A Low Cost and Eco-Sustainable Device to Determine the End of the Disinfection Process in SODIS.

The lack of safe drinking water is one of the main health problems in many regions of the world. In order to face it, Solar water disinfection (SODIS) proposes the use of transparent plastic containers, which are filled with contaminated water, and exposed to direct sunlight until enough UV radiation is received to inactivate the pathogens. However, a reliable method for determining the end of the disinfection process is needed. Although several approaches have been proposed in the literature for this purpose, they do not strictly accomplish two critical constraints that are essential in this type of project, namely, low cost and sustainability. In this paper, we propose an electronic device to determine when the lethal UV dose has been reached in SODIS containers, which accomplishes both constraints mentioned above: on the one hand, its manufacturing cost is around EUR 12, which is much lower than the price of other electronic solutions; on the other hand, the device is sufficiently autonomous to work for months with small low-cost disposable batteries, thereby avoiding the use of rechargeable batteries, which are considered hazardous waste at the end of their useful life. In our approach, we first analyze different low cost UV sensors in order to select the most accurate one by comparing their response with a reference pattern provided by a radiometer. Then, an electronic device is designed using this sensor, which measures the accumulated UV radiation and compares this value with the lethal UV dose to determine the end of the disinfection process. Finally, the device has been manufactured and tested in real conditions to analyze its accuracy, obtaining satisfactory results.

An Approximation for Metal-Oxide Sensor Calibration for Air Quality Monitoring Using Multivariable Statistical Analysis.

Good air quality is essential for both human beings and the environment in general. The three most harmful air pollutants are nitrogen dioxide (NO2), ozone (O3) and particulate matter. Due to the high cost of monitoring stations, few examples of this type of infrastructure exist, and the use of low-cost sensors could help in air quality monitoring. The cost of metal-oxide sensors (MOS) is usually below EUR 10 and they maintain small dimensions, but their use in air quality monitoring is only valid through an exhaustive calibration process and subsequent precision analysis. We present an on-field calibration technique, based on the least squares method, to fit regression models for low-cost MOS sensors, one that has two main advantages: it can be easily applied by non-expert operators, and it can be used even with only a small amount of calibration data. In addition, the proposed method is adaptive, and the calibration can be refined as more data becomes available. We apply and evaluate the technique with a real dataset from a particular area in the south of Spain (Granada city). The evaluation results show that, despite the simplicity of the technique and the low quantity of data, the accuracy obtained with the low-cost MOS sensors is high enough to be used for air quality monitoring.

Prevalencia de síntomas de trastorno por déficit de atención con hiperactividad en adolescentes y adultos jóvenes con otros trastornos psiquiátricos refractarios a tratamientos previos / Prevalence of attention deficit/hyperactivity disorder symptoms in outpatient adolescents and young adults with other psychiatric disorders refractory to previous treatments

Introducción. El objetivo de este estudio fue evaluar la prevalencia de síntomas de trastorno por déficit de atención con hiperactividad (TDAH) en adolescentes y adultos jóvenes diagnosticados de otros trastornos psiquiátricos primarios que no habían respondido a tratamientos previos. Material y métodos. Se incluyeron 795 pacientes ambulatorios de 15-24 años. Se estudió la presencia de un TDAH según los criterios DSM-IV y la frecuencia de los síntomas utilizando la escala de valoración del TDAH de DuPaul de 18 ítems. Resultados. Se objetivó la presencia de un TDAH (criterios DSM-IV) en 48 pacientes (6%), ninguno de los cuales previamente había recibido este diagnóstico. Un total de 260 pacientes (32,7%) presentaron síntomas moderados de TDAH y en ellos la gravedad del trastorno psiquiátrico de base era mayor según la ICG-S (p = 0,007). Los factores de riesgo para tener síntomas moderados de TDAH fueron la presencia de trastornos por uso de sustancias (TUS) (odds ratio = 1,543; p = 0,01) y de trastorno límite de la personalidad (odds ratio = 2,173; p = 0,0001). Conclusiones. El TDAH no diagnosticado previamente estaba presente en el 6% de los pacientes, observándose asimismo una elevada frecuencia de síntomas moderados del trastorno (32,7%) en la muestra. Por estos motivos sería recomendable hacer un minucioso estudio del TDAH en los jóvenes refractarios al tratamiento del trastorno primario, principalmente en aquellos con trastornos por uso de sustancias, trastornos de conducta y de personalidad, debido a la elevada comorbilidad entre el TDAH y estos trastornos (AU)

Introduction. The aim of the current study was to assess the prevalence of symptoms of attention deficit/hyperactivity disorder (ADHD) in adolescents and young adults diagnosed with other primary psychiatric disorders, who had not responded to previous treatments. Material and methods. A total of 795 outpatients aged 15 to 24 years were included. The presence of ADHD was studied using DSM-IV criteria and the frequency of symptoms using the 18 item DuPaul ADHD Rating Scale. Results. ADHD (DSM-IV criteria) was present in 48 patients (6%), none of whom had previously received the diagnosis. A total of 260 patients (32.7%) met the criteria for moderate ADHD and between them, severity of primary psychiatric disorder was higher according to the CGI-S (P = .007). Risk factors for moderate ADHD symptoms were the presence of substance use disorders (SUD) (odds ratio = 1.543, P = .01) and borderline personality disorders (odds ratio = 2.173, p = .0001). Conclusion. Unrecognized ADHD was present in 6% of patients; moreover 32.7% of the sample also presented moderate symptoms of the disorder. Screening for ADHD in young patients with refractory response to primary disorder treatment, mainly those with substance use disorders, conduct and personality disorders is highly advisable, due to the high frequency of ADHD comorbidity in these psychiatric disorders (AU)

[Prevalence of attention deficit/hyperactivity disorder symptoms in outpatient adolescents and young adults with other psychiatric disorders refractory to previous treatments]. / Prevalencia de síntomas de trastorno por déficit de atención con hiperactividad en adolescentes y adultos jóvenes con otros trastornos psiquiátricos refractarios a tratamientos previos.

INTRODUCTION: The aim of the current study was to assess the prevalence of symptoms of attention deficit/hyperactivity disorder (ADHD) in adolescents and young adults diagnosed with other primary psychiatric disorders, who had not responded to previous treatments. MATERIAL AND METHODS: A total of 795 outpatients aged 15 to 24 years were included. The presence of ADHD was studied using DSM-IV criteria and the frequency of symptoms using the 18 item DuPaul ADHD Rating Scale. RESULTS: ADHD (DSM-IV criteria) was present in 48 patients (6%), none of whom had previously received the diagnosis. A total of 260 patients (32.7%) met the criteria for moderate ADHD and between them, severity of primary psychiatric disorder was higher according to the CGI-S (P=.007). Risk factors for moderate ADHD symptoms were the presence of substance use disorders (SUD) (odds ratio=1.543, P=.01) and borderline personality disorders (odds ratio =2.173, p=.0001). CONCLUSION: Unrecognized ADHD was present in 6% of patients; moreover 32.7% of the sample also presented moderate symptoms of the disorder. Screening for ADHD in young patients with refractory response to primary disorder treatment, mainly those with substance use disorders, conduct and personality disorders is highly advisable, due to the high frequency of ADHD comorbidity in these psychiatric disorders.

Epidemiological study on the incidence of gastroesophageal reflux disease symptoms in patients in acute treatment with NSAIDs.

Gastroesophageal reflux disease (GERD) is one of the most common disorders in medical practice. The prevalence of GERD in Spain has been reported to be 15%. GERD is associated with esophageal and extra-esophageal complications and with a negative impact on the patients' related quality of life. Several risk factors have been related with the development of GERD, including smoking, coffee intake, alcohol consumption and use of medication, such as NSAIDs. If untreated, GERD symptoms can lead to a decrease of patients' related quality of life and to treatment discontinuation. From this study, it was confirmed that the relationship between GERD and some behavioral risk factors, such as alcohol intake, smoking and coffee consumption, and concomitant treatment with NSAID drugs. Among the protective factors for GERD, antisecretory agents and antacids have shown to be essential for the control of GERD, the use of proton pump inhibitors being the predominant protective factor.

Beneficios y riesgos de la discontinuación del tratamiento durante las vacaciones de verano en niños de edad escolar con trastorno por déficit de atención con hiperactividad / Benefits and risks of treatment discontinuation during summer holidays in school-aged children with attention deficit/hyperactivity disorder

En este estudio retrospectivo se evaluaron los beneficios y riesgos de la discontinuación del tratamiento farmacológico durante las vacaciones de verano (≥ 30 días) en 802 niños con trastorno por déficit de atención con hiperactividad (TDAH). En 440 de los pacientes (55%) se retiró el tratamiento durante el verano. El riesgo de mala adherencia (≤ 85%) fue más alto en los pacientes con vacaciones de tratamiento (odds ratio: 5,82). Comparados con los pacientes que recibieron tratamiento, los pacientes que no lo recibieron durante el verano tenían cuatro veces mayor probabilidad de empeorar o de no mejorar en la Escala de Impresión Clínica Global de Gravedad del TDAH (ICG-G-TDAH) (odds ratio 4,20, P < 0,0001). Además, los pacientes del grupo de vacaciones de tratamiento tenían tres veces mayor probabilidad de tener una puntuación > 1,67 en la escala de valoración SNAP-IV (odds ratio 2,60, P < 0,0001), y era más probable que sufrieran lesiones accidentales (odds ratio 1,49, P < 0,01), con un mayor número de lesiones por paciente (1,24 [DE = 3,67] frente a 0,8 [DE = 2,9], P = 0,05). Este análisis sugiere que las vacaciones del tratamiento en niños con TDAH pueden asociarse con resultados clínicos adversos

This retrospective study assessed the benefits and risks of discontinuation of pharmacological treatment during summer holidays (≥ 30 days) in 802 school-aged children with attention deficit/hyperactivity disorder (ADHD). A total of 440 patients (55%) discontinued medical treatment during the summertime. The risk of poor adherence (≤ 85%) was higher for patients with drug holidays (odds ratio 5.82). As compared with children treated pharmacologically during the summertime, patients in the drug holiday group were four times more likely to have worsening or no improvement of their symptoms in the Clinical Global Impression ADHD Severity (GCIADHD- S) scale (odds ratio 4.20, P < 0.0001). Moreover, patients in the drug holiday group as compared with patients treated pharmacologically were almost three times more likely to score > 1.67 in the ADHD SNAP-IV rating scale (odds ratio 2.60, P < 0.0001), and more likely to suffer from accidental injuries (odds ratio 1.49, P < 0.01), with a higher mean number of injuries per patient (1.24 [SD = 3.67] vs. 0.8 [SD = 2.9], P = 0.05). This retrospective cohort analyses suggest that drug holidays during the summertime in children with ADHD may be associated with adverse clinical outcomes

Management of Patients With Unclassified Epileptic Seizures in Outpatient Clinics in Spain. Results of the RETO Study.

PURPOSE: The objective of this study was to determine the approach and management of specialists in patients with unclassified epileptic seizures in outpatient clinics in Spain. METHODS: Observational, multicenter, and cross-sectional study. Ninety-three neurologists or neuropediatricians documented consecutive patients with a history of at least two difficult to classify or unclassified epileptic seizures. Patient demographics, quality of life (QOLIE-10-P), disease characteristics, and anticonvulsant treatment were captured. Physicians were asked about their therapeutic approach for the selection of an antiepileptic drug and underlying reasons. RESULTS: A total of 725 patients were included. At the time of the survey, 81% were treated (69% with monotherapy). Most frequently given reasons for starting antiepileptic therapy were ([mean] on a scale of 1­5) efficacy, (3.9), safety (3.61), and broad-spectrum effectiveness (3.5). Reasons given for switching therapy (226/725) included need for broader spectrum of action: 70 (31.0%); simpler dosing regimen: 25 (11.1%); quality of life considerations: 24 (10.6%); lack of adherence to therapy: 24 (10.6%); comorbidities: 13 (5.8%); drug interactions: 12 (5.3%); and possibility of pregnancy 6 (2.7%). CONCLUSIONS: When deciding on starting or switching therapy for patients with difficult to classify or unclassified epilepsy, the most important consideration for the specialists included efficacy, safety, and broad-spectrum efficacy.

Análisis de las diferencias entre indicación y prescripción de gastroprotección en pacientes con factores de riesgo tratados con antiinflamatorios no esteroideos: estudio GAP / Analysis of differences between indication and prescription of gastroprotection in patients with risk factors treated with nonsteroidal anti-inflammatory agents: The GAP study

ResumenSe ha señalado que las medidas de prevención en pacientes tratados con antiinflamatorios no esteroideos (AINE) estan infrautilizadas. El objetivo de este estudio es analizar las diferencias entre indicación y prescripción real de gastroprotección con inhibidores de bomba de protones en pacientes con factores de riesgo para complicaciones gastrointestinales en tratamiento con AINE.MétodosEstudio observacional, transversal y multicéntrico. Recogida retrospectiva de datos a partir de historias clínicas y cumplimentación de un cuestionario sobre factores de riesgo e indicación de gastroprotección.ResultadosUn total de 432 facultativos recogieron datos de 2.160 pacientes tratados con AINE. Un 90,4% de pacientes recibían prescripción de gastroprotección con inhibidores de bomba de protones. El tratamiento con AINE a largo plazo frente a corto plazo (<1 mes) mostraba una asociación con gastroprotección (odds ratio=2,37; intervalo de confianza del 95%: 1,779–3,171). La media de factores de riesgo por paciente fue de 2±0,16 (rango: 0–7), se observó una asociación significativa entre número de factores de riesgo y porcentaje de pacientes en gastroprotección. Aun así, la proporción de pacientes con factores de riesgo sin gastroprotección fue del 3% para historia previa de enfermedad ulcerosa o hemorragia digestiva por AINE y del 7–10% para los demás factores. Se observaron diferencias entre indicación y gastroprotección prescrita entre las diferentes especialidades, los especialistas de radioterapia son los que presentaron menor grado de gastroprotección.ConclusionesEstos resultados reflejan que en la práctica clínica diaria las diferencias entre indicación y prescripción real de gastroprotección en pacientes con factores de riesgo tratados con AINE son pequeñas en nuestro país(AU)

AbstractPreventive measures in patients treated with nonsteroidal anti-inflammatory drugs (NSAIDS) have been reported to be underused. The aim of the present study was to analyze differences between the indication and prescription of gastroprotection with proton pump inhibitors (PPI) in patients treated with NSAIDS and with risk factors for gastrointestinal complications.MethodsWe performed an observational, cross-sectional, multicenter study. Data were gathered retrospectively from medical records and from a questionnaire on risk factors and indication for gastroprotection.ResultsA total of 432 physicians gathered data from 2,160 patients treated with NSAIDs. Nearly all (90.4%) of the patients were prescribed gastroprotection with a PPI. Long-term versus short-term (<1 month) NSAID treatment was associated with gastroprotection (OR=2.37; 95% CI 1.779–3.171). The mean number of risk factors per patient was 2±0.16 (range 0–7), and a significant association was found between the number of risk factors and the percentage of patients receiving gastroprotection. Nevertheless, the proportion of patients with risk factors not receiving gastroprotection was 3% for those with a prior history of ulcer and/or gastrointestinal bleeding due to NSAIDS and 7–10% for the remaining factors. Differences were found between the indication for gastroprotection and the gastroprotection prescribed among the various specialties. The specialists prescribing gastroprotection the least were radiotherapy specialists.ConclusionsThese results demonstrate that, in daily clinical practice, differences between the indication and prescription of gastroprotection in patients treated with NSAIDS and with risk factors are small in Spain(AU)

[Analysis of differences between indication and prescription of gastroprotection in patients with risk factors treated with nonsteroidal anti-inflammatory agents: the GAP study]. / Análisis de las diferencias entre indicación y prescripción de gastroprotección en pacientes con factores de riesgo tratados con antiinflamatorios no esteroideos: estudio GAP.

UNLABELLED: Preventive measures in patients treated with nonsteroidal anti-inflammatory drugs (NSAIDS) have been reported to be underused. The aim of the present study was to analyze differences between the indication and prescription of gastroprotection with proton pump inhibitors (PPI) in patients treated with NSAIDS and with risk factors for gastrointestinal complications. METHODS: We performed an observational, cross-sectional, multicenter study. Data were gathered retrospectively from medical records and from a questionnaire on risk factors and indication for gastroprotection. RESULTS: A total of 432 physicians gathered data from 2,160 patients treated with NSAIDs. Nearly all (90.4%) of the patients were prescribed gastroprotection with a PPI. Long-term versus short-term (<1 month) NSAID treatment was associated with gastroprotection (OR=2.37; 95% CI 1.779-3.171). The mean number of risk factors per patient was 2+/-0.16 (range 0-7), and a significant association was found between the number of risk factors and the percentage of patients receiving gastroprotection. Nevertheless, the proportion of patients with risk factors not receiving gastroprotection was 3% for those with a prior history of ulcer and/or gastrointestinal bleeding due to NSAIDS and 7-10% for the remaining factors. Differences were found between the indication for gastroprotection and the gastroprotection prescribed among the various specialties. The specialists prescribing gastroprotection the least were radiotherapy specialists. CONCLUSIONS: These results demonstrate that, in daily clinical practice, differences between the indication and prescription of gastroprotection in patients treated with NSAIDS and with risk factors are small in Spain.