Progress and challenges in valorisation of biomass waste from ornamental trees pruning through pyrolysis processes. Prospects in the bioenergy sector.

Nowadays, the scarcity of energy resources is promoting the search for alternative energy sources, boosting interest in the use of forest lignocellulosic residue in the energy sector. In this study, the focus is on the energy recovery from two lignocellulosic residues originated during the pruning of ornamental trees (Horse Chestnut, CI, and False Acacia, FA). Both conventional and flash pyrolysis techniques were applied. The experimental pyrolysis variables were obtained from the study of the thermal behaviour of the pruning residues in thermogravimetric analysis. It was carried out under 5 heating rates and kinetic parameters were estimated using Flynn-Wall-Ozawa method. Results denoted higher maximum mass loss rate values for the same release temperature regions under FA experiments. Also, FA samples had lower final residues for the processes. However, activation energy values were so close for both species. FA was also linked to the faster reactions according frequency factor outcomes. Conventional pyrolysis of pruning residues was carried out in a horizontal oven of original design at a heating rate of 25 °C/min, at 750 °C and 60 min of permanence at that temperature; flash pyrolysis was tested in that oven at 750 and 850 °C. In these pyrolysis processes, three fractions were obtained: bio-char, bio-oil and gas. The physicochemical attributes of the bio-chars suggested their potential utility as biofuels (28.4-29.8 MJ/kg), adsorbent precursors or soil additives. Conventional pyrolysis bio-oils had a dominant monoaromatic hydrocarbons nature, with phenols being the most abundant (≥60%), while flash bio-oils contain mainly polycyclic aromatic hydrocarbons. Conventional pyrolysis gases contained up to 60 vol% of CO2; flash pyrolysis gases had high combustible gas content (CO, CH4, H2) and a low CO2 content (<25 vol%). As a result, their calorific value (18.06 MJ/kg) exhibited a threefold increase compared to the gas produced through conventional pyrolysis (6.04 MJ/kg).

Paracetamol and salicylic acid removal from contaminated water by microalgae.

The biomass growth, pharmaceutical removal and light conversion efficiency of Chlorella sorokiniana under the presence of paracetamol (PC) and salicylic acid (SaC) were assessed and compared at two different concentrations of these pharmaceuticals (I: 25 mg l-1, II: 250 mg l-1). Microalgae were resistant to these concentrations and, moreover, their growth was significantly stimulated (p ≤ 0.05) under these drugs (biomass concentration increased above 33% PCI, 35% SaCI, 13% PCII and 45% SaCII, as compared with the respective positive controls). At the steady state of the semicontinuous culture, C. sorokiniana showed removal efficiencies above 41% and 69% for PCI and PCII, respectively; and above 93% and 98% for SaCI and SaCII, respectively. Under an irradiance of 370 µE m-2 s-1, higher quantum yields were reached by microalgae under the presence of drugs, either at dose I or II, than by the respective positive controls. These results point to C. sorokiniana as a robust strain for the bioremediation of paracetamol and salicylic acid concentrated wastewaters.

Dietary administration of the probiotic SpPdp11: Effects on the intestinal microbiota and immune-related gene expression of farmed Solea senegalensis treated with oxytetracycline.

Few antimicrobials are currently authorised in the aquaculture industry to treat infectious diseases. Among them, oxytetracycline (OTC) is one of the first-choice drugs for nearly all bacterial diseases. The objective of this study was to evaluate the effect of the dietary administration of OTC both alone and jointly with the probiotic Shewanella putrefaciens Pdp11 (SpPdp11) on the intestinal microbiota and hepatic expression of genes related to immunity in Senegalese sole (Solea senegalensis) juveniles. The results demonstrated that the richness and diversity of the intestinal microbiota of fish treated with OTC decreased compared with those of the control group but that these effects were lessened by the simultaneous administration of SpPdp11. In addition, specimens that received OTC and SpPdp11 jointly showed a decreased intensity of the Denaturing Gradient Gel Electrophoresis (DGGE) bands related to Vibrio genus and the presence of DGGE bands related to Lactobacillus and Shewanella genera. The relationship among the intestinal microbiota of fish fed with control and OTC diets and the expression of the NADPH oxidase and CASPASE-6 genes was demonstrated by a Principal Components Analysis (PCA) carried out in this study. In contrast, a close relationship between the transcription of genes, such as NKEF, IGF-ß, HSP70 and GP96, and the DGGE bands of fish treated jointly with OTC and SpPdp11 was observed in the PCA study. In summary, the results obtained in this study demonstrate that the administration of OTC results in the up-regulation of genes related to apoptosis but that the joint administration of OTC and S. putrefaciens Pdp11 increases the transcription of genes related to antiapoptotic effects and oxidative stress regulation. Further, a clear relationship between these changes and those detected in the intestinal microbiota is established.

The treatment with the probiotic Shewanella putrefaciens Pdp11 of specimens of Solea senegalensis exposed to high stocking densities to enhance their resistance to disease.

Aquaculture industry exposes fish to acute stress events, such as high stocking density, and a link between stress and higher susceptibility to diseases has been concluded. Several studies have demonstrated increased stress tolerance of fish treated with probiotics, but the mechanisms involved have not been elucidated. Shewanella putrefaciens Pdp11 is a strain isolated from healthy gilthead seabream (Sparus aurata L.) and it is considered as probiotics. The aim of this study was to evaluate the effect of the dietary administration of this probiotics on the stress tolerance of Solea senegalensis specimens farmed under high stocking density (PHD) compared to a group fed a commercial diet and farmed under the same conditions (CHD). In addition, during the experiment, a natural infectious outbreak due to Vibrio species affected fish farmed under crowding conditions. Changes in the microbiota and histology of intestine and in the transcription of immune response genes were evaluated at 19 and 30 days of the experiment. Mortality was observed after 9 days of the beginning of the experiment in CHD and PHD groups, it being higher in the CHD group. Fish farmed under crowding stress showed reduced expression of genes at 19 day probiotic feeding. On the contrary, a significant increase in immune related gene expression was detected in CHD fish at 30 day, whereas the gene expression in fish from PHD group was very similar to that showed in specimens fed and farmed with the conventional conditions. In addition, the dietary administration of S. putrefaciens Pdp11 produced an important modulation of the intestinal microbiota, which was significantly correlated with the high number of goblet cells detected in fish fed the probiotic diet.

Adsorption studies of a phosphonic acid on ITO: film coverage, purity, and induced electronic structure changes.

The deposition of a prototypical phosphonic acid from an ethanol solution onto indium-tin oxide is studied using XPS to assess the chemisorption kinetics and the purity of the film deposited, and UPS is employed to determine the electronic structure changes induced by the modifier. Room temperature (r.t.) vs. 75 °C depositions are compared, as well as the effect of using air plasma (AP) pretreatment vs. utilizing only detergent-solvent cleaning (DSC) prior to immersion. It is concluded that the order of adsorption kinetics and film purity follows the trend AP 75 °C > DSC 75 °C > AP r.t. > DSC r.t., while the work function obtained for each immersion time depends on whether the substrate is plasma pretreated or not and on the molecular dipole, which saturates at high coverages.

Microbiota composition and intestinal integrity remain unaltered after the inclusion of hydrolysed Nannochloropsis gaditana in Sparus aurata diet.

The use of lysed microalgae in the diet of carnivorous fish can increase the bioavailability of proteins and bioactive compounds, such as unsaturated fatty acids or vitamins in the digestive tract. These are essential molecules for the proper physiological development of fish in aquaculture. However, some antinutritional components and other undesirable molecules can be released from an excess of microalgae supplied, compromising the integrity of the intestine. The inclusion of small amounts of hydrolized microalgae in the fish diet can be a good strategy to avoid negative effects, improving the availability of beneficial compounds. Nannochloropsis gaditana is an interesting microalgae as it contains nutraceuticals. Previous studies reported beneficial effects after its inclusion in the diet of Sparus aurata, a widely cultured species in Europe and in all Mediterranean countries. However, administration of raw microalgae can produce intestinal inflammation, increased intestinal permeability, bacterial translocation and disturbance of digestion and absorption processes. The aim of this study was to evaluate changes in the intestinal microbiota and barrier stability of S. aurata fed with low inclusion (5%) hydrolysed N. gaditana. Intestinal microbiota was analyzed using Illumina MiSeq technology and libraries were constructed using variable regions V3-V4 of 16S rDNA molecules. Analysis were based in the identification, quantification and comparison of sequences. The predictive intestinal microbial functionality was analyzed with PICRUSt software. The results determined that the intestinal microbiota bacterial composition and the predictive intestinal microbiota functionality did not change statistically after the inclusion of N. gaditana on the diet. The study of gene expression showed that genes involved in intestinal permeability and integrity were not altered in fish treated with the experimental diet. The potential functionality and bacterial taxonomic composition of the intestinal microbiota, and the expression of integrity and permeability genes in the intestine of the carnivorous fish S. aurata were not affected by the inclusion of hydrolysed 5% N. gaditana microalgae.

Characterization of Vibrio harveyi strains recovered from diseased farmed Senegalese sole (Solea senegalensis).

AIM: To characterize 16 Vibrio harveyi strains isolated from different epizootic outbreaks affecting farmed Senegalese sole. MATERIALS AND RESULTS: The Vibrio harveyi strains tested have broad phenotypic diversity based on their biochemical and exoenzymatic patterns, outer membrane proteins (OMP), extracellular product (ECP) patterns and presence of prophages. Lethal dose 50 (LD(50)) of the strains and in vitro antagonism tests with two probiotic strains were also determined. The OMP analysis revealed three different patterns (A, M and V). The electrophoretic analysis of the ECP showed two different groups. All strains considered virulent based on their LD(50) exhibited the same protein pattern in their ECP (pattern I), while all nonvirulent strains showed a different profile (pattern II). About 32% of the tested strains were positive for prophages, although a clear relationship between virulence and the presence of prophages has not been established. CONCLUSIONS: The results obtained have shown differences between virulent and avirulent strains isolated from diseased farmed Senegalese sole based on the protein patterns of their ECP. However, a clear relationship between virulence and presence of prophages has not been established. SIGNIFICANCE AND IMPACT OF THE STUDY: The differences observed between virulent and nonvirulent strains could be used to design prophylactic strategies against diseases caused by V. harveyi in farmed Senegalese sole.

[The duodenal microbiota composition in children with active coeliac disease is influenced by the degree of enteropathy]. / La composición de la microbiota duodenal en niños con enfermedad celíaca activa está influenciada por el grado de enteropatía.

OBJECTIVES: To establish whether the duodenal mucosa microbiota of children with active coeliac disease (CD) and healthy controls (HC) differ in composition and biodiversity. MATERIAL AND METHODS: Samples of duodenal biopsies in 11 CD patients were obtained at diagnosis, and in 6 HC who were investigated for functional intestinal disorders of non-CD origin. Total duodenal microbiota and the belonging to the genus Lactobacillus using PCR-denaturing gradient gel electrophoresis (DGGE) were analysed. The banding patterns obtained in the resulting gels were analysed to determine the differences between the microbiota of CD patients and HC (FPQuest 4.5) while environmental indexes (richness, diversity and habitability) were calculated with the Past version 2.17 program. RESULTS: The intestinal microbiota of patients with Marsh 3c lesion showed similarity of 98% and differs from other CD patients with other type of histologic lesion as Marsh3a, Marsh3b and Marsh2. The main differences were obtained in ecological indexes belonging to the genus Lactobacillus, with significant richness, diversity and habitability reduction in CD patients. In CD bands were categorized primarily with Streptococcus, Bacteroides and E.coli species. In HC the predominant bands were Bifidobacterium, Lactobacillus and Acinetobacter, though the Streptococcus and Bacteroides were lower. CONCLUSIONS: The celiac patients with major histological affectation presented a similar microbiota duodenal. The ecological indexes applied to the genus Lactobacillus were significantly reduced in CD.

Nutrients and pharmaceuticals removal from wastewater by culture and harvesting of Chlorella sorokiniana.

This work aimed to study both the removal of nutrients and pharmaceuticals, namely salicylic acid or paracetamol, from water by the culture of Chlorella sorokiniana. The removal of nutrients was nearly complete at the end of the batch culture; above 70% for nitrates and 89% for phosphates in the semicontinuous culture. The pharmaceuticals removal kinetics were 2.3 times greater for the salicylic acid than paracetamol, reaching volumetric efficiencies above 93% for salicylic acid in the semicontinuous culture. Finally, to separate the microalgae biomass from treated water, metal salts, synthetic polyelectrolytes and a biopolymer were tested as coagulants-flocculants. The best flocculation results were achieved with AlCl3 (95.23% with 200mgg(-1), 1min incubation time). However, given that resulting flocs had different characteristics, flocculants must be chosen on the basis of the subsequent use of the biomass.

[Food consumption patterns among adolescents]. / La alimentación en el adolescente.

BACKGROUND: Adolescence is a critical time for the establishment of healthy eating habits. The objective was to analyze food consumption patterns among adolescents and their relationship with family and social factors. METHODS: Multicentre observational cross-sectional descriptive study using a food frequency questionnaire for the last week. It was answered anonymously. The adolescent's age/gender, parents' studies/occupation and school's location/type were included. The population sample was composed of 1,095 adolescents in sixth grade at primary schools from an Andalusian region. They were chosen by polietapic random sampling that distinguished between public/private and capital/provincial schools. RESULTS: 1,005 surveys were analyzed. The mean age is 11.45 (SD: 0.59). Fifty-three percent were male. The intake of dairy products (only two-thirds taken daily), pasta, fruit and vegetables (daily consumption of 30%) is deficient. Sixty-four point five percent consume legumes weekly. Fish consumption is equal to meat, with a preference for poultry. More than half consume red meat daily. Olive oil is preferred. The intake of "empty calories" (fast food, candies, soft drink) is high. Through multivariate analysis the existence of clusters of healthy and unhealthy foods, related to the social status of the parents and the type of school, is proved. CONCLUSIONS: A healthy diet based on the nutritional pyramid is not the consumption pattern in the adolescents surveyed. There is a low consumption of diary products, legumes, fruits and vegetables. There is a relationship between the social class of the family and consumption patterns (healthy and unhealthy). Health strategies are needed to modify such inappropriate consumption.

[Bilateral pelvic stress fracture]. / Fractura bilateral de pelvis por estrés.

A stress fracture is defined as that which occurs as a consequence of many low intensity traumas. These were originally described in the metatarsals of soldiers, and later on in athletes, and now we should consider them in general population subjected to excessive stress. Statistically, it generally occurs in women and in weight-bearing bones, such as the tibia, fibula and metatarsals. This case is of interest due to the diagnosis a double fracture in a woman without risk factors or increase in physical activity, and in an unusual location such as the pelvis. A detailed clinical history and examination are essential for the diagnosis.

[Permanence of last generation antiretroviral in daily clinical practice]. / Permanencia del tratamiento antirretroviral de última generación en la práctica clínica diaria.

INTRODUCTION: Time of permanence is a useful measure of success in last generation antiretroviral (LGA) therapy: raltegravir, darunavir, etravirine and maraviroc. The aim of our study was to analyze the permanence of antiretroviral therapy (ART) containing at least one LGA, and to compare it with other ART used in experienced patients. METHODS: Observational case-control study. It included adult outpatients whose ART was switched between 01/05/2008 and 01/09/2009. Cases (patients with at least one LGA) were matched (1:1) with pretreated patients who switched to an ART without any LGA (controls). The primary endpoint was the permanence of ART. The follow-up was conducted from the modification of ART to a year after the closure of the inclusion period. Results were adjusted for confounding variables: CD4 and viral load (VL) at baseline, MDR HIV infection and time from the first ART. RESULTS: 112 patients were included in each group. The permanence of ART was 16.7 months (cases) vs 16.8 months (controls), although statistically significant differences were not found after adjusting for confounding variables. Toxicity was the main reason of discontinuation (53.3% in cases vs 45.2% in controls, p = 0.70). The mean decrease in the logarithm of the VL was 0.89 in cases and 0.58 in controls (p = 0.223). The increase of CD4/microL was 77 and 73 respectively (p = 0.480). CONCLUSION: The permanence of ART in patients whose treatment contains a LGA is similar to those without any LGA.

Introducción: La permanencia es una medida útil del éxito de los tratamientos antirretrovirales de última generación (AUG): raltegravir, darunavir, etravirina y maraviroc. El objetivo de nuestro estudio fue analizar la permanencia de los tratamientos antirretrovirales (TAR) que contenían al menos un AUG, y compararla con otros TAR utilizados en pacientes experimentados. Métodos: Estudio observacional, de casos y controles, de pacientes adultos externos cuyo TAR fue modificado entre 01/05/2008 y 01/09/2009. Los casos (pacientes con al menos un AUG) fueron emparejados (relación 1:1) con pacientes pretratados que cambiaron a un TAR sin AUG (controles). La variable principal fue la permanencia del TAR. El seguimiento se realizó desde la modificación del TAR hasta un año después del cierre del período de inclusión. Los resultados se ajustaron por las variables de confusión: CD4 y carga viral (CV) basales, infección VIH multirresistente y tiempo desde el primer TAR. Resultados: Se incluyeron 112 pacientes en cada grupo. El tiempo de permanencia del TAR fue 16,7 meses (casos) vs 16,8 meses (controles), sin encontrarse diferencias estadísticamente significativas ajustando por las variables de confusión. La toxicidad fue el principal motivo de discontinuación (53,3% en casos vs 45,2% en controles, p = 0,70). La media en la disminución del logaritmo de la CV fue 0,89 en los casos y 0,58 en los controles (p = 0,223). El incremento de CD4/microL fue 77 y 73 respectivamente (p = 0,480). Conclusión: La permanencia del TAR en los pacientes cuyo tratamiento contiene algún AUG es similar a la de los pacientes que no lo contienen.

[Development and validation of a prediction model to identify HIV+ patients with drug-related problems. A prediction study]. / Desarrollo y validación de un modelo predictivo para la identificación de pacientes infectados por el VIH con problemas relacionados con los medicamentos. Estudio predictor.

OBJECTIVE: To develop and validate a prediction model for the detection of drug-related problems (DRP) in patients on antiretroviral treatment during their regular monitoring in Pharmaceutical Care Clinics before dispensing drugs. MEHOD: Open multicentre prospective study. HIV patients with and without DRP were included. Demographic, clinical and pharmacotherapy variables (related and unrelated to antiretroviral treatment) were included in the model design. To find prognostic factors for DRP, a binary logistic regression model was created after performing a univariate analysis that identified independent variables related to DRP these variables were introduced in the multivariate model for the final selection. Model validity was determined by the shrinkage method and the discriminatory power by Harrell's C-index. RESULTS: 733 patients were included. The variables "adherence", "prescription of drugs needing dosage adjustment", and "total number of drugs prescribed (apart from the antiretroviral treatment)" were independently related to the appearance of DRP. Probabilities predicted by the model, customising the coefficients using the uniform shrinkage method, showed a R(2)=0.962 for the construction sample and a R(2)=0.872 for the validation sample. The discriminatory capacity of the model was 0.816 for the construction sample and 0.779 for the validation sample. CONCLUSIONS: The developed and validated model enables detection of patients on antiretroviral treatment who are at a higher risk for experiencing a DRP. The prediction variables employed are commonly used in patient's pharmacotherapy record, allowing the model to be used in routine clinical practice.

La composición de la microbiota duodenal en niños con enfermedad celíaca activa está influenciada por el grado de enteropatía / The duodenal microbiota composition in children with active coeliac disease is influenced by the degree of enteropathy

OBJETIVOS: Comprobar diferencias en la microbiota duodenal al diagnóstico de la enfermedad celíaca (EC) en relación con un grupo control. MATERIAL Y MÉTODOS: Se obtuvieron muestras de biopsias duodenales en 11 pacientes con EC al diagnóstico y en 6 controles. Se analizó la microbiota duodenal total así como la perteneciente al género Lactobacillus mediante la técnica molecular PCR-electroforesis en gel con gradiente desnaturalizante (DGGE). Los patrones de bandas obtenidos en los geles resultantes fueron analizados para determinar las diferencias presentes entre la microbiota de pacientes con EC y de los controles (FPQuest 4.5), mientras que los índices ecológicos (riqueza, diversidad y habitabilidad) fueron calculados con el programa Past versión 2.17. RESULTADOS: La microbiota intestinal de los individuos con histología Marsh 3c presentó similitud del 98% y fue diferente del resto de pacientes celíacos. Las principales diferencias se obtuvieron en los índices ecológicos pertenecientes al género Lactobacillus, con importante reducción de especies en los celíacos respecto al grupo control (riqueza, diversidad y habitabilidad). En los pacientes con EC las bandas principalmente fueron catalogadas con las especies Streptococcus, Bacteroides y E.coli. En los controles las bandas predominantes fueron Bifidobacterium, Acinetobacter y Lactobacillus; sin embargo, los Streptococcus y Bacteroides fueron más bajos. CONCLUSIONES: Los índices ecológicos aplicados al género Lactobacillus fueron significativamente reducidos en los pacientes celíacos. Los casos con mayor afectación histológica presentaron una microbiota duodenal similar

OBJECTIVES: To establish whether the duodenal mucosa microbiota of children with active coeliac disease (CD) and healthy controls (HC) differ in composition and biodiversity. MATERIAL AND METHODS: Samples of duodenal biopsies in 11 CD patients were obtained at diagnosis, and in 6 HC who were investigated for functional intestinal disorders of non-CD origin. Total duodenal microbiota and the belonging to the genus Lactobacillus using PCR-denaturing gradient gel electrophoresis (DGGE) were analysed. The banding patterns obtained in the resulting gels were analysed to determine the differences between the microbiota of CD patients and HC (FPQuest 4.5) while environmental indexes (richness, diversity and habitability) were calculated with the Past version 2.17 program. RESULTS: The intestinal microbiota of patients with Marsh 3c lesion showed similarity of 98% and differs from other CD patients with other type of histologic lesion as Marsh3a, Marsh3b and Marsh2. The main differences were obtained in ecological indexes belonging to the genusLactobacillus, with significant richness, diversity and habitability reduction in CD patients. In CD bands were categorized primarily with Streptococcus, Bacteroides and E.coli species. In HC the predominant bands were Bifidobacterium, Lactobacillus and Acinetobacter, though theStreptococcus and Bacteroides were lower. CONCLUSIONS: The celiac patients with major histological affectation presented a similar microbiota duodenal. The ecological indexes applied to the genus Lactobacillus were significantly reduced in CD

Permanencia del tratamiento antirretroviral de última generación en la práctica clínica diaria / Permanence of last generation antiretroviral in daily clinical practica

Introducción: La permanencia es una medida útil del éxito de los tratamientos antirretrovirales de última generación (AUG): raltegravir, darunavir, etravirina y maraviroc. El objetivo de nuestro estudio fue analizar la permanencia de los tratamientos antirretrovirales (TAR) que contenían al menos un AUG, y compararla con otros TAR utilizados en pacientes experimentados. Métodos: Estudio observacional, de casos y controles, de pacientes adultos externos cuyo TAR fue modificado entre 01/05/2008 y 01/09/2009. Los casos (pacientes con al menos un AUG) fueron emparejados (relación 1:1) con pacientes pretratados que cambiaron a un TAR sin AUG (controles). La variable principal fue la permanencia del TAR. El seguimiento se realizó desde la modificación del TAR hasta un año después del cierre del período de inclusión. Los resultados se ajustaron por las variables de confusión: CD4 y carga viral (CV) basales, infección VIH multirresistente y tiempo desde el primer TAR. Resultados: Se incluyeron 112 pacientes en cada grupo. El tiempo de permanencia del TAR fue 16,7 meses (casos) vs 16,8 meses (controles), sin encontrarse diferencias estadísticamente significativas ajustando por las variables de confusión. La toxicidad fue el principal motivo de discontinuación (53,3% en casos vs 45,2% en controles, p =0,70). La media en la disminución del logaritmo de la CV fue 0,89 en los casos y 0,58 en los controles (p =0,223). El incremento de CD4/microL fue 77 y 73 respectivamente (p =0,480). Conclusión: La permanencia del TAR en los pacientes cuyo tratamiento contiene algún AUG es similar a la de los pacientes que no lo contienen (AU)

Introduction: Time of permanence is a useful measure of success in last generation antiretroviral (LGA) therapy: raltegravir, darunavir, etravirine and maraviroc. The aim of our study was to analyze the permanence of antiretroviral therapy (ART) containing at least one LGA, and to compare it with other ART used in experienced patients. Methods: Observational case-control study. It included adult outpatients whose ART was switched between 01/05/2008 and 01/09/2009. Cases (patients with at least one LGA) were matched (1:1) with pretreated patients who switched to an ART without any LGA (controls). The primary endpoint was the permanence of ART. The follow-up was conducted from the modification of ART to a year after the closure of the inclusion period. Results were adjusted for confounding variables: CD4 and viral load (VL) at baseline, MDR HIV infection and time from the first ART. Results: 112 patients were included in each group. The permanence of ART was 16.7 months (cases) vs 16.8 months (controls), although statistically significant differences were not found after adjusting for confounding variables. Toxicity was the main reason of discontinuation (53.3% in cases vs 45.2% in controls, p = 0.70). The mean decrease in the logarithm of the VL was 0.89 in cases and 0.58 in controls (p = 0.223). The increase of CD4/microL was 77 and 73 respectively (p = 0.480). Conclusion: The permanence of ART in patients whose treatment contains a LGA is similar to those without any LGA (AU)

Caracterización de adolescentes escolarizados con riesgo de suicidio, Medellín, 2006 / Characterization of school adolescent students with suicide risk in Medellin, 2006

OBJETIVO: explorar la posible asociación entre el riesgo de suicidio, depresión, consumo de psicoactivos y disfunción familiar en adolescentes escolarizados. METODOLOGÍA: se administró una encuesta de autoaplicación a una muestra aleatoria de 779 adolescentes para evaluar el riesgo de suicidio, depresión, consumo de sustancias psicoactivas y disfunción familiar; se utilizaron los instrumentos ISO-30, CDI-LA, CIDI-II y Apgar familiar respectivamente. Para el análisis se empleó la técnica del método casos y controles. RESULTADOS: la prevalencia del riesgo de suicidio se situó entre 23,0% y 26,5%. La depresión y la disfunción familiar se asociaron positivamente con el riesgo de suicidio, con una razón de disparidad de 4,3 y 2,0 respectivamente. CONCLUSIONES: los resultados muestran la magnitud de un problema que deben tener en cuenta las autoridades educativas, la administración municipal y los padres de familia. Es prioritario fortalecer los programas de detección de la depresión adolescente, como también exigir al Estado mejores tratamientos para depresión (no solo limitados al medicamento). Es necesario promover la estrategia de escuela de padres en instituciones educativas, hacer énfasis en temas referentes a la salud mental y resaltar la importancia en la comunicación, la cooperación, el afecto y el respeto entre los miembros de la familia.

OBJECTIVE: To explore the possible association between the risk of suicide, depression, consumption of psychoactive and family dysfunction in school adolescents. METHODOLOGY: It was administered a self-administered survey to a random sample of 779 adolescents to assess the risk of suicide, depression, psychoactive substance use and family dysfunction, the instruments were used ISO-30, CDI-LA-II CIDI and Family Apgar respectively. The analysis used the technique of case-control method. RESULTS: The prevalence of suicide risk was between 23.0% and 26.5%. Depression and family dysfunction were positively associated with suicide risk, with a disparity ratio of 4.3 and 2.0 respectively. CONCLUSIONS: The results show the magnitude of a problem that must take into account the educational authorities, the municipal administration and parents. A priority is to strengthen programs for adolescent depression screening, and also require to the State better treatments for depression (not just limited to the drug). We must promote the strategy of school parents in educational institutions, emphasizing issues related to mental health and stress the importance of communication, cooperation, affection and respect among family members.

Desarrollo y validación de un modelo predictivo para la identificación de pacientes infectados por el VIH con problemas relacionados con los medicamentos. Estudio predictor / Development and validation of a prediction model to identify HIV+ patients with drug-related problems. A prediction study

Objetivo: Desarrollar y validar un modelo predictivo para la detección de problemas relacionados con los medicamentos (PRM) en pacientes con tratamiento antirretroviral (TAR), durante su seguimiento periódico en consultas de atención farmacéutica (AF) y previamente a la dispensación. Método Para encontrar factores pronósticos de PRM, se realizó un modelo de regresión logística binaria tras un análisis univariante, el cual identificó variables independientes relacionadas con PRM que fueron introducidas en el modelo multivariante para la selección final. La validez del modelo se determinó por el método Shrinkage y la capacidad discriminatoria por el estadístico C-Harrell. Estudio multicéntrico, abierto, prospectivo. Se incluyeron pacientes infectados por el VIH con y sin PRM. Para el diseño del modelo se incluyeron variables demográficas, clínicas y farmacoterapéuticas (relacionadas o no con el TAR).Resultados Se incluyeron 733 pacientes. Las variables «adherencia», «prescripción de fármacos con necesidad de ajuste posológico» y «número de medicamentos totales prescritos (al margen del TAR)» se relacionaban de manera independiente con la aparición de PRM. Las probabilidades predichas por el modelo, personalizando los coeficientes por el método shrinkage uniforme mostraron un valor R2=0,962 para la muestra de construcción y R2=0,872 para la de validación. La capacidad discriminatoria del modelo fue de 0,816 para la muestra de construcción y 0,779 para la de validación. Conclusiones El modelo predictivo desarrollado y validado permite la detección de pacientes con tratamiento antirretroviral y con mayor riesgo de sufrir un PRM. Las variables predictoras utilizadas se corresponden con las manejadas habitualmente en la historia farmacoterapéutica del paciente, permitiendo su empleo sistemático en la práctica asistencial (AU)

Objective: To develop and validate a prediction model for the detection of drug-related problems (DRP) in patients on antiretroviral treatment during their regular monitoring in Pharmaceutical Care Clinics before dispensing drugs. Method: Open multicentre prospective study. HIV patients with and without DRP were included. Demographic, clinical and pharmacotherapy variables (related and unrelated to antiretroviral treatment) were included in the model design. To find prognostic factors for DRP, a binary logistic regression model was created after performing a univariate analysis that identified independent variables related to DRP these variables were introduced in the multivariate model for the final selection. Model validity was determined by the shrinkage method and the discriminatory power by Harrell’s C-index. Results: 733 patients were included. The variables ‘‘adherence’’, ‘‘prescription of drugs needing dosage adjustment’’, and ‘‘total number of drugs prescribed (apart from the antiretroviral treatment)’’ were independently related to the appearance of DRP. Probabilities predicted by the model, customising the coefficients using the uniform shrinkage method, showed aR2= 0.962 for the construction sample and a R2= 0.872 for the validation sample. The discriminatory capacity of the model was 0.816 for the construction sample and 0.779 for the validationsample. Conclusions: The developed and validated model enables detection of patients on antiretroviral treatment who are at a higher risk for experiencing a DRP. The prediction variables employed are commonly used in patient’s pharmacotherapy record, allowing the model to be used in routine clinical practice (AU)