Lithium levels and lifestyle in patients with bipolar disorder: a new tool for self-management.

BACKGROUND: Patients should get actively involved in the management of their illness. The aim of this study was to assess the influence of lifestyle factors, including sleep, diet, and physical activity, on lithium levels in patients with bipolar disorder. METHODS: A multicenter study was performed. In total, 157 lithium measurements were done biweekly in a sample of 65 patients (35 women) over 6 weeks. Lifestyle, based on total sleep hours and physical activity, was assessed by actigraphy. Diet was evaluated using the Mediterranean Lifestyle Index (Medlife). RESULTS: 35.4% of patients had a normal weight. The mean Medlife score was 14.5 (± 2.5) (moderate-good adherence to Mediterranean diet). BMI, daily dose of lithium and intensity of physical activity had a combined effect on lithium levels, after adjustment for other variables. Patients who practiced intense physical exercise, who took lower doses and had a higher BMI exhibited lower levels of lithium. CONCLUSIONS: Higher physical activity and BMI contribute to lower lithium levels. Patients should be made aware of these relationships to improve their perception of control and self-management. Lifestyle-based interventions contribute to establishing a more personalized medicine.

[Epidemiological data about attention deficit hyperactivity disorder in a sample of Marabino children]. / Datos epidemiológicos del trastorno por déficit de atención con hiperactividad en una muestra de niños marabinos.

AIMS: This study reports the findings of a research project aimed at determining the rate of prevalence of attention deficit hyperactivity disorder (ADHD) in school aged children. PATIENTS AND METHODS: Different behavioural and cognitive measures were administered to a sample of children between 3 and 13 years of age obtained by means of a multistage sampling procedure that was stratified by socioeconomic and educational level. The sample was made up of 394 children; 33.25% (n = 131) were females and the remaining 66.75% (n = 263) males. The mean age of the sample was 7.64 years old (SD: 2.33). The assessment battery included the Conners Rating Scales adapted for parents and teachers, the abbreviated version of the Wechsler Intelligence Scale for Children (WISC III) and for Preschool children Revised (WPPSI R), several academic achievement scales, development history and DISC IV. RESULTS: The estimated prevalence of ADHD was 10.15%, and a figure of 2.03% was obtained for the hyperactive type, 0.51% for the inattentive subtype, and 7.61% for the combined subtype. Prevalence was higher for males, the ratio being 3:1. Subjects performance in the cognitive and academic measures was within the average interval. CONCLUSIONS: The prevalence of ADHD in our population oscillates around the average figures reported in other countries. This study confirms the prevalence of ADHD in the population of Venezuela, with a distribution of subtypes and in terms of gender similar to those reported in the literature.

Datos epidemiológicos del trastorno por déficit de atención con hiperactividad en una muestra de niños marabinos / Epidemiological data about attention deficit hyperactivity disorder in a sample of marabino children

Objetivo. Este estudio comunica los resultados de una investigación dirigida a determinar la tasa de prevalencia del trastorno por déficit de atención con hiperactividad (TDAH) en niños en edad escolar. Pacientes y método. Se administraron diferentes pruebas conductuales y cognitivas a una muestra comunitaria de niños entre 3 y 13 años, extraída a través de un muestreo en varias etapas y estratificado por nivel socioeconómico y escolaridad. La muestra estaba constituida por 394 niños; el 33,25 por ciento (n = 131) fueron niñas, y el 66,75 por ciento (n = 263), niños. La edad promedio de la muestra fue 7,64 años (DE: 2,33). La batería de evaluación incluyó las escalas de Conners revisadas para padres y maestros, la versión abreviada de la escala Wechsler para niños, 3.ª edición (WISC-III) y para preescolares revisada (WPPSI-R), unas escalas de aprovechamiento académico, historia de desarrollo, y la DISC-IV. Resultados. La prevalencia estimada del TDAH fue del 10,15 por ciento, y se obtuvo un 2,03 por ciento para el tipo hiperactivo, un 0,51 por ciento para el subtipo desatento, y un 7,61 por ciento para el subtipo combinado. La prevalencia fue mayor para el sexo masculino, en una proporción de 3:1. La ejecución de los sujetos en las medidas cognitivas y académicas estuvo dentro del intervalo promedio. Conclusiones. Las cifras de prevalencia del TDAH en nuestra población oscilan alrededor de los datos promedios comunicados en otros países. Este estudio confirma la prevalencia del TDAH en la población venezolana, con una distribución de los subtipos y por sexos similar a lo descrito en la bibliografía (AU)

Aims. This study reports the findings of a research project aimed at determining the rate of prevalence of attention deficit hyperactivity disorder (ADHD) in school-aged children. Patients and methods. Different behavioural and cognitive measures were administered to a sample of children between 3 and 13 years of age obtained by means of a multistage sampling procedure that was stratified by socioeconomic and educational level. The sample was made up of 394 children; 33.25% (n = 131) were females and the remaining 66.75% (n = 263) males. The mean age of the sample was 7.64 years old (SD: 2.33). The assessment battery included the Conners’ Rating Scales adapted for parents and teachers, the abbreviated version of the Wechsler Intelligence Scale for Children (WISC-III) and for Preschool children-Revised (WPPSI-R), several academic achievement scales, development history and DISC-IV. Results. The estimated prevalence of ADHD was 10.15%, and a figure of 2.03% was obtained for the hyperactive type, 0.51% for the inattentive subtype, and 7.61% for the combined subtype. Prevalence was higher for males, the ratio being 3:1. Subjects’ performance in the cognitive and academic measures was within the average interval. Conclusions. The prevalence of ADHD in our population oscillates around the average figures reported in other countries. This study confirms the prevalence of ADHD in the population of Venezuela, with a distribution of subtypes and in terms of gender similar to those reported in the literature (AU)

[Estimations of the prevalence of attention deficit hyperactivity disorder in Marabino children]. / Estimaciones de la prevalencia del trastorno por déficit de atención-hiperactividad en niños marabinos.

AIMS: This study reports the findings of research aimed at determining the rate of prevalence of attention deficit hyperactivity disorder (ADHD) in children of school age. SUBJECTS AND METHOD: The epidemiological study was conducted using a community sample extracted by means of multi stage stratified sampling according to socio economic level and schooling and consisted in 1,141 children of both sexes of school age from the city of Maracaibo. The revised Conners scales were used to collect data. RESULTS: The estimated prevalence of ADHD was 7.19% and we also obtained 0.35% for the hyperactive type, 1.14% for the disattentional subtype, and 5.70% for the combined type. Contrary to what was expected, prevalence was higher for females. It was found that 7.45% of the general sample scored higher on the academic problems scales, whereas for the sample identified as having ADHD, academic problems were 50% and the comorbidity between ADHD and academic problems was confirmed. CONCLUSIONS: The estimates for prevalence found in this study are consistent with those reported in the literature, which suggests that ADHD is a valid diagnosis for Marabino children.

Estimaciones de la prevalencia del trastorno por déficitde atención-hiperactividad en niños marabinos / Estimations of the prevalence of attention deficit hyperactivity disorder in marabino children

Objetivo. Este estudio comunica los resultados de una investigación dirigida a determinar la tasa de prevalencia del trastorno por déficit de atención-hiperactividad (TDAH) en niños en edad escolar. Sujetos y métodos. El estudio epidemiológico se realizó con una muestra comunitaria extraída a través de un muestreo polietápico y estratificado por nivel socioeconómico y escolaridad; quedó constituida por 1.141 niños de ambos sexos en edad escolar de la ciudad de Maracaibo. Se utilizaron las escalas de Conners revisadas como mé todo de recolección de datos. Resultados. La prevalencia estimada del TDAH fue del 7,19 por ciento, y se obtuvo un 0,35 por ciento para el subtipo hiperactivo, un 1,14 por ciento para el subtipo desatento y un 5,70 por ciento para el subtipo combinado. Contrario a lo esperado, la prevalencia fue mayor para el sexo femenino. Se encontró que el 7,45 por ciento de la muestra general puntuó elevado en las escalas de problemas académicos, mientras que para la muestra identificada como con TDAH, los problemas académicos fueron del 50 por ciento, y se confirmó la comorbilidad entre TDAH y problemas académicos. Conclusiones. Los estimados de prevalencia encontrados en este estudio son consistentes con los hallazgos comunicados en la literatura, lo cual sugiere que el TDAH es un diagnóstico válido para los niños marabinos (AU)

Toluene alters mu-opioid receptor expression in the rat brainstem.

Toluene is an ototoxic organic solvent widely used in industry and could be a cause of sleep apnea. Acute toluene administration in rats induces an increase in the number of neural cells immunostained for mu-opioid receptors in several brainstem nuclei, such as the inferior colliculus, dorsal and lateral periaqueductal gray and dorsal raphe, without changes in the superior colliculus and the interpeduncular and lateral reticular nuclei. These data suggest that mu-opioid receptors could be involved in toluene-induced neurotoxic effects on the physiological regulation of breathing during sleep, and auditive function.

Comparación de los efectos de la administración de fluoxetinay sertralina sobre el inmunomarcajedel receptor opioide mu en el cerebro de la rata / Comparison of the effects of the administration of fluoxetine and sertraline on the immunomarking of the mu opioid receptor in rat brain

Introducción. La administración crónica de fluoxetina en ratas origina un incremento en el número de células nerviosas que expresan el receptor opioide mu en diversas regiones prosencefálicas, siguiendo un patrón muy parecido al desencadenado por la administración de imipramina. Objetivo. Este trabajo pretende describir los efectos de la administración crónica de sertralina sobre el inmunomarcaje de receptores opioides mu en diversas regiones prosencefálicas de la rata y comparar su acción con la ejercida por la fluoxetina. Material y métodos. Se emplearon ratas tratadas por vía intraperitoneal con el fármaco, utilizándose posteriormente un método inmunocitoquímico y un equipo de análisis de imagen para determinar el número de células nerviosas por unidad de superficie que expresaban el receptor opioide mu en las regiones prosencefálicas estudiadas. Resultados. Aunque la administración crónica de sertralina en ratas genera un incremento estadísticamente significativo en el número de células nerviosas que expresan el receptor opioide mu en el caudado putamen, el giro dentado, el septo lateral y las cortezas frontal, parietal y piriforme, existen algunas ligeras diferencias regionales en su acción con respecto a lo descrito anteriormente para el caso de la fluoxetina, tales como un mayor efecto de la sertralina sobre la corteza parietal y el septo y una acción menos intensa sobre la corteza frontal. Conclusión. Las diferencias regionales observadas en la acción de la sertralina (con respecto a fluoxetina) sobre la expresión del receptor opioide mu en el prosencéfalo de la rata podrían relacionarse con una menor incidencia de efectos adversos de tipo psicomotor (AU)

[Comparison of the effects of the administration of fluoxetine and sertraline on the immune markers of the mu opioid receptor in the rat brain]. / Comparación de los efectos de la administración de fluoxetina y sertralina sobre el inmunomarcaje del receptor opioide mu en el cerebro de la rata.

INTRODUCTION: Chronic fluoxetine or imipramine administration in rats can generate a similar increase in the number of neural cells immunostained for mu opioid receptors in several prosencephalic regions. OBJECTIVE: The aim of the present work was to describe the effects of chronic sertraline administration on mu opioid receptor immunostaining in several rat brain prosencephalic regions, in order to compare with previously described fluoxetine effects. MATERIALS AND METHODS: Experimental animals were chronically administered with sertraline (i.p.). An immunocytochemical method, with the aid of a computerized image analysis system, was used in order to measure the number of neural cells immunostained for mu opioid receptors in several prosencephalic regions. RESULTS: Although chronic sertraline administration in rats generates a significant increase in the number of neural cells immunostained for mu opioid receptors in the caudatus-putamen, dentate gyrus, lateral septum and the frontal, parietal and piriform cortices, slight regional differences, with respect to fluoxetine action, were found. Thus, a more marked action on parietal cortex and lateral septum, and a lesser action on the frontal cortex, were found. CONCLUSION: Regional differences in sertraline effects, with respect to fluoxetine, could be related to a lesser incidence of psychomotor impairment.

[Clinical assessment of a group of children with juvenile rheumatoid arthritis receiving long-term treatment with oral gold salt]. / Valutazione clinica su un gruppo di bambini affetti da artrite reumatoide giovanile in terapia con sali d'oro orali a lungo termine.

The authors assess the efficacy of gold salt treatment for juvenile rheumatoid arthritis. The study was carried out on 16 children suffering from mono-pauciarticular, polyarticular and systemic arthritis. Treatment consisted of the administration of auranofin alone in a group of 8 children and auranofin associated to corticosteroids in a second group of 8 children. A marked improvement in clinical conditions was observed with slight transitory side effects at follow-up after 12 and 24 months.