Presencia e influencia de sintomatología sugestiva de trastorno por déficit de atención e hiperactividad en adultos con un trastorno de la conducta alimentaria(AU) / Presence and influence of attention deficit hyperactivity disorder symptoms in adults with an eating disorder

Fundamento. La coexistencia de trastornos de la conducta alimentaria (TCA) y del trastorno por déficit de atención e hiperactividad (TDAH) es frecuente. El objetivo del estudio fue cuantificar la presencia de sintomatología TDAH en pacientes adultos con TCA y evaluar posibles correlaciones entre ambas sintomatologías. Material y métodos. Estudio transversal en pacientes con TCA. Se cumplimentaron los cuestionarios Eating Attitudes Test de 40 ítems (EAT-40), Eating Disorder Inventory 3ª edición (EDI-3) y la versión abreviada del Adult ADHD Self-Report Scale (ASRS v1.1). Aquellos pacientes con ≥12 puntos en ASRS v1.1 completaron el cuestionario Attention Déficit Hyperactivity Disorder Rating Scale 4ª edición (ADHD-RS IV). Resultados. El 42,6% de los 108 pacientes incluidos puntuaron ≥12 en el ASRS v1.1. Estos sujetos puntuaron más en bulimia y en algunas escalas de desajuste psicológico del EDI-3, y aquellos con conductas de atracón y/o purga puntuaron más en Trastornos psicobiológicos del EAT-40 y en Insatisfacción corporal y Riesgo de TCA del EDI-3. No hubo diferencias en ADHD-RS IV según fueran cuadros restrictivos puros (n=13) o compulsivo-purgativos (n=33). La sintomatología TDAH correlacionó más con la clínica alimentaria y con el desajuste psicológico general en los casos compulsivopurgativos. Conclusiones. En población clínica con TCA son frecuentes los síntomas sugestivos de TDAH, más en cuadros con clínica compulsivo-purgativa pero no necesariamente más intensos. La correlación entre TDAH y TCA es mayor en cuadros compulsivo-purgativos. Los síntomas de TDAH conllevan mayor desajuste psicológico y mayor gravedad a nivel alimentario en los cuadros con sintomatología compulsivo-purgativa.(AU)

Background. The coexistence of eating disorders (ED) and attention deficit hyperactivity disorder (ADHD) is common. The aim of the study was to quantify the presence of ADHD symptoms in adult patients with ED and evaluate any possible correlation between both symptomatologies. Methods. Cross-sectional study of patients with ED. The following questionnaires were completed: the Eating Attitudes Test - 40 items (EAT-40), the Eating Disorder Inventory 3rd edition (EDI-3) and the abbreviated version of the Adult ADHD Self-Report Scale (ASRS v1.1). The patients who scored ≥12 points in ASRS v1.1 completed the Attention Deficit Hyperactivity Disorder Rating Scale (4th edition, ADHD-RS IV). Results. 42.6% of the 108 patients scored ≥12 in the ASRS v1.1. These subjects scored higher in bulimia and in some scales of psychological maladjustment of the EDI-3, and those with binging and/or purging behaviours scored higher in Psychobiological disorders of the EAT-40 and in Body dissatisfaction and Eating disorder risk composite scales of the EDI-3. There were no differences in ADHD-RS IV between pure restrictive syndromes (n=13) and those with binging and/or purging behaviours (n=33). We found that, in cases with binge/purge symptoms, ADHD symptoms correlated higher with ED symptoms and with general psychological maladjustment. Conclusion. ADHD symptoms are common in the clinical population with ED, and more in groups with binge/purge symptoms, although they are not necessarily more intense. The correlation between ADHD symptoms and ED is higher in cases with binging and/or purging behaviours. ADHD symptoms involve more psychological maladjustment and more serious ED symptomatology in cases with binge/purge symptoms.(AU)

[Presence and influence of attention deficit hyperactivity disorder symptoms in adults with an eating disorder].

BACKGROUND: The coexistence of eating disorders (ED) and attention deficit hyperactivity disorder (ADHD) is common. The aim of the study was to quantify the presence of ADHD symptoms in adult patients with ED and evaluate any possible correlation between both symptomatologies. METHODS: Cross-sectional study of patients with ED. The following questionnaires were completed: the Eating Attitudes Test - 40 items (EAT-40), the Eating Disorder Inventory 3rd edition (EDI-3) and the abbreviated version of the Adult ADHD Self-Report Scale (ASRS v1.1). The patients who scored =12 points in ASRS v1.1 completed the Attention Deficit Hyperac-tivity Disorder Rating Scale (4th edition, ADHD-RS IV). RESULTS: 42.6% of the 108 patients scored =12 in the ASRS v1.1. These subjects scored higher in bulimia and in some scales of psychological maladjustment of the EDI-3, and those with binging and/or purging behaviours scored higher in Psychobi-ological disorders of the EAT-40 and in Body dissatisfaction and Eating disorder risk composite scales of the EDI-3. There were no differences in ADHD-RS IV between pure restrictive syndromes (n=13) and those with binging and/or purging behaviours (n=33). We found that, in cases with binge/purge symptoms, ADHD symptoms correlated higher with ED symptoms and with general psychological maladjustment. CONCLUSION: ADHD symptoms are common in the clinical population with ED, and more in groups with binge/purge symptoms, although they are not necessarily more intense. The correlation between ADHD symptoms and ED is higher in cases with binging and/or purging behaviours. ADHD symptoms involve more psychological maladjustment and more serious ED symptomatology in cases with binge/purge symptoms.

Putrescine: Essential factor for in vitro proliferation of Babesia bovis.

This study reports the effect of putrescine addition, either alone or in combination with insulin, transferrin and selenite (ITS), to serum-free Advanced DMEM/F12 (A-DMEM/F12) medium, on the in vitro culture of Babesia bovis and using a perfusion bioreactor to improve efficiency of the process. A B. bovis strain previously adapted to proliferate in serum-free medium (Bbovis-SF) was evaluated using eight increasing concentrations of putrescine. The percentage of parasitized erythrocytes (PPE) obtained from cultures supplemented with 0.101 mg/L was 6.23% compared with 2.3% for control cultures with M199 with Earle's salts (M199) and 40% serum. The combination of putrescine (0.101 mg/L) and a mixture of ITS (2000, 1100, and 1.34 mg/L, respectively) (Pu-ITS), in A-DMEM/F12 culture medium without serum yielded a maximum PPE of 17.26% compared to 2.58% in the control medium. This new formulation of culture medium, together with the use of a hollow-fiber perfusion bioreactor system (HFPBS), caused a substantial increase in the proliferation of B. bovis, yielding a maximum cumulative PPE of 118.8% after five days, compared to 58.6% in cultures treated with control medium M199 and 40% serum. We concluded that the addition of the ITS mixture and putrescine to the culture medium stimulated the proliferation of B. bovis in vitro. This new medium formulation, used in a HFPBS culture system, can be an effective, automated-prone system that can induce massive proliferation of B. bovis for use as a source of parasite antigens and immunogens.

In vitro culture of Babesia bovis in a bovine serum-free culture medium supplemented with insulin, transferrin, and selenite.

Bovine serum is an important factor for the optimal growth of Babesia bovis in vitro. This protozoan can be cultured in M-199 with Earle's salts medium (M-199) supplemented with 40% bovine serum (BS). In the present study, four media were assessed along with the control medium M-199. The effect on the proliferation of B. bovis in vitro was tested when these media were combined with insulin (Ins), transferrin (Trans) and selenite (Sel) in the absence of bovine serum. Treatment with Advanced DMEM/F12 medium (A-DMEM/F12) achieved the highest percentage of parasitized erythrocytes (PPE), reaching a maximum value of 9.59%. A-DMEM/F12 medium supplemented with a mixture of Ins (2000 mg/L), Trans (1100 mg/L), and Sel (1.34 mg/L) allowed for the adaptation and proliferation of B. bovis without bovine serum, showed a constant increase in PPE, and reached a maximum value of 9.7% during seven cycles of in vitro culture. It was concluded that continuous proliferation of B. bovis in vitro could be achieved using A-DMEM/F12 medium supplemented with Ins-Trans-Sel, without bovine serum. After adaptation for proliferation in serum-free medium, the B. bovis strain of parasites could have future use in the study of this economically important protozoan species that affects cattle.

[Incidence, air pollution and risk factors of acute otitis media in the first year of life: a prospective study]. / Incidencia, contaminación ambiental y factores de riesgo de otitis media aguda en el primer año de vida: estudio prospectivo.

BACKGROUND: Epidemiological studies of acute otitis media (AOM) are scarce and no prospective studies have been performed in Spain. OBJECTIVES: To describe the incidence of AOM in the first year of life and its associated risk factors, with special focus on air pollution. METHODS: We performed a prospective cohort study of 229 newborn infants during the first year of life stratified by pollution zones, and followed-up by their pediatricians in their health center. AOM was defined on clinical grounds. A questionnaire on risk/protective factors included items on the following: sex, older siblings, smoking, breastfeeding, socioeconomic status, parental education and the mother's occupational status. RESULTS: The incidence of AOM episodes during the first year of life was 45 % and the proportion of children who experienced at least one episode was 32 %. Independent risk factors were male gender (aOR: 2.03; 95 % CI: 1.09-3.7) and living in a polluted area (aOR: 2.01; 95 % CI: 1.05-3.84). Independent protective factors were being born in spring (aOR: 0.41; 95 % CI: 0.19-0.88) and having a mother with at least primary school education (aOR: 0,53; 95 % CI: 0.24-1.15). Socioeconomic markers indicated a lower mean level among families whose children had at least one AOM episode. CONCLUSIONS: Air pollution and low socioeconomic status are greater risk factors for AOM than having siblings or parents who smoke. A minimum educational level reduces the risk of AOM. The incidence of AOM could be reduced by modifying certain environmental factors.

Incidencia, contaminación ambiental y factores de riesgo de otitis media aguda en el primer año de vida: estudio prospectivo / Incidence, air pollution and risk factors of acute otitis media in the first year of life. A prospective study

Antecedentes: Los estudios epidemiológicos sobre la otitis media aguda (OMA) son muy escasos y en España no existe ninguno de tipo prospectivo. Objetivos: Describir la incidencia de la OMA durante el primer año de vida y sus factores de riesgo, con especial atención a la contaminación ambiental. Métodos: Estudio de una cohorte prospectiva de 229 recién nacidos durante el primer año de vida estratificados por zonas de contaminación, seguidos por sus pediatras en el centro de salud. La OMA de definió clínicamente. Se aplicó un cuestionario con los factores de riesgo/protectores, incluyendo sexo, hermanos mayores, hábito de fumar, lactancia materna, nivel socioeconómico, nivel de estudios y situación laboral de la madre. Resultados: La incidencia de episodios de OMA durante el primer año fue del 45 por ciento y la proporción de niños con al menos un episodio fue del 32 por ciento. Los factores de riesgo independientes fueron el sexo varón (odds ratio ajustada [ORa], 2,03; intervalo de confianza del 95 por ciento [IC 95 por ciento], 1,09-3,7) y vivir en una zona contaminada (ORa, 2,01; IC 95 por ciento, 1,05-3,84).Fueron factores protectores independientes nacer en primavera (ORa, 0,41; IC 95 por ciento, 0,19-0,88) y que la madre tuviera al menos estudios primarios (ORa, 0,53; IC 95 por ciento, 0,24-1,15). Los marcadores socioeconómicos indicaron un menor nivel medio entre las familias cuyos niños tuvieron al menos un episodio de OMA. Conclusiones: La contaminación ambiental y el bajo nivel socioeconómico son factores de riesgo de OMA mayores que tener hermanos o que los padres fumen. Un nivel cultural mínimo reduce el riesgo de OMA. Es posible disminuir en parte la incidencia de OMA actuando sobre algunos factores ambientales (AU)

[Osseous lithiasis: an unusual condition]. / Litiasis ósea: patología excepcional.

Bone lithiasis is an uncommon disease unfrequent reported in the literature. Its origin is supported on urothelium and conjuctive tissue bone metaplasia. High suspicious index is needed to establish its diagnosis; where radiological signs and extracorporeal lithotripsy resistence drive to these uncommon entity. Definitive diagnosis is based on histological exam. We report a 49-year-old patient with left obstructive uropathy due to a high ureteral lumbar lithiasis who precised ureterolithectomy and partial ureterectomy after extracorporeal litotripsy failure. Histological exam confirmed bone lithiasis and squamous metaplasia. Epidemiologic, diagnostic and therapeutic aspects are briefly reviewed in literature. Bone calculus treatment includes lithectomy and urothelium resection to avoid posterior recurrence. Possible association to tumoral transformation suggests close evolutive follow-up.

[Skin metastasis as first manifestation of prostatic adenocarcinoma]. / Metástasis cutáneas como primera manifestación de un adenocarcinoma prostático.

Incidence of prostate disease has seen a sudden boost over the last few years as a result of an increase in male life expectancy. Prostate carcinoma is the third most common cause of cancer mortality in Spain. Post-mortem studies reveal that this is the most prevalent neoplasia in the elderly. 30% of all males over 50 years could host malignant cells in their prostate, although only 20% of these neoplasias have clinical manifestations. Prostate carcinoma expansion occurs by local spreading, as well as lymph and blood dissemination. Local spreading to the urethra, bladder neck, trigonous and seminal vesicles is frequent. Lymph dissemination to obturating, hypogastric, iliac, presacral and paraaortic nodes is a major path for metastasis. Bone metastasis with increased acid phosphatase is the most illustrative sign of prostate adenocarcinoma expansion. Visceral metastasis occur more frequently in lungs, liver and renal glands. There is a 0.3% likelihood of skin metastasis from prostate adenocarcinoma. Considering the rareness of skin metastasis from prostate adenocarcinoma, the case reported in the present paper, first evidence of a prostate carcinoma, is even more exceptional.

[Mixed urogenital schistosomiasis]. / Esquistosomiasis genitourinaria mixta.

Urinary schistosomiasis is a parasitosis caused by Schistosoma Haematobium which affect in a diffuse manner all the genitourinary tract. Presentation of 5 patients (4 male, 1 female) with mixed Bilharziosis that was detected after the study of a young male that came to the clinic with a complaint of haematuria and who underwent transurethral resection under the suspicion of a vesical urothelial neoformation. Sch. Hameatobium eggs were detected in the urine and Sch. Mansoni in the semen of all 4 male. All of them evolved favourably with Praziquantel. Considering the rarity of schistosomiasis in our environment and its increased incidence in endemic areas, this process should be included in the algorithm of differential diagnosis in young patients reporting dysuric syndromes associated to haematuria; the relevance of an epidemiological anamnesis so as to institute early treatment and avoid the consequences of chronic infection is pointed out.

[Spontaneous disappearance of pulmonary metastasis secondary to renal cell carcinoma after nephrectomy. Presentation of a case and review of the literature]. / Desaparición espontánea de metástasis pulmonares secundarias a carcinoma de células renales tras la nefrectomía. Aportación de un caso y revisión de la literatura.

Spontaneous disappearance of pulmonary metastasis is an occasionally occurring phenomenon, thus reflected in the literature. The article presents one case of spontaneous disappearance of pulmonary metastasis of clear cells renal carcinoma, histologically confirmed by fine needle puncture aspiration. After 36 months of follow-up, the patient shows no evidence of recurrence.

[Bladder adenocarcinoma of the signet-ring cell type. Report of a case]. / Adenocarcinoma vesical del tipo células en anillo de sello. Aportación de un caso.

Report of a case of vesical adenocarcinoma of the rarely occurring signet-ring cell type, characterized by an insidious development, predominance of urination disorders, submucosal growth, late diagnosis and very poor prognosis since it is not susceptible to radiotherapy or chemotherapy.