.

The production of micron-size droplets using microfluidic tools offers new opportunities to carry out biological assays in a controlled environment. We apply these strategies by using a flow-focusing microfluidic device to encapsulate Xenopus egg extracts, a biological system recapitulating key events of eukaryotic cell functions in vitro. We present a method to generate monodisperse egg extract-in-oil droplets and use high-speed imaging to characterize the droplet pinch-off dynamics leading to the production of trains of droplets. We use fluorescence microscopy to show that our method does not affect the biological activity of the encapsulated egg extract by observing the self-organization of microtubules and actin filaments, two main biopolymers of the cell cytoskeleton, encapsulated in the produced droplets. We anticipate that this assay might be useful for quantitative studies of biological systems in a confined environment as well as high throughput screenings for drug discovery.

[Patients with headache and medication abuse. Indicators of response to ambulatory treatment]. / Pacientes con cefalea y abuso de medicación. Indicadores de respuesta al tratamiento ambulatorio.

INTRODUCTION: Patients with headache and medication abuse (HMA) are difficult to treat, have a greater tendency towards chronification and a poorer quality of life than those with other types of headache. AIM. To evaluate the indicators showing that these patients are responding to ambulatory treatment. PATIENTS AND METHODS: From a series of patients with migraine, we selected those who satisfied HMA criteria according to the appendix of the 2006 International Classification of the Headache Disease (ICHD-2) and who had never previously undergone treatment. As outpatients, they were advised to stop taking the drug that they were abusing. The treatment of their seizures was adjusted with the most efficient drugs and preventive treatment was started from the outset with topiramate or flunarizine. Patients were grouped according to whether they continued with HMA or not. Comparisons were made between the number of days with headache during the previous month and after four months of treatment and the persistence of abuse. RESULTS: HMA criteria were met by 178 patients (mean age 40.9; 88.7% females). Results showed that 68.5% (122 patients) responded and no longer met HMA criteria after treatment. The treatment used for their seizures (triptans, nonsteroidal antiinflammatory drugs, analgesics) and preventive treatment (topiramate or flunarizine) were similar in both groups. The average number of days with headache prior to treatment was 18.52 in the group that responded and 20.87 (p = 0.0263) in the group that did not respond to treatment. In the group of responders 7.3% dropped out of preventive treatment compared with 35% (p = 0.0001) in the group of non-responders. CONCLUSIONS: A higher number of days with headache during the previous month and withdrawing from preventive treatment were indicators of a bad progression.

Susceptibility to Coccidioides species in C57BL/6 mice is associated with expression of a truncated splice variant of Dectin-1 (Clec7a).

Coccidioides posadasii spherules stimulate macrophages to make cytokines via TLR-2 and Dectin-1. We used formalin-killed spherules and 1,3-beta-glucan purified from spherules to stimulate elicited peritoneal macrophages and myeloid dendritic cells (mDCs) from susceptible (C57BL/6) and resistant (DBA/2) mouse strains. DBA/2 macrophages produced more TNF-alpha and IL-6 than macrophages from C57BL/6 mice, and the amount of TNF-alpha made was dependent on both TLR2 and Dectin-1. DCs from C57BL/6 mice made more IL-10 and less IL-23p19 and IL-12p70 than did DBA/2 DC. These responses were inhibited by a monoclonal antibody to Dectin-1. DBA/2 mice expressed full-length Dectin-1, whereas C57BL/6 mice spliced out exon 3, which encodes most of the stalk. RAW cells transduced to express the full-length Dectin-1 responded better to FKS than cells expressing truncated Dectin-1. We compared the isoform of Dectin-1 expressed by 34 C57BL/6 X DBA/2 recombinant inbred (BXD RI) lines with their susceptibility to Coccidioides immitis. In 25 of 34 RI lines susceptibility or resistance corresponded to short or full-length isoforms, respectively. These results suggest that alternative splicing of the Dectin-1 gene contributes to susceptibility of C57BL/6 mice to coccidioidomycosis, and affects the cytokine responses of macrophages and mDCs to spherules.

[Topiramate in chronic daily headache due to migraine]. / Topiramato en cefalea crónica diaria por migraña.

INTRODUCTION: Chronic daily headache (CDH) includes primary headaches that last more than four hours with a frequency equal or superior to 15 days a month over the last three months. It has a prevalence of 4-5% in the general population and is a frequent reason for visiting the physician in headache units. AIM: To evaluate the effectiveness of topiramate, as the primary drug, in CDH due to probable chronic migraine with or without medication abuse. PATIENTS AND METHODS: From the 447 patients with migraine in our database, we selected those: a) satisfying Silberstein criteria for CDH; b) that had not followed prior prophylactic treatment; and c) who were treated with topiramate as the primary drug. The mean number of days with headache and bouts of severe migraine in the fourth month of treatment using topiramate as compared to the month preceding treatment, as well as the percentage of responses and the rate of respondents in the fourth month were all analysed. RESULTS: Eighty-three patients (88% females) with a mean age of 38.0 +/- 14.13 years were selected. Medication abuse was reported in 44% of cases. At the fourth month of treatment, the mean number of days with headache dropped significantly from 20.8 to 7.9 (p < 0.0001) and the mean number of bouts of severe migraine diminished from 4.4 to 1.7 (p < 0.0001). The rate of respondents was 72%. Medication abuse continued in 14% of cases. Side effects were produced in 58% of patients and the dropout rate was 24%. CONCLUSIONS: Topiramate proved to be effective in the treatment of CDH due to probable chronic migraine and with probable medication abuse in de novo migraine patients.

Kinetic analysis of the anaerobic digestion of untreated vinasses and vinasses previously treated with Penicillium decumbens.

A kinetic study was carried out on the anaerobic digestion of untreated vinasses and vinasses previously fermented with Penicillium decumbens. Two 1-l volume continuous-flow stirred tank reactors (CFSTR) operating at mesophilic temperature (35 degrees C) were used for the study. One reactor was fed with untreated vinasses (COD concentration of 80.5 g/l) and the other with vinasses previously fermented (COD concentration of 23.0 g/l). Both reactors were operated at organic loading rates in the range of 1.5-7.5 g chemical oxygen demand (COD)/l-d. The results obtained were evaluated using the Chen-Hashimoto methane production model to determine the values of the maximum specific growth rate (micromax) and the model kinetic constant (K) of the process for each case studied. The kinetic constants (micromax and K) were affected by the pre-treatment, and the respective values were 9.6 and 6.9 times higher for pretreated vinasses than those of untreated vinasses. This was significant at the 95% confidence level. This behaviour is believed to be due to the lower levels of phenolic compounds present in the pretreated vinasses, as compared to untreated vinasses, resulting in an improved process performance, kinetics and stability. Finally, the experimental values of methane production were reproduced with deviations equal to or less than 4% and 10% for pretreated and untreated vinasses, respectively.

A study of the natural biodegradation of two-phase olive mill solid waste during its storage in an evaporation pond.

A study of the natural biodegradation of two-phase olive mill solid waste (OMSW) during its storage in an evaporation pond was carried out. This system is traditionally used as the final disposal of this waste or constitutes a previous stage before being processed by cogeneration or anaerobic digestion processes. A laboratory-scale pond with a total volume of 520 l was used. The experiment was carried out between December 2002 and August 2003 covering a total period of 269 days. During the experiment, the variations of temperature (outside and inside the pond), the effective volume of the OMSW in the pond, moisture content, total solids (TS), volatile solids (VS), the total chemical oxygen demand (TCOD), total volatile acids (TVA), pH and cumulative methane production as a function of the operation time were evaluated. The experimental results obtained showed that the characteristics of the two-phase OMSW in the pond were dependent on the time of operation and temperature. During the experiment, three periods were clearly observed and differentiated: (a) An initial period with a rapid reduction of moisture content and effective volume, with an increase of TS, VS and TCOD removals, a decrease of pH and an increase of TVA and methane production until day 21. (b) A second period of slow decrease of moisture content and effective volume, due to the decrease of the ambient temperature. This period took place between day 21 and days 120-150 of assay, and it was characterised by a slight change in the OMSW properties. (c) A third period where the characteristics of the waste in the pond changed considerably due to the increase of the temperature outside the pond. The methane gas production also showed an increase due to the increase of methanogenic activity with the increase of temperature. An empirical model to describe the changes of two-phase OMSW characteristics and methane production with the operation time was developed. The proposed model, based on the use of polynomial equations, took into account the influence of the temperature and fit adequately into the experimental results obtained. It was found that the pond could probably be used as preliminary treatment of two-phase OMSW before its anaerobic digestion process, because a maximum conversion of organic matter to TVA was obtained after an operation time of around 200 days.

[Topiramate or flunarizine in the preventive treatment of migraine. A comparative study of two series of cases]. / Topiramato o flunaricina en el tratamiento preventivo de la migraña. Estudio comparativo de dos series de casos.

INTRODUCTION: Both flunarizine and, more recently, topiramate have proved to be effective in the prophylaxis of migraine. AIM: To compare two independent groups of patients with similar clinical and demographic characteristics who were treated with flunarizine or topiramate as the preferred drug in the prevention of their migraines and to evaluate effectiveness and safety according to the medication they received. PATIENTS AND METHODS: All the patients reported more than four episodes a month and/or transformed migraine according to Silberstein's criteria, and had never received prophylactic treatment. Data determined: the number and average number of migraines in the previous month and at the fourth month of treatment, and the rate of respondents. RESULTS: A total of 125 patients were included in each group. No significant differences were found between the groups as regards mean age or the average number of migraines in the previous month. With both drugs there was a significant decrease (0.0001) in the mean number of episodes in the fourth month of treatment, but with no significant difference between them: topiramate (5.88 +/- 3.7 to 2.1 +/- 2.5) and flunarizine (5.24 +/- 3.2 to 2.3 +/- 2.7). The mean reduction in the number of migraines at the fourth month was 58.2 +/- 38.2% with topiramate, and 55.4 +/- 37.5% with flunarizine. The respondent rate was 71% with topiramate and 67% with flunarizine. The percentage of dropouts with topiramate (28%) was higher than with flunarizine (11%) (0.0013). With topiramate 69 patients reported side effects and 53 patients reported them with flunarizine (0.0427). CONCLUSIONS: Both drugs showed a high degree of effectiveness when used as the preferred drug in the preventive treatment of migraine. Topiramate offered better results as far as effectiveness is concerned, but also more side effects, none of which were serious.