CandeSpartan Study: Candesartan Spanish Response-prediction and Tolerability study in migraine.

INTRODUCTION: Effectiveness of candesartan in migraine prevention is supported by two randomized controlled trials. We aimed to assess the effectiveness, tolerability, and response predictors of candesartan in the preventive treatment of migraine. METHODS: Observational, multicenter, prospective cohort study. The 50%, 75% and 30% responder rates, between weeks 8-12 and 20-24, were compared with the baseline. Treatment emergent adverse effects were systematically evaluated. Response predictors were estimated by multivariate regression models. RESULTS: Eighty-six patients were included, 79.1% females, aged 39.5 (inter-quartile range [IQR] 26.3-50.3), with chronic migraine (43.0%), medication overuse headache (55.8%) and a median of two (inter-quartile range: 0.75-3) prior preventive treatments. At baseline patients had 14 (10-24) headache and 8 (5-11) migraine days per month. The 30%, 50% and 75% responder rates were 40%, 34.9% and 15.1% between weeks 8-12, and 48.8%, 36%, and 18.6% between weeks 20-24. Adverse effects were reported by 30 (34.9%) and 13 (15.1%) patients between weeks 0-12 and 12-24, leading to discontinuation in 15 (17.4%) patients. Chronic migraine, depression, headache days per month, medication overuse headache, and daily headache at baseline predicted the response between weeks 20-24. CONCLUSION: Candesartan effectiveness and tolerability in migraine prevention was in line with the clinical trials' efficacy.Trial registration: The study protocol is registered in ClinicalTrials.gov (NCT04138316).

Vitamin D deficiency and SARS­CoV­2 infection: A retrospective case-Control study with big-data analysis covering March 2020 to March 2021.

BACKGROUND: Vitamin D may have immunomodulatory functions, and might therefore play a role in the pathogenesis of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, no conclusive evidence exists regarding its impact on the prevalence of this infection, the associated course of disease, or prognosis. OBJECTIVE: To study the association between SARS-CoV-2 infection and vitamin D deficiency in patients attending a tertiary university hospital, and to examine the clinical course of infection and prognosis for these patients. METHODS: This non-interventional, retrospective study, which involved big-data analysis and employed artificial intelligence to capture data from free text in the electronic health records of patients diagnosed with SARS-CoV-2, was undertaken at a tertiary university hospital in Madrid, Spain, between March 2020 and March 2021. The variables recorded were vitamin D deficiency, sociodemographic and clinical characteristics, course of disease, and prognosis. RESULTS: Of the 143,157 patients analysed, 36,261 had SARS-CoV-2 infection (25.33%) during the study period, among whom 2,588 (7.14%) had a vitamin D deficiency. Among these latter patients, women (OR 1.45 [95%CI 1.33-1.57]), adults over 80 years of age (OR 2.63 [95%CI 2.38-2.91]), people living in nursing homes (OR 2.88 [95%CI 2.95-3.45]), and patients with walking dependence (OR 3.45 [95%CI 2.85-4.26]) appeared in higher proportion. After adjusting for confounding factors, a higher proportion of subjects with SARS-CoV-2 plus vitamin D deficiency required hospitalisation (OR 1.38 [95%CI 1.26-1.51]), and had a longer mean hospital stay (3.94 compared to 2.19 days in those with normal levels; P = 0.02). CONCLUSION: A low serum 25(OH) vitamin D concentration in patients with SARS-CoV-2 infection is significantly associated with a greater risk of hospitalisation and a longer hospital stay. Among such patients, higher proportions of institutionalised and dependent people over 80 years of age were detected.

Corrigendum: Editorial: Cross-talk between heterogeneous cell types in skeletal muscle: implications for glucose metabolism.

[This corrects the article DOI: 10.3389/fendo.2023.1185725.].

The transcriptional control of the VEGFA-VEGFR1 (FLT1) axis in alternatively polarized murine and human macrophages.

Introduction: Macrophages significantly contribute to the regulation of vessel formation under physiological and pathological conditions. Although the angiogenesis-regulating role of alternatively polarized macrophages is quite controversial, a growing number of evidence shows that they can participate in the later phases of angiogenesis, including vessel sprouting and remodeling or regression. However, the epigenetic and transcriptional regulatory mechanisms controlling this angiogenesis-modulating program are not fully understood. Results: Here we show that IL-4 can coordinately regulate the VEGFA-VEGFR1 (FLT1) axis via simultaneously inhibiting the proangiogenic Vegfa and inducing the antiangiogenic Flt1 expression in murine bone marrow-derived macrophages, which leads to the attenuated proangiogenic activity of alternatively polarized macrophages. The IL-4-activated STAT6 and IL-4-STAT6 signaling pathway-induced EGR2 transcription factors play a direct role in the transcriptional regulation of the Vegfa-Flt1 axis. We demonstrated that this phenomenon is not restricted to the murine bone marrow-derived macrophages, but can also be observed in different murine tissue-resident macrophages ex vivo and parasites-elicited macrophages in vivo with minor cell type-specific differences. Furthermore, IL-4 exposure can modulate the hypoxic response of genes in both murine and human macrophages leading to a blunted Vegfa/VEGFA and synergistically induced Flt1/FLT1 expression. Discussion: Our findings establish that the IL-4-activated epigenetic and transcriptional program can determine angiogenesis-regulating properties in alternatively polarized macrophages under normoxic and hypoxic conditions.

Regenerative inflammation: When immune cells help to re-build tissues.

Inflammation is an essential immune response critical for responding to infection, injury and maintenance of tissue homeostasis. Upon injury, regenerative inflammation promotes tissue repair by a timed and coordinated infiltration of diverse cell types and the secretion of growth factors, cytokines and lipids mediators. Remarkably, throughout evolution as well as mammalian development, this type of physiological inflammation is highly associated with immunosuppression. For instance, regenerative inflammation is the consequence of an in situ macrophage polarization resulting in a transition from pro-inflammatory to anti-inflammatory/pro-regenerative response. Immune cells are the first responders upon injury, infiltrating the damaged tissue and initiating a pro-inflammatory response depleting cell debris and necrotic cells. After phagocytosis, macrophages undergo multiple coordinated metabolic and transcriptional changes allowing the transition and dictating the initiation of the regenerative phase. Differences between a highly efficient, complete ad integrum tissue repair, such as, acute skeletal muscle injury, and insufficient regenerative inflammation, as the one developing in Duchenne Muscular Dystrophy (DMD), highlight the importance of a coordinated response orchestrated by immune cells. During regenerative inflammation, these cells interact with others and alter the niche, affecting the character of inflammation itself and, therefore, the progression of tissue repair. Comparing acute muscle injury and chronic inflammation in DMD, we review how the same cells and molecules in different numbers, concentration and timing contribute to very different outcomes. Thus, it is important to understand and identify the distinct functions and secreted molecules of macrophages, and potentially other immune cells, during tissue repair, and the contributors to the macrophage switch leveraging this knowledge in treating diseases.

Evaluation of the viasure Neisseria gonorrhoeae ciprofloxacin resistant assay for the simultaneous identification and direct detection of ciprofloxacin susceptibility.

The detection of resistance without the need for culture is essential to establish a guided treatment against Neisseria gonorrhoeae (NG) infections. We evaluated the VIASURE Neisseria gonorrhoeae ciprofloxacin resistant Real Time PCR Detection Kit (CerTest Biotec S.L, Zaragoza, Spain) for the simultaneous identification and direct detection of ciprofloxacin susceptibility in 88 NG isolates and 133 positive NG clinical samples of different anatomical location. The sensitivity for NG detection was 93.2% and the specificity 100%. The sensitivity of the test to characterize resistance/susceptibility to ciprofloxacin was (96.5%). In conclusion, the test evaluated is suitable for use to establish a targeted therapy with oral ciprofloxacin in case of not detecting resistance.

Antibody Response Induced by BNT162b2 and mRNA-1273 Vaccines against the SARS-CoV-2 in a Cohort of Healthcare Workers.

The aim of this study was to characterize the antibody response induced by SARS-CoV-2 mRNA vaccines in a cohort of healthcare workers. A total of 2247 serum samples were analyzed using the Elecsys® Anti-SARS-CoV-2 S-test (Roche Diagnostics International Ltd., Rotkreuz, Switzerland). Sex, age, body mass index (BMI), arterial hypertension, smoking and time between infection and/or vaccination and serology were considered the confounding factors. Regarding the medians, subjects previously infected with SARS-CoV-2 who preserved their response to the nucleocapsid (N) protein showed higher humoral immunogenicity (BNT162b2: 6456.0 U/mL median; mRNA-1273: 2505.0 U/mL) compared with non-infected (BNT162b2: 867.0 U/mL; mRNA-1273: 2300.5 U/mL) and infected subjects with a lost response to N protein (BNT162b2: 2992.0 U/mL). After controlling for the confounders, a higher response was still observed for mRNA-1273 compared with BNT162b2 in uninfected individuals (FC = 2.35, p < 0.0001) but not in previously infected subjects (1.11 FC, p = 0.1862). The lowest levels of antibodies were detected in previously infected non-vaccinated individuals (39.4 U/mL). Clinical variables previously linked to poor prognoses regarding SARS-CoV-2 infection, such as age, BMI and arterial hypertension, were positively associated with increasing levels of anti-S protein antibody exclusively in infected subjects. The mRNA-1273 vaccine generated a higher antibody response to the S protein than BNT162b2 in non-infected subjects only.

Comparison of the PU.1 transcriptional regulome and interactome in human and mouse inflammatory dendritic cells.

Dendritic cells (DCs) are key immune modulators and are able to mount immune responses or tolerance. DC differentiation and activation imply a plethora of molecular and cellular responses, including transcriptional changes. PU.1 is a highly expressed transcription factor in DCs and coordinates relevant aspects of DC biology. Due to their role as immune regulators, DCs pose as a promising immunotherapy tool. However, some of their functional features, such as survival, activation, or migration, are compromised due to the limitations to simulate in vitro the physiologic DC differentiation process. A better knowledge of transcriptional programs would allow the identification of potential targets for manipulation with the aim of obtaining "qualified" DCs for immunotherapy purposes. Most of the current knowledge regarding DC biology derives from studies using mouse models, which not always find a parallel in human. In the present study, we dissect the PU.1 transcriptional regulome and interactome in mouse and human DCs, in the steady state or LPS activated. The PU.1 transcriptional regulome was identified by performing PU.1 chromatin immunoprecipitation followed by high-throughput sequencing and pairing these data with RNAsequencing data. The PU.1 interactome was identified by performing PU.1 immunoprecipitation followed by mass spectrometry analysis. Our results portray PU.1 as a pivotal factor that plays an important role in the regulation of genes required for proper DC activation and function, and assures the repression of nonlineage genes. The interspecies differences between human and mouse DCs are surprisingly substantial, highlighting the need to study the biology of human DCs.

Mineral dust as a driver of carbon accumulation in northern latitudes.

Peatlands in northern latitudes sequester one third of the world's soil organic carbon. Mineral dusts can affect the primary productivity of terrestrial systems through nutrient transport but this process has not yet been documented in these peat-rich regions. Here we analysed organic and inorganic fractions of an 8900-year-old sequence from Store Mosse (the "Great Bog") in southern Sweden. Between 5420 and 4550 cal yr BP, we observe a seven-fold increase in net peat-accumulation rates corresponding to a maximum carbon-burial rate of 150 g C m-2 yr-1 - more than six times the global average. This high peat accumulation event occurs in parallel with a distinct change in the character of the dust deposited on the bog, which moves from being dominated by clay minerals to less weathered, phosphate and feldspar minerals. We hypothesize that this shift boosted nutrient input to the bog and stimulated ecosystem productivity. This study shows that diffuse sources and dust dynamics in northern temperate latitudes, often overlooked by the dust community in favour of arid and semi-arid regions, can be important drivers of peatland carbon accumulation and by extension, global climate, warranting further consideration in predictions of future climate variability.

Prevalence of rheumatoid cachexia assessed by bioelectrical impedance vector analysis and its relation with physical function.

Rheumatoid arthritis (RA) patients frequently have changes in their body composition, with a decrease in muscle mass and an increase in fat mass, a syndrome that is termed rheumatoid cachexia (RC). The prevalence of this nutritional alteration is not well known; there is as yet no consensus, seeing as it depends on the methods, techniques, and cutoff points that are used for its diagnosis. The main aim of this study was to identify RC through assessment by bioelectrical impedance vector analysis (BIVA) and its association with metabolic causes, physical function, and the main disease status, among others. The prevalence of RC was identified in those subjects who fell outside the right lower quadrant of the reference curve of RXc graph of BIVA. Clinical, anthropometric, biochemical and physical activity, emotional status, and diet markers were also evaluated. Ninety-four patients were included (92.55% women). The prevalence of RC assessed by BIVA was 21.28%. BIVA-cachexia patients had a lesser value of handgrip strength vs. patients without BIVA-cachexia 10.2 kg (7.2-13.4) vs. 14.7 kg (9.6-19), p = 0.0062. Disability and folic acid with methotrexate consumption are related to BIVA-cachexia ((OR 4.69, 95% CI 1.33, 16.54, p = 0.016) and (OR 0.19, 95%CI 0.058, 0.651, p = 0.008), respectively). BIVA could represent a valuable tool to assess presence of RC. It is important that RA patients have physical therapy to improve their nutritional status.

Long-term evaluation of quality of life and satisfaction between implant bar overdentures and conventional complete dentures: A 23 years retrospective study.

BACKGROUND: Dental implants have been used in edentulous jaws to improve the retention and stability of complete dentures. Attachment to the implants improves stability and function of the prostheses and increases patient satisfaction. PURPOSE: The aim of this study was to evaluate quality of life and satisfaction between patients with implant overdentures and complete dentures for more than 20 years. METHODS: Forty patients with overdentures and 40 patients with conventional complete dentures were included in this study. Both groups are carriers of their prosthesis more than 20 years. All patients completed an OHIP-14 and perception and satisfaction questionnaire related their implant prothesis. RESULTS: Follow-up mean in patients with overdentures were 23.27 ± 1.87 years and 23.20 ± 3.91 years for conventional prosthesis group. A worse quality of life was shown in the group of patients with conventional dentures in the 7 dimensions and in the total value, with statistically significant differences in 6 dimensions and in the total value (P ≤ .05). Patients with implants overdenture were more satisfied than patients with conventional dentures, with statistically significant differences (P < .001). CONCLUSIONS: Implant overdentures on cobalt chrome and gold bars offer an excellent long-term solution for edentulism compared with conventional denture.

Crestal bone loss around submerged and non-submerged implants during the osseointegration phase with different healing abutment designs: a randomized prospective clinical study.

OBJECTIVE: To evaluate peri-implant crestal bone loss during the osseointegration period, comparing submerged and non-submerged implants with healing abutments of different design. MATERIALS AND METHODS: A total of 90 Avinent®  dental implants (Avinent Implant System, Barcelona, Spain) were placed in 90 patients. All were sited in the posterior mandibular zone to replace teeth 3.6 or 4.6. Patients were divided randomly into three groups: submerged (n = 30), non-submerged with anatomical healing abutment (n = 30), and non-submerged with esthetic healing abutment (n = 30). Peri-implant crestal bone loss was evaluated in intraoral radiographs taken at baseline, 1, and 3 months after implant placement. RESULTS: Peri-implant crestal bone loss at the end of the (3-month) osseointegration period was lowest in the submerged group (0.11 ± 0.14 mm), followed by the esthetic non-submerged group (0.15 ± 0.06 mm), but without statistically significant difference between these groups (P = 0.234). The greatest bone loss was produced in the non-submerged group with anatomical healing abutments (0.37 ± 0.12 mm), with significant differences between this group and the other two (P < 0.001). CONCLUSIONS: On the basis of these findings, bone resorption during the osseointegration period using the non-submerged technique varied significantly depending on the morphology of the healing abutment used. The non-submerged technique with an esthetic healing post-produced an equally predictable outcome compared with the submerged technique.

Industrial-era lead and mercury contamination in southern Greenland implicates North American sources.

To study the long-range transport of atmospheric pollutants from lower latitude industrial areas to the Arctic, we analysed a peat core spanning the last ~700cal.yr (~1300-2000CE) from southern Greenland, an area sensitive to atmospheric pollution from North American and Eurasian sources. A previous investigation conducted in the same location recorded atmospheric lead (Pb) pollution after ~1845, with peak values recorded in the 1970s, and concluded that a North American source was most likely. To confirm the origin of the lead, we present new Pb isotope data from Sandhavn, together with a high-resolution record for mercury (Hg) deposition. Results demonstrate that the mercury accumulation rate has steadily increased since the beginning of the 19th century, with maximum values of 9.3µgm-2yr-1 recorded ~1940. Lead isotopic ratios show two mixing lines: one which represents inputs from local and regional geogenic sources, and another that comprises regional geogenic and pollution sources. Detrending the Pb isotopic ratio record (thereby extracting the effect of the geogenic mixing) has enabled us to reconstruct a detailed chronology of metal pollution. The first sustained decrease in Pb isotope signals is recorded as beginning ~1740-1780 with the lowest values (indicating the highest pollution signature) dated to ~1960-1970. The 206Pb/207Pb ratio of excess Pb (measuring 1.222, and reflecting pollution-generated Pb), when compared with the Pb isotopic composition of the Sandhavn peat record since the 19th century and the timing of Pb enrichments, clearly points to the dominance of pollution sources from North America, although it did not prove possible to further differentiate the emissions sources geographically.

Novel Marfan Syndrome-Associated Mutation in the FBN1 Gene Caused by Parental Mosaicism and Leading to Abnormal Limb Patterning.

Marfan syndrome is an autosomal dominant disorder of the connective tissue caused by mutations in the fibrillin-1 (FBN1) gene. Mutations affecting cysteine residues within the epidermal growith factor-like calcium-binding domains (EGF_CA) of FBN1 are associated with Marfan syndrome features and, especially, with ectopia lentis. We report a novel substitution, affecting the first cysteine of an EGF_CA-binding module encoded by exon 63 of FBN1 (C2571Y), in a patient presenting with typical Marfan syndrome features but without ectopia lentis. The involvement of this particular carboxi-terminal domain in bone morphogenetic protein signaling is evidenced by patterning defects in the apendicular skeleton shown by the gain of a phalange at digit 1 and the fusion of some wrist bones. Although the mutation appeared as sporadic, detailed analysis revealed that the asymptomatic father was a gonosomal mosaic, and that aproximately 25% of his body cells carry the mutation. Based on this and previous evidence on the origin of sporadic mutations, we would like to stress the importance of detailed parental genetic screening, so the risk of recurrence may be evaluated.

Evaluation of the potential therapeutic benefits of macrophage reprogramming in multiple myeloma.

Tumor-associated macrophages (TAM) are important components of the multiple myeloma (MM) microenvironment that support malignant plasma cell survival and resistance to therapy. It has been proposed that macrophages (MØ) retain the capacity to change in response to stimuli that can restore their antitumor functions. Here, we investigated several approaches to reprogram MØ as a novel therapeutic strategy in MM. First, we found tumor-limiting and tumor-supporting capabilities for monocyte-derived M1-like MØ and M2-like MØ, respectively, when mixed with MM cells, both in vitro and in vivo. Multicolor confocal microscopy revealed that MM-associated MØ displayed a predominant M2-like phenotype in the bone marrow of MM patient samples, and a high expression of the pro-M2 cytokine macrophage migration inhibitory factor (MIF). To reprogram the protumoral M2-like MØ present in MM toward antitumoral M1-like MØ, we tested the pro-M1 cytokine granulocyte-macrophage colony-stimulating factor (GM-CSF) plus blockade of the M2 cytokines macrophage colony-stimulating factor or MIF. The combination of GM-CSF plus the MIF inhibitor 4-iodo-6-phenyl-pyrimidine achieved the best reprogramming responses toward an M1 profile, at both gene and protein expression levels, as well as remarkable tumoricidal effects. Furthermore, this combined treatment elicited MØ-dependent therapeutic responses in MM xenograft mouse models, which were linked to upregulation of M1 and reciprocal downregulation of M2 MØ markers. Our results reveal the therapeutic potential of reprogramming MØ in the context of MM.

A low dose of subperiosteal anaesthesia injection versus a high dose of infiltration anaesthesia to minimise the risk of nerve damage at implant placement: A randomised controlled trial.

PURPOSE: To evaluate whether a low-dose subperiosteal anaesthesia is effective in minimising risks of inferior alveolar nerve damage at implant placement when compared to high-dose infiltration anaesthesia. MATERIAL AND METHODS: One hundred and twenty patients requiring the placement of a single implant in order to replace a missing first mandibular were randomly allocated to two groups: group A (awake hemilip) subperiosteal crestal injection equal to 0.9 ml of articaine with 0.5% epinephrine and group B (numb hemilip) infiltration equal to 7.2 ml of articaine with 0.5% epinephrine in the vestibular fundus. Intraoperative sensory control using sensory tests was carried out in all patients. Outcome measures were neurological complications, intraoperative and postoperative visual analogue scale (VAS) scores for pain and swelling, and a questionnaire evaluating patient satisfaction. Patients were followed for 1 week postoperatively. RESULTS: There were no cases of nerve injury. Seven days after surgery the postoperative VAS score for pain and swelling was lower in group A in a statistically significant manner (difference = -3.41%; 95% CI: -5.57, -1.26; P = 0.002 and difference = -3.33%; 95% CI: -5.41, -1.25; P = 0.002, respectively). CONCLUSIONS: No nerve damage occurred using either anaesthesia types, therefore the choice of type of anaesthesia is a subjective clinical decision, however it may be preferable to use a low dose (0.9 ml) of subperiosteal anaesthesia, since it is unnecessary to deliver 7.2 ml of articaine to anaesthetise a single mandibular molar implant site.

Salivary Concentration of Oxidative Stress Biomarkers in a Group of Patients with Peri-Implantitis: A Transversal Study.

PURPOSE: The purpose of this study was to know if peri-implantitis causes an increase in the total salivary concentration of oxidative stress markers. MATERIALS AND METHODS: Seventy patients, 28 men and 42 women, 60 of them with dental implants, 30 of which had peri-implantitis and 30 were healthy. The remaining 10 were the control group: healthy subjects without implants. The average number of implants per patient was 4.70 ± 2.29 in the peri-implantitis group and 2 70 ± 2.11 in the control group. Periodontal/peri-implant variables were assessed, including bleeding index, gingival index, clinical attachment level, probing depth, presence of pockets larger than 4 and 6 mm, pain to percussion, suppuration, gingival hyperplasia or granuloma, crestal bone loss (both mesially and distally), evaluated through periapical radiography. Saliva samples from the 70 subjects were collected for measurement of malondialdehyde high performance liquid chromatography (HPLC) and myeloperoxidase (enzyme-linked immunosorbent assay analysis) concentrations. RESULTS: Implants affected with peri-implantitis had an average follow-up of 26.40 ± 7.97 months. 4.12% of implants with peri-implantitis had a painful response to percussion. 2.06% showed suppuration; 25.77% had granuloma. The mean crestal bone loss in implants wtih peri-implantitis was 3.78 ± 1.17 mm. Total salivary malondialdehyde concentration in the peri-implantitis group (0.52 ± 0.37 µM/l) was slightly higher than that in the group with healthy implants (0.40 ± 0.16 µM/l) and also slightly higher than that in the group of healthy patients without implants (0.41 ± 0.79 µM/l), although the difference was not statistically significant, p value = .442. Myeloperoxidase concentration was slightly higher in the peri-implantitis group (12.32 ± 2.17 ng/ml) than in the group with healthy implants (11.54 ± 2.80 ng/ml) and the group of healthy patients without implants (11.86 ± 2.67 ng/ml), without statistically significant differences, p value = .584. CONCLUSIONS: The salivary concentration of oxidative stress markers in patients with peri-implantitis and without periodontitis is not higher than that found in healthy patients.

Troubled adolescents: substance abuse and mental disorder in young offenders.

INTRODUCTION: Many studies indicate the high prevalence of juvenile substance abuse. There is increasingly more dual diagnosis and mental illnesses in adolescents and many juvenile offenses are related to drug abuse. METHOD: This is a descriptive study about the relationship between drug abuse and clinical, demographic and criminal characteristics in a sample of 144 youths seen in the Therapeutic Juvenile Justice Unit (UTJJ) of the Parc Sanitari Sant Joan de Deu. RESULTS: A total of 65.3% of the sample had a disorder on Axis I, 22.2% of which were related with the psychotic spectrum and 18.1% ADHD. Personality disorder occurred in 42.4%, the most frequent ones being antisocial disorder (16%), and borderline personality disorder (6.9%). Of the sample, 78.5% were drug consumers and 51.4% of the total only consumed 1 substance. There is a tendency among psychotic teenagers to consume cannabis and ADHD patients to consume cannabis and cocaine. A significant relationship is found between nationality and inhalants drugs, social and economic level and sedative drugs and alcohol, and parental death and alcohol (p<0.05-0.005). CONCLUSIONS: The level of drug use/abuse in juvenile justice is very high. Although there is no evidence about the relationship between the substance they consume and the profile of the young offender, some tendencies are observed.

Adolescentes multiproblemáticos: consumo de tóxicos y trastorno mental en jóvenes que delinquen / Troubled adolescents: substance abuse and mental disorder in young offenders

Introducción. Numerosos estudios ponen de manifiesto la alta prevalencia de consumo de tóxicos en jóvenes. La patología dual y las enfermedades mentales en adolescentes aumentan cada vez más y muchos delitos se asocian al consumo de tóxicos. Metodología. Estudio descriptivo de la relación entre el consumo de tóxicos y las características clínicas, sociodemográficas y delictivas en una muestra de 144 jóvenes atendidos en la Unidad Terapéutica de Justicia Juvenil (UTJJ) del Parc Sanitari Sant Joan de Deu. Resultados. El 65.3% de la muestra presentan un trastorno en el Eje I siendo el 22.2% del espectro psicótico y el 18.1% TDAH. El 42.4% presentan un trastorno de personalidad, los más frecuentes: Trastorno Antisocial (16%) y Trastorno Límite de Personalidad (6.9%). El 78.5% de los jóvenes consumen tóxicos, el 51.4% una única sustancia. Existe una tendencia en los jóvenes psicóticos a consumir cannabis y en los pacientes con TDAH al consumo de cannabis y cocaína. Se encuentra relación significativa entre la nacionalidad y el consumo de inhalantes, nivel socioeconómico y sedantes y alcohol, y la muerte de los padres y el alcohol (p<0.05-0.005). Conclusiones: El perfil de consumo de tóxicos en justicia juvenil es muy alto. A pesar de no haber encontrado perfiles diferenciados en función de tipo desustancia consumida, se evidencian algunas tendencias

Introduction. Many studies indicate the high prevalence of juvenile substance abuse. There is increasingly more dual diagnosis and mental illnesses in adolescents and many juvenile offenses are related to drug abuse. Method. This is a descriptive study about the relationship between drug abuse and clinical, demographic and criminal characteristics in a sample of 144 youths seen in the Therapeutic Juvenile Justice Unit (UTJJ) of the Parc Sanitari Sant Joan de Deu. Results. A total of 65.3% of the sample had a disorder on Axis I, 22.2% of which were related with the psychotic spectrum and 18.1% ADHD. Personality disorder occurred in 42.4%, the most frequent ones being antisocial disorder (16%), and borderline personality disorder (6.9%). Of the sample, 78.5% were drug consumers and 51.4% of the total only consumed 1 substance. There is a tendency among psychotic teenagers to consume cannabis and ADHD patients to consume cannabis and cocaine. A significant relationship is found between nationality and inhalants drugs, social and economic level and sedative drugs and alcohol, and parental death and alcohol (p<0.05-0.005). Conclusions: The level of drug use/abuse in juvenile justice is very high. Although there is no evidence about the relationship between the substance they consume and the profile of the young offender, some tendencies are observed