Disrupted sleep-wake regulation in the MCI-Park mouse model of Parkinson's disease.

Disrupted sleep has a profound adverse impact on lives of Parkinson's disease (PD) patients and their caregivers. Sleep disturbances are exceedingly common in PD, with substantial heterogeneity in type, timing, and severity. Among the most common sleep-related symptoms reported by PD patients are insomnia, excessive daytime sleepiness, and sleep fragmentation, characterized by interruptions and decreased continuity of sleep. Alterations in brain wave activity, as measured on the electroencephalogram (EEG), also occur in PD, with changes in the pattern and relative contributions of different frequency bands of the EEG spectrum to overall EEG activity in different vigilance states consistently observed. The mechanisms underlying these PD-associated sleep-wake abnormalities are poorly understood, and they are ineffectively treated by conventional PD therapies. To help fill this gap in knowledge, a new progressive model of PD - the MCI-Park mouse - was studied. Near the transition to the parkinsonian state, these mice exhibited significantly altered sleep-wake regulation, including increased wakefulness, decreased non-rapid eye movement (NREM) sleep, increased sleep fragmentation, reduced rapid eye movement (REM) sleep, and altered EEG activity patterns. These sleep-wake abnormalities resemble those identified in PD patients. Thus, this model may help elucidate the circuit mechanisms underlying sleep disruption in PD and identify targets for novel therapeutic approaches.

Influence of Spectroscopic Techniques on the Estimation of the Degree of Conversion of Bulk-fill Composites.

OBJECTIVES: To compare the degree of conversion (DC) of different flowable and sculptable bulk-fill composites (BFC), at 0- and 4-mm depths from the surface, by Fourier transform infrared (FTIR), attenuated total reflection FTIR (ATR-FTIR), and FT-Raman spectroscopic techniques. METHODS AND MATERIALS: Six BFC were investigated, including three sculptable composites (Admira Fusion [Voco], Aura Bulk Fill [SDI], and X-tra Fill [Voco]) and three flowable composites (Venus Bulk Fill [Heraeus], Filtek [3M], and X-tra Base [Voco]). Three molds of each composite were light cured as specified by the manufacturer. For each mold, slices corresponding to 0-mm (surface) and 4-mm depth were analyzed by spectroscopic techniques: ATR-FTIR, FTIR, and FT-Raman. The spectra of uncured composite material were used as an analytical control for background subtraction of the treated composite. The area and amplitude of the reference peaks (1607 and 1637 cm-1) were obtained to calculate the DC percentage at 0- and 4-mm depth. A Kruskal-Wallis nonparametric test was used for materials, and paired comparisons were made using Mann-Whitney nonparametric test. Wilcoxon's rank test was used for comparison between spectroscopic methods and between 0- and 4-mm depth in each composite. Significance was accepted at p<0.05. RESULTS: FTIR showed significantly lower DC values, both in areas and amplitudes of the peaks, when compared with the results reported by different BFC. Differences between the surface and 4-mm depth were detected more precisely by FT-Raman. ATR-FTIR obtained DC values significantly higher than those obtained by FTIR. CONCLUSIONS: The vibrational spectroscopy method significantly influenced DC measurements of the flowable and sculptable BFC explored.

Porous Layered Double Hydroxides Synthesized using Oxygen Generated by Decomposition of Hydrogen Peroxide.

Porous magnesium-aluminium layered double hydroxides (LDH) were prepared through intercalation and decomposition of hydrogen peroxide (H2O2). This process generates oxygen gas nano-bubbles that pierce holes in the layered structure of the material by local pressure build-up. The decomposition of the peroxide can be triggered by microwave radiation or chemically by reaction with iodide (I-) ions. The carbonate LDH version [Mg0.80Al0.20(OH)2](CO3)0.1∙mH2O was synthesized by microwave-assisted urea coprecipitation and further modified by iodide or H2O2 intercalation. High resolution Scanning Electron Microscopy (HR-SEM) and Brunauer-Emmet-Teller (BET) analysis were used to assess the morphology and surface area of the new porous materials. The presence of H2O2 in the interlayer region and later decomposition triggered by microwave radiation generated more pores on the surface of the LDH platelets, increasing their specific surface area from initially 9 m2/g to a maximum of 67 m2/g. X-Ray Diffraction showed that the formation of the pores did not affect the remaining crystal structure, allowing possible further functionalization of the material.

Hypoxic induction of T-type Ca(2+) channels in rat cardiac myocytes: role of HIF-1α and RhoA/ROCK signalling.

T-type Ca(2+) channels are expressed in the ventricular myocytes of the fetal and perinatal heart, but are normally downregulated as development progresses. Interestingly, however, these channels are re-expressed in adult cardiomyocytes under pathological conditions. We investigated low voltage-activated T-type Ca(2+) channel regulation in hypoxia in rat cardiomyocytes. Molecular studies revealed that hypoxia induces the upregulation of Cav 3.2 mRNA, whereas Cav 3.1 mRNA is not significantly altered. The effect of hypoxia on Cav 3.2 mRNA was time- and dose-dependent, and required hypoxia inducible factor-1α (HIF-1α) stabilization. Patch-clamp recordings confirmed that T-type Ca(2+) channel currents were upregulated in hypoxic conditions, and the addition of 50 µm NiCl2 (a T-type channel blocker) demonstrated that the Cav 3.2 channel is responsible for this upregulation. This increase in current density was not accompanied by significant changes in the Cav 3.2 channel electrophysiological properties. The small monomeric G-protein RhoA and its effector Rho-associated kinase I (ROCKI), which are known to play important roles in cardiovascular physiology, were also upregulated in neonatal rat ventricular myocytes subjected to hypoxia. Pharmacological experiments indicated that both proteins were involved in the observed upregulation of the Cav 3.2 channel and the stabilization of HIF-1α that occurred in response to hypoxia. These results suggest a possible role for Cav 3.2 channels in the increased probability of developing arrhythmias observed in ischaemic situations, and in the pathogenesis of diseases associated with hypoxic Ca(2+) overload.

A new water absorbable mechanical Epidermal skin equivalent: the combination of hydrophobic PDMS and hydrophilic PVA hydrogel.

Research on human skin interactions with healthcare and lifestyle products is a topic continuously attracting scientific studies over the past years. It is possible to evaluate skin mechanical properties based on human or animal experimentation, yet in addition to possible ethical issues, these samples are hard to obtain, expensive and give rise to highly variable results. Therefore, the design of a skin equivalent is essential. This paper describes the design and characterization of a new Epidermal Skin Equivalent (ESE). The material resembles the properties of epidermis and is a first approach to mimic the mechanical properties of the human skin structure, variable with the length scale. The ESE is based on a mixture of Polydimethyl Siloxane (PDMS) and Polyvinyl Alcohol (PVA) hydrogel cross-linked with Glutaraldehyde (GA). It was chemically characterized by XPS and FTIR measurements and its cross section was observed by macroscopy and cryoSEM. Confocal Microscope analysis on the surface of the ESE showed an arithmetic roughness (Ra) between 14-16 µm and contact angle (CA) values between 50-60°, both of which are close to the values of in vivo human skins reported in the literature. The Equilibrium Water Content (ECW) was around 33.8% and Thermo Gravimetric Analysis (TGA) confirmed the composition of the ESE samples. Moreover, the mechanical performance was determined by indentation tests and Dynamo Thermo Mechanical Analysis (DTMA) shear measurements. The indentation results were in good agreement with that of the target epidermis reported in the literature with an elastic modulus between 0.1-1.5 MPa and it showed dependency on the water content. According to the DTMA measurements, the ESE exhibits a viscoelastic behavior, with a shear modulus between 1-2.5MPa variable with temperature, frequency and the hydration of the samples.

Robust depth selectivity in mesoscopic scattering regimes using angle-resolved measurements.

We study optical imaging of tissues in the mesoscopic scattering regime in which light multiply scatters in tissues but is not fully diffusive. We use the radiative transport equation to model light propagation and an ℓ1-optimization method to solve the inverse source problem. We show that recovering the location and strength of several point-like sources that are close to each other is not possible when using angle-averaged measurements. The image reliability is limited by a spatial scale that is on the order of the transport mean-free path, even under the most ideal conditions. However, by using just a few angle-resolved measurements, the proposed method is able to overcome this limitation.

Blogs médicos como fuente de formación e información. El ejemplo del blog Pediatría basada en pruebas / Medical blogs as a source of training and information: the example of the blog "Pediatría basada en pruebas

Los blogs se han convertido en una potencial fuente de información y formación en Medicina, en general, y en Pediatría, en particular, máxime en el actual entorno sanitario de la “web social”. La experiencia personal de los autores en relación con el blog Pediatría basada en pruebas ha permitido analizar el interés temático de los lectores del blog, así como los flujos de comunicación en el entorno de la “blogosfera” pediátrica española. Se analizan las 1311 entradas publicadas en el blog Pediatría basada en pruebas durante el periodo de revisión (de mayo de 2008 a septiembre de 2012), con un estudio pormenorizado de las 105 entradas que han recibido más de 1000 visitas. Los temas que más interesan a los lectores del blog Pediatría basada en pruebas se concentran en seis grupos: 1) enfermedades infecciosas (gripe, meningitis, sepsis, sarampión, varicela, vacunas, etc.); 2) Perineonatología (temas de la gestación y del recién nacido, algunos volcados en dos secciones ya consolidadas como Propositus y Neo-Dividencias); 3) temas sociales (tabaquismo, accidentes, inmigración, acoso escolar, etc.); 4) guías e informes de sociedades científicas; 5) secciones ya establecidas del blog (con cinco consolidadas: Propositus, Neo-Dividencias, Formación e Información en Pediatría, Resumen de la blogosfera pediátrica y Cine y Pediatría), y 6) polémicas (temas de especial debate social y/o médico y que corresponden con los más comentados, y donde se incluyen temas como el aborto, la circuncisión neonatal, grupos antivacunas, mala praxis sanitaria, etc.). Teniendo en cuenta que el entorno de los blogs ya es considerado por la propia Asociación Española de Pediatría como una fuente de información fiable, nuestro compromiso en el blog es construir esta información de la mejor forma posible. Y la mejor forma posible inicial es conocer la dinámica de nuestros lectores y, con ello, y sin dejar de ser rigurosos y éticos, podemos (y debemos) plantear como válida esta forma de transmitir formación e información a nuestros colegas de profesión, a pacientes y familias, y a la sociedad en general (AU)

Blogs have become a potential source of information and training in medicine in general and in pediatrics in particular, especially in the present health care environment in the social web. The authors’ personal experience relating to the blog Pediatría basada en pruebas has made possible to analyze the readers’ interests, as well as the communication movements around the Spanish pediatric blogosphere. The 1311 public entries from May 2008 to September 2012 are analyzed, with a detailed study of the 105 posts with more than 1000 visits. The subjects that interest the most to the readers of Pediatría basada en pruebas blog gather around six groups: 1) infectious diseases (flu, meningitis, septicemia, measles, chickenpox, vaccinations, etc.); 2) peri-neonatology (pregnancy and newborn subjects, some of them issued in two established sections named Propositus and Neo-Dividencias; 3) social subjects (smoking, injuries, immigration, bulling, etc.); 4) guidelines and reports of scientific societies; 5) established sections in the blog (five of them consolidated: Propositus, Neo-Dividencias, Training and Information in Pediatrics, Pediatric blogosphere summary and Cinema and Pediatrics; 6) controversies (subjects of special social and/or healthcare debate, that are the more commented ones and include subjects such as abortion, newborn circumcision, anti-vaccination groups, medical malpractice, etc.). Taking into account that blogs are already considered by the Spanish Pediatrics Association itself as a source of information, our compromise with the blog is to build this information in the best possible way. And the initial best possible way is to know our readers’ dynamics, and therefore staying rigorous and ethical, we can (and should) consider valid this way of transmitting training and information to our colleagues, patients and families, and to society in general (AU)

Fuentes de información bibliográfica (XVIII). Pediatría basada en la evidencia y bases de datos de agencias de evaluación de tecnologías sanitarias / Sources of bibliographic information (XVIII). Evidencebased paediatrics and database of health technology assessment agencies

La evaluación de tecnologías sanitarias es una herramienta que permite valorar la introducción de nuevas tecnologías en los sistemas de salud, y se fundamenta en la evidencia científica con utilidad para la toma de decisiones, tanto en la práctica clínica como en política sanitaria. Enumeramos las características de las 8 agencias de evaluación de tecnologías sanitarias en España, así como el papel del International Network of Agencies for Health Technology Assessment como principal base de datos o repositorio de informes de evaluación de tecnologías sanitarias(AU)

Health technology assessment is a tool based on scientific evidence useful for making decisions (in clinical practice and, mainly, in heath policy) about the introduction of technological advances in healthcare systems. We describe the characteristics of the eight health technology assessment agencies in Spain and the role of the International Network of Agencies for Health Technology Assessment as the main database for Health technology assessment(AU)

Fuentes de información bibliográfica (XVI). Pediatría basada en la evidencia y bases de datos de revisiones sistemáticas / Sources of bibliographic information (XVI). Evidence-based pediatrics and database of systematic reviews

La revisión sistemática es un paso más de la revisión de autor. La Colaboración Cochrane se considera la base de datos principal de revisiones sistemáticas, cuyo objetivo se concreta en la preparación, actualización y difusión de revisiones sistemáticas rigurosas sobre los efectos de la atención sanitaria. La estructura organizativa de la Colaboración Cochrane consta de 53grupos colaboradores de revisión, 14 centros Cochrane, 12campos y redes de trabajo y 16 grupos metodológicos. En estos momentos es posible recuperar 5.222 revisiones sistemáticas y 2.259 protocolos en su base de datos. Comentamos la búsqueda a través de la web original (The Cochrane Library) y de su versión en español (Biblioteca Cochrane Plus). Conocer la Colaboración Cochrane por dentro y por fuera es la mejor forma de conocer sus fortalezas y debilidades(AU)

Systematic review is a step forward in the autor review. The Cochrane Collaboration is the main database of systematic reviews. Its aim is to prepare, update and disseminate the accurate systematic reviews about the effects of health care interventions. The members of the Cochrane Collaboration are organised in groups, of which there are five different types: 53 Review Groups, 14 Cochrane Centres,12 Files and Networks, and 16 Methods Groups. At this moment we can retrieve 5.222 systematic reviews and 2.259 protocols. In this paper we talk about the searching in the original web (The Cochrane Library) and in the Spanish version of the web (Biblioteca Cochrane Plus). Knowing the Cochanre Collaboration from the inside out is the best way to know its strengths and weaknesses(AU)

Fuentes de información bibliográfica (XVII). Pediatría basada en la evidencia y bases de datos de guías de práctica clínica / Sources of bibliographic information (XVII). Evidence-based paediatrics and database of clinical practice guidelines

Las guías de práctica clínica son un conjunto de recomendaciones desarrolladas de forma sistemática para ayudar a los profesionales y los pacientes a tomar decisiones sobre la atención sanitaria más apropiada, y a seleccionar las opciones diagnósticas o terapéuticas más adecuadas a la hora de abordar un problema de salud o una afección clínica específica. Enumeramos las características de los principales centros elaboradores de guías (SIGN, NICE, GuiaSalud, etc.) y de los centros de almacenamiento para su recuperación (National Guideline Clearinghouse, Guideline International Network, GuiaSalud)(AU)

Clinical practice guidelines are systematically developed statements to assist practitioners and patient decisions about appropriate health care and to select the most appropriate therapeutic and diagnostic options for specific clinical circumstances. We describe the characteristics of the most relevant guidelines resources (SIGN, NICE, GuiaSalud, etc.) and the main databases for evidence-based clinical practice guidelines (National Guideline Clearinghouse, Guideline International Networf, GuiaSalud)(AU)

Fuentes de información bibliográfica (XV). Pediatría basada en la evidencia y metabuscadores de MBE / Sources of bibliographic information (XV). Evidencebased pediatrics and search engines of MBE

Los metabuscadores de medicina basada en la evidencia permiten la realización de búsquedas electrónicas en las principales fuentes de información terciaria (revisiones sistemáticas, guías de práctica clínica, archivos de temas valorados críticamente, informes de agencias, etc.). En este artículo analizamos las características y los aspectos básicos de búsqueda de dos metabuscadores clásicos y muy conocidos, TRIP Database y SUMSearch, y uno de reciente aparición, exclusivamente pediátrico, PediaClic(AU)

Clinical search engines in evidence based medicine allow to search simultaneously in the main evidence based sources (systematic reviews, practice guidelines, critically appraised topics and articles, agency reports, etc.). We analyze the characteristics and basic searching tools of two classic and kwon search engines(TRIP Database and SUMSearch) and a search engine recently launched of exclusively paediatric content (PediaClic)(AU)

Fuentes de información bibliográfica (XIV). Sobre «fuentes», «pirámides» y «revoluciones» en la gestión del conocimiento en pediatría / Sources of bibliographic (XIV). About "sources", "pyramids” and "revolutions" in knowledge management in pediatrics

Para realizar una mejor gestión de la información en pediatría hemos de conocer las «fuentes» de información (primarias, secundarias y terciarias), la «pirámide» del conocimiento de las«6S» y el estado actual de las «revoluciones» pendientes en biomedicina y ciencias de la salud. De esta forma, será más fácil pasar de la información al conocimiento y del conocimiento a la acción en nuestra práctica clínica(AU)

In order to improve health care and medical standards we need to develop the management of information in pediatrics. To achieve this goal, we have to know the primary, secondary and tertiary "resources", the "6S pyramid" model and the actual situation of "revolution" in biomedical and health sciences. In this manner it will be easier to move from information to knowledge and from knowledge to action(AU)

Percepción y hábitos de salud bucodental en niños y adolescentes de Navarra, 2007 / Oral health perception and oral habits in children and teenagers in Navarre, 2007

Fundamento. Conocer la auto-percepción del nivel desalud oral y de las necesidades de tratamiento, los hábitosde higiene y la frecuencia de asistencia al dentistade los escolares de Navarra.Material y métodos. La población de estudio fue la de6, 12 y 14 años de edad. La muestra se obtuvo de loscolegios de 1º y 6º de Enseñanza Primaria (EP) y 2º deEnseñanza Secundaria Obligatoria (ESO) y la recogidade datos se hizo mediante cuestionarios auto-cumplimentados.Resultados. El 92%, a los 6 y 12 años, y el 82,9% a los 14años está satisfecho con su salud oral. El 13,1% de losde 12 años y el 19,3% de 14 están descontentos, sobretodo por el mal alineamiento dental. Aproximadamente,un tercio cree necesitar algún tratamiento, sobre todoobturaciones a los 6 años y ortodoncia a los 12 y 14.Casi dos tercios dicen cepillarse los dientes más de unavez al día y entre el 80 y el 90% dicen haber ido al dentistaen el último año. Más del 75% de los responsables delos escolares de 6 y 12 años valoran positivamente lasprestaciones del Programa de Atención Dental Infantil(PADI) y más del 95% está satisfecho con la asistenciaque el dentista del PADI presta a sus hijos. El sexo, mediode residencia y nivel socioeconómico apenas influyenen la percepción de salud, frecuencia de cepillado onecesidades de tratamiento sentidas.Conclusión. El estudio revela que la percepción subjetivade salud dental es buena y que un tercio de los encuestadoscreen necesitar algún tipo de tratamiento. Es muypositivo que la mayoría digan que hayan ido al dentistaen el último año y que se cepillan la boca más de una vezal día, mejorando los resultados de estudios anteriores(AU)

Background. To determine the self-perception of oralhealth levels and the need for treatment, hygienichabits and frequency of visits to the dentist amongstschoolchildren in Navarre.Methods. The population of the study was aged 6, 12and 14 years. The sample was obtained from schoolsteaching 1st and 6th year in Primary Education and 2ndyear in Compulsory Secondary Education. The datawas gathered through self-answering questionnaires.Results. Ninety-two percent of 6 and 12 year olds, and82.9% of 14 year olds are satisfied with their oral health.Thirteen point one percent of 12 year olds and 19.3% of14 year olds are dissatisfied, above all with misalignedteeth. Approximately one-third think they need sometreatment, above all fillings at age 6 and orthodontics at12 and 14 years. Nearly two-thirds say they brush theirteeth more than once a day and between 80 and 90% saythey have visited the dentist in the last year. More than75% of those responsible for the schoolchildren aged 6and 12 years make a positive evaluation of the contributionsof the child dental care program (PADI) and morethan 95% are satisfied with the care given by PADI dentiststo their children. Sex, average residence and socioeconomiclevel barely influence the perception of health,frequency of brushing teeth or need for treatment.Conclusion. The study reveals that the subjective perceptionof oral health is good and that one-third of thosesurveyed think they need some type of treatment. Itis very positive that they majority say that they havebeen to the dentist in the last year and that they brushtheir teeth more than once a day, which is an improvementon the results of previous studies(AU)

¿Qué profesional médico es el más adecuado para impartir cuidados en salud a niños en Atención Primaria en países desarrollados? Revisión sistemática / What medical professional is the most adequate to provide health care to children in primary care in developed countries? Systematic review

Introducción: existe controversia sobre el tipo de profesional más adecuado –pediatras (PED) o médicos de familia/generales (MF/MG)– para prestar atención sanitaria a niños y adolescentes en Atención Primaria (AP). No existen revisiones sistemáticas previas que hayan estudiado este aspecto. El objetivo de este estudio es comparar la atención sanitaria proporcionada por PED y MF/MG en los siguientes aspectos de la práctica clínica: la prescripción de antibióticos (ATB), la indicación de pruebas diagnósticas, el manejo de la otitis media (OMA), del asma, del síndrome febril y de diversas alteraciones psicopatológicas, así como la realización de actividades preventivas. Material y métodos: diseño de estudio: revisión sistemática. Fuente de los datos: hasta diciembre de 2008 se revisaron las bases de datos MEDLINE y CENTRAL, el metabuscador TRIP Database y el buscador Google Académico para recuperar artículos originales y revisiones sistemáticas que compararan la práctica clínica de ambos tipos de profesionales. No se efectuó restricción por idioma. Selección de estudios: se incluyeron estudios de cualquier tipo de diseño (transversal, cohortes, casos y controles, experimentales) que compararan la práctica clínica del PED y el MF/MG. Se excluyeron todas las referencias que no contuvieran investigación original (cartas al director o editoriales). Asimismo, se evaluó la calidad metodológica de cada estudio con el instrumento “OSTEBA; Fichas de lectura crítica”. Dicha calidad era valorada de forma independiente por dos revisores, que llegaban a un consenso en caso de discrepancia. La extracción de datos fue realizada por siete parejas de revisores de forma independiente. Las discrepancias se resolvieron mediante consenso. Resultados: como promedio, los MF/MG prescribieron más ATB que los PED en infecciones del tracto respiratorio superior de probable etiología vírica –odds ratio (OR): 1,4; intervalo de confianza del 95% (IC 95%): 1,1-1,8–. Los PED tuvieron más probabilidades de adherirse a las recomendaciones de guías de práctica clínica sobre el manejo del síndrome febril (OR: 9; IC 95%: 3-25) y del trastorno por déficit de atención con/sin hiperactividad (OR: 5; IC 95%: 3-11), y una mayor capacidad de resolución para otras enfermedades de elevada prevalencia durante la infancia y la adolescencia (como asma y OMA). Los PED presentaban porcentajes de vacunación superiores a los de los MF/MG en todos los estudios que evaluaron este resultado. Conclusión: en vista de los resultados expuestos, parece recomendable mantener la figura del PED en los equipos de AP y reforzar su función específica como primer punto de contacto del niño con el sistema sanitario (AU)

Introduction: There is controversy about which health professional is the most adequate –pediatricians (PED) or family practitioners/general physicians (FP/GP)– to provide health care services to children and adolescents in Primary Care (PC). There are not previous systematic reviews approaching this subject in the previously published literature. The objective of this study is to compare health care provided between PED and FP/GP in the following aspects of the clinical practice: antibiotic (ATB) prescription; diagnostic test indication; acute otitis media (AOM), asthma, febrile syndrome and several psychopathological conditions’ management; and preventive measures accomplishment. Material and methods: study design: systematic review. Data sources: MEDLINE and CENTRAL databases, TRIP Database and Google Scholar, were searched until December 2008 to retrieve original papers and systematic reviews comparing the clinical practice of both kinds of health professionals. No language restriction was made. Studies’ selection: studies of any kind of design were included (cross-sectional, cohorts, case-controls and experimental) comparing the clinical practice of PED and FP/GP. The references without original research were excluded (letters to the editor, editorials). The methodological quality of each study was assessed with the tool “OSTEBA; Critical Appraisal Cards”. Two reviewers assessed the quality of the studies independently, achieving consensus in case of discrepancy. Seven pairs of reviewers made the data extraction independently. Discrepancies were achieved by consensus. Results: On average, FP/GP prescribed more ATB than PED in upper respiratory tract infections of probable viral etiology –odds ratio (OR): 1.4; 95% confidence interval (95% CI): 1.1-1.8–; PED were more likely to adhere to clinical guidelines recommendations on febrile syndrome management (OR: 9; 95% CI: 3-25) and on attention deficit disorder with/without hyperactivity (OR: 5; 95% CI: 3-11), and showed more resolution capacity on other highly prevalent conditions in children and adolescents (such as asthma and AOM). PED showed higher vaccination coverage than FP/GP in all the studies assessing this result. Conclusion: based on the presented results, it seems reasonable to recommend maintaining the PED figure in PC health centers and reinforcing its specific task as the first point of contact of the child with the health care system (AU)

Medicina basada en pruebas para los pediatras: sinopsis de información científica útil en Evidencias en Pediatría / Evidence based Medicine for paediatricians: scientific information synopsis

No disponible

Primer aniversario de la revista secundaria Evidencias en Pediatría. Reflexiones sobre su pasado, presente y futuro / First anniversary of the secondary journal Evidencias en Pediatría. Reflections on its past, present and future

No disponible

En los adolescentes que no fuman se ha producido una mayor disminución de algunas conductas de riesgo que en los que fuman / Non smoker adolescents have achieved a bigger decrease in some risk behaviours than smokers

No disponible

Application of statistical experimental design to study the formulation variables influencing the coating process of lidocaine liposomes.

In this paper, we have used statistical experimental design to investigate the effect of several factors in coating process of lidocaine hydrochloride (LID) liposomes by a biodegradable polymer (chitosan, CH). These variables were the concentration of CH coating solution, the dripping rate of this solution on the liposome colloidal dispersion, the stirring rate, the time since the liposome production to the liposome coating and finally the amount of drug entrapped into liposomes. The selected response variables were drug encapsulation efficiency (EE, %), coating efficiency (CE, %) and zeta potential. Liposomes were obtained by thin-layer evaporation method. They were subsequently coated with CH according the experimental plan provided by a fractional factorial (2(5-1)) screening matrix. We have used spectroscopic methods to determine the zeta potential values. The EE (%) assay was carried out in dialysis bags and the brilliant red probe was used to determine CE (%) due to its property of forming molecular complexes with CH. The graphic analysis of the effects allowed the identification of the main formulation and technological factors by the analysis of the selected responses and permitted the determination of the proper level of these factors for the response improvement. Moreover, fractional design allowed quantifying the interactions between the factors, which will consider in next experiments. The results obtained pointed out that LID amount was the predominant factor that increased the drug entrapment capacity (EE). The CE (%) response was mainly affected by the concentration of the CH solution and the stirring rate, although all the interactions between the main factors have statistical significance.

La escuela y el trastorno por déficit de atención con/sin hiperactividad (TDAH) / No disponible

Se realiza una revisión de la bibliografía obtenida, tras una búsqueda sistemática en lasprincipales bases de datos, para responder a algunas preguntas clínicas relacionadas con eltrastorno por déficit de atención con/sin hiperactividad (TDAH), la escuela y los trastornos deaprendizaje: ¿los niños con TDAH tienen problemas de aprendizaje, emocionales o sociales?,¿cuáles son y quién los detecta?, ¿los tratamientos en el ámbito escolar tienen algún papelpara mejorar su resolución?, ¿qué nivel de evidencia tienen las respuestas que se proponen?Se concluye que existen problemas de aprendizaje, de conducta y emocionales que semanifiestan especialmente en el ecosistema escolar alterando la calidad de vida del niño y quese deben abordar de un modo comprehensivo, mediante programas de intervención multimodal.Se presenta además un glosario de términos, conocidos en el ambiente escolar, quepueden resultar confusos para el pediatra de Atención Primaria y un ejemplo de trabajo decolaboración entre la escuela y el centro de salud de una comunidad rural madrileña

This work presents the results of a systematic search in the most important bibliographicdatabases in order to answer some clinical questions related to attention-deficit/hyperactivitydisorder (ADHD), school and learning impairment: do children with ADHD havelearning, emotional or social impairments?, which are these impairments and who detectsthem?, do treatments at school have any role at improving the outcome?, what level of evidencehave the proposed answers?The results indicate that there is ample evidence that children identified as havingADHD have significant impairments in psychosocial and academic functioning, learning disorders,emotional problems and psychosocial problems, that can impact on child’s functioning. They can be accurately detected by the teacher at school. The underlying principle ofsuccessful management includes multiple treatment modalities to address the multidimensionalnature of the disorder. A glossary of terms of the school environment is included. PrimaryCare paediatricians can be unfamiliar with these terms. We also describe a project asan example of cooperation among schools and a health centre in a population located inthe surroundings of Madrid