Calidad de vida en el trastorno por déficit de atención con hiperactividad: percepción de padres e hijos / Quality of life in attention deficit hyperactivity disorder: perception of parents and children

INTRODUCCIÓN: la calidad de vida relacionada con la salud (CVRS) es una dimensión relevante en la evaluación y consideración de los efectos de un tratamiento en el trastorno por déficit de atención con hiperactividad (TDAH). El objetivo del estudio es analizar las diferencias entre la percepción de padres e hijos en la CVRS en casos TDAH tratados farmacológicamente (TDAH-T), casos no tratados (TDAH-N) y controles. MATERIAL Y MÉTODOS: muestra de 228 participantes entre 8 y 14 años (114 controles, 57 TDAH-T y 57 TDAH-N). Muestreo consecutivo de TDAH según DSM-IV (ADHD RS-IV) y muestreo aleatorio de controles emparejados por sexo y edad. Evaluación de CVRS mediante las diez dimensiones del KIDSCREEN-52 versión padres y versión hijos. RESULTADOS: en los controles existen diferencias significativas entre padres e hijos en tres de las diez dimensiones del KIDSCREEN-52 (autonomía, autopercepción y recursos económicos), en cuatro dimensiones en TDAH-T (bienestar psicológico, autopercepción, entorno escolar y recursos económicos) y en seis dimensiones en TDAH-N (bienestar psicológico y físico, estado de ánimo, autopercepción, entorno escolar y recursos económicos). En todas las dimensiones donde existen diferencias significativas los hijos perciben mejor CVRS que la atribuida por los padres, excepto en la dimensión económica que sucede a la inversa. No existen diferencias significativas entre padres e hijos en controles, TDAH-N o TDAH-T en las dimensiones de aceptación social, relación con padres y amigos. CONCLUSIONES: es necesario que en la evaluación que precede a cualquier intervención clínica se deban tener en cuenta las perspectivas de padres e hijos sobre la CVRS

INTRODUCTION: health-related quality of life (HRQL) is a relevant dimension in the evaluation and consideration of the effects of a treatment in Attention Deficit Hyperactivity Disorder (ADHD). The objective of the study is to analyze the differences on the perception between parents and children in the HRQL in ADHD cases treated pharmacologically (ADHD-T), untreated cases (ADHD-N) and controls. MATERIAL AND METHODS: sample of 228 participants between 8 and 14 years old (114 controls, 57 ADHD-T and 57 ADHD-N). Consecutive sampling of ADHD according to DSM-IV (ADHD Rating Scales IV) and random sampling of controls matched by sex and age. HRQL assessment using the ten dimensions of the KIDSCREEN-52 parent version and child version. RESULTS: there are significant differences between parents/children in three out of ten dimensions of KIDSCREEN-52 (autonomy, self-perception, and financial resources), in four ADHD-T dimensions (psychological well-being, self-perception, school environment, and financial resources), and in six ADHD-N dimensions (psychological and physical well-being, mood, self-perception, school environment and financial resources) in controls. Children perceive HRQL better than parents in all dimensions with significant differences, except for economic dimension (the opposite). There are no significant differences between parents/children in controls, ADHD-N or ADHD-T in the dimensions of social acceptance, relationship with parents and friends. CONCLUSIONS: it is necessary to take into account the perspectives of parents and children regarding HRQL in the evaluation preceding any clinical intervention

[Children's and adolescents' perception of their quality of life in cases of attention deficit hyperactivity disorder with and without pharmacological treatment and in controls]. / Percepcion de niños y adolescentes sobre la calidad de vida en casos de trastorno por deficit de atencion/hiperactividad con y sin tratamiento farmacologico y en controles.

INTRODUCTION: Health-related quality of life perceived by children and teenagers is important to assess the effects of therapeutic intervention. AIM: To analyze quality of life, comparing cases of attention deficit hyperactivity disorder (ADHD) treated with methylphenidate, untreated cases and controls. SUBJECTS AND METHODS: Sampling of 228 participants between 8 and 14 years-old. Consecutive sampling in ADHD according to DSM-IV criteria (ADHD Rating Scales IV) and random sampling of matched controls by sex and age. Evaluation of quality of life using KIDSCREEN-52 (children version). ANOVA with Bonferroni correction was used. RESULTS: There is a moderate significant correlation between greater intensity of ADHD symptoms and worse quality of life, except in the dimension of physical well-being. Cases of untreated ADHD have significantly worse quality of life than controls on psychic well-being, mood, autonomy school environment and social acceptance. Cases of treated ADHD present similar results, except in the school environment and psychological well-being. The cases of ADHD treated only differ significantly from ADHD not treated in having a better school environment. CONCLUSIONS: The cases of ADHD present dimensions of KIDSCREEN-52 with worse quality of life than controls and the cases of ADHD treated with methylphenidate only differ significantly from those not treated in presenting better results in the school environment.

TITLE: Percepcion de niños y adolescentes sobre la calidad de vida en casos de trastorno por deficit de atencion/hiperactividad con y sin tratamiento farmacologico y en controles.Introduccion. La calidad de vida relacionada con la salud percibida por niños y adolescentes es un factor importante para valorar los efectos de una intervencion terapeutica. Objetivo. Analizar la calidad de vida comparando casos con trastorno por deficit de atencion/hiperactividad (TDAH) tratados farmacologicamente con metilfenidato, casos no tratados y controles. Sujetos y metodos. Muestra de 228 participantes de 8-14 años. Muestreo consecutivo de casos de TDAH segun los criterios del Manual diagnostico y estadistico de los trastornos mentales, cuarta edicion, y muestreo aleatorio de controles emparejados por sexo, edad y zona sociodemografica. Evaluacion de la calidad de vida mediante el KIDSCREEN-52 (version niños y adolescentes). Para responder al objetivo se utilizo ANOVA con correccion de Bonferroni. Resultados. Observamos una correlacion significativa moderada entre mayor intensidad de sintomas de TDAH y peor calidad de vida, excepto en el bienestar fisico. Los casos de TDAH no tratados tienen significativamente peor calidad de vida que los controles en bienestar psiquico, autonomia, estado de animo, entorno escolar y aceptacion social. Los casos de TDAH tratados observan similares resultados excepto en el entorno escolar y el bienestar psiquico, que no presentan diferencias significativas con los controles. Los casos de TDAH tratados por comparacion con los de TDAH no tratados solo presentan significativamente mejor calidad de vida en el entorno escolar. Conclusion. Los casos de TDAH presentan dimensiones del KIDSCREEN-52 con peor calidad de vida que los controles y los casos de TDAH tratados con metilfenidato solo se diferencian significativamente de los no tratados porque presentan mejores resultados en el entorno escolar.

Percepción de niños y adolescentes sobre la calidad de vida en casos de trastorno por déficit de atención/hiperactividad con y sin tratamiento farmacológico y en controles / Children's and adolescents' perception of their quality of life in cases of attention deficit hyperactivity disorder with and without pharmacological treatment and in controls

Introducción. La calidad de vida relacionada con la salud percibida por niños y adolescentes es un factor importante para valorar los efectos de una intervención terapéutica. Objetivo. Analizar la calidad de vida comparando casos con trastorno por déficit de atención/hiperactividad (TDAH) tratados farmacológicamente con metilfenidato, casos no tratados y controles. Sujetos y métodos. Muestra de 228 participantes de 8-14 años. Muestreo consecutivo de casos de TDAH según los criterios del Manual diagnóstico y estadístico de los trastornos mentales, cuarta edición, y muestreo aleatorio de controles emparejados por sexo, edad y zona sociodemográfica. Evaluación de la calidad de vida mediante el KIDSCREEN-52 (versión niños y adolescentes). Para responder al objetivo se utilizó ANOVA con corrección de Bonferroni. Resultados. Observamos una correlación significativa moderada entre mayor intensidad de síntomas de TDAH y peor calidad de vida, excepto en el bienestar físico. Los casos de TDAH no tratados tienen significativamente peor calidad de vida que los controles en bienestar psíquico, autonomía, estado de ánimo, entorno escolar y aceptación social. Los casos de TDAH tratados observan similares resultados excepto en el entorno escolar y el bienestar psíquico, que no presentan diferencias significativas con los controles. Los casos de TDAH tratados por comparación con los de TDAH no tratados sólo presentan significativamente mejor calidad de vida en el entorno escolar. Conclusión. Los casos de TDAH presentan dimensiones del KIDSCREEN-52 con peor calidad de vida que los controles y los casos de TDAH tratados con metilfenidato sólo se diferencian significativamente de los no tratados porque presentan mejores resultados en el entorno escolar

Introduction. Health-related quality of life perceived by children and teenagers is important to assess the effects of therapeutic intervention. Aim: To analyze quality of life, comparing cases of attention deficit hyperactivity disorder (ADHD) treated with methylphenidate, untreated cases and controls. Subjects and methods: Sampling of 228 participants between 8 and 14 years-old. Consecutive sampling in ADHD according to DSM-IV criteria (ADHD Rating Scales IV) and random sampling of matched controls by sex and age. Evaluation of quality of life using KIDSCREEN-52 (children version). ANOVA with Bonferroni correction was used. Results: There is a moderate significant correlation between greater intensity of ADHD symptoms and worse quality of life, except in the dimension of physical well-being. Cases of untreated ADHD have significantly worse quality of life than controls on psychic well-being, mood, autonomy school environment and social acceptance. Cases of treated ADHD present similar results, except in the school environment and psychological well-being. The cases of ADHD treated only differ significantly from ADHD not treated in having a better school environment. Conclusions: The cases of ADHD present dimensions of KIDSCREEN-52 with worse quality of life than controls and the cases of ADHD treated with methylphenidate only differ significantly from those not treated in presenting better results in the school environment

Use of antifungal saponin SC-2 of Solanum chrysotrichum for the treatment of vulvovaginal candidiasis: in vitro studies and clinical experiences.

Saponin SC-2 from Solanum chrysotrichum showed antifungal activity, demonstrated in vitro, which inhibited the growth of dermatophytes, and in vivo, to be effective in the treatment against tinea pedis and pityriasis capitis. Fungistatic and fungicidal activity of saponin SC-2 on Candida albicans and other Candida species, fluconazole and ketoconazole resistaent strains was demostrated. SC-2-associated ultrastructural alterations in several Candida species were observed. An exploratory clinical, randomized, double-blind, and controlled ketoconazole study of ketoconazole was conducted with the aim of assessing the effectiveness and tolerability of an herbal medicinal product containing SC-2, on women with Vulvovaginal candidiasis (VVC). The results exhibited a percentage of therapeutic clinical effectiveness similar to that of ketoconazole (X(2), p ≥0.30), but obtained a smaller percentage of mycological effectiveness, and 100% tolerability. In conclusion, saponin SC-2 possesses fungicidale and fungistatic activity on Candida albicans and other multi resistant Candida species, causes morphological changes and fungal death, and it is an alternative therapy for the treatment of VVC.

Utilización de Duodopa en el paciente con enfermedad de Parkinson / Use of duodenal levodopa infusion therapy in advanced Parkinson's disease patients

El tratamiento con infusión continua de levodopa/carbidopa intraduodenal (Duodopa®) constituye una opción de tratamiento para pacientes con enfermedad de Parkinson (EP) avanzada que no responden de forma satisfactoria al tratamiento convencional. Publicaciones previas han reportado que Duodopa mejora las complicaciones motoras, síntomas no motores, calidad de vida y autonomía de los pacientes así como el grado de estrés y sobrecarga del cuidador. Asegura la mayoría de las veces la monoterapia evitando otros fármacos con efectos secundarios. Las complicaciones graves son excepcionales, mientras que las menores relacionadas con el estoma y el dispositivo son frecuentes. El presente trabajo revisa la evidencia científica existente sobre Duodopa y aspectos prácticos para el manejo de los pacientes con EP tratados con dicha terapia (AU)

The treatment with continuous intraduodenal levodopa/carbidopa infusion (Duodopa ®) is an option in the treatment of patients with advanced Parkinson's disease (PD) who do not respond satisfactorily to the conventional treatment. Earlier publications have reported that Duodopa improves the motor complications, non-motor symptoms, quality of life and autonomy of patients, as well as the level of stress and burden on caregivers. It can usually be administered in monotherapy, thus avoiding the need for other drugs with secondary effects. Severe complications are exceptional, while minor ones related with the stoma and the device are frequent. This work reviews the existing scientific evidence on Duodopa and practical aspects for the management of patients with PD treated with this therapy (AU)

Otros parkinsonismos de base genética: ataxias espinocerebelosas, síndrome temblor-ataxia asociado a premutación X frágil y xantomatosis cerebrotendinosa / Other genetically-based parkinsonisms: spinocerebellar ataxias, tremor-ataxia syndrome associated to fragile X premutation and cerebrotendinous xanthomatosis

Las ataxias espinocerebelosas autosómicas dominantes, el síndrome temblor-ataxia asociado a premutación X frágil y la xantomatosis cerebrotendinosa son enfermedades de base genética que cursan con manifestaciones neurológicas diversas. Aunque habitualmente no es el rasgo clínico principal, los trastornos extrapiramidales, incluido el parkinsonismo, pueden aparecer con frecuencia e intensidad variable. Durante las últimas décadas los avances en el campo de la genética molecular de han permitido profundizar en el conocimiento de estos trastornos. Realizamos una revisión sobre los aspectos etiopatogénicos, clínicos, neuropatológicos y diagnósticos de estas entidades (AU)

Autosomal dominant spinocerebellar ataxias, tremor-ataxia syndrome associated to fragile X premutation syndrome and cerebrotendinous xanthomatosis are diseases with a genetic base that are accompanied by diverse neurological manifestations. Although they are not usually the main clinical feature, extrapyramidal disorders, including parkinsonism, may appear with varying frequency and intensity. Over the last few decades, the progress made in the field of molecular genetics has enabled researchers to gain a deeper understanding of these disorders. We conduct a review of the aetiopathogenic, clinical, neuropathological and diagnostic aspects of these condition (AU)

Patterning small-molecule biocapture surfaces: microcontact insertion printing vs. photolithography.

Chemical patterns prepared by self-assembly, combined with soft lithography or photolithography, are directly compared. Pattern fidelity can be controlled in both cases but patterning at the low densities necessary for small-molecule probe capture of large biomolecule targets is better accomplished using microcontact insertion printing (µCIP). Surfaces patterned by µCIP are used to capture biomolecule binding partners for the small molecules dopamine and biotin.

Mycelial forms of Coccidioides spp. in the parasitic phase associated to pulmonary coccidioidomycosis with type 2 diabetes mellitus.

Pulmonary coccidioidomycosis shares characteristics with other pulmonary pathologies. In tissue, spherules containing endospores are markers of Coccidioides immitis and C. posadasii infection. Mycelial forms presenting without classical parasitic structures are often misdiagnosed. The study was performed at the National Institute of Respiratory Diseases (INER) of Mexico between September 1991 and June 2005 and analyzed the association between cases, controls, and risk factors, including co-morbidity. A case was defined as any patient who presented mycelial forms and a control as any patient who presented only spherules or no parasitic forms. All patients (n = 44) with pulmonary coccidioidomycosis were diagnosed by culture, histopathology, cytology, and immunology. Type 2 diabetic patients with pulmonary coccidioidomycosis were four times more likely than non-diabetics to develop parasitic mycelial forms (95% confidence interval [CI], 0.85-20.10; P < 0.01). We formulated a comprehensive definition based on the results as follows: patients with pulmonary coccidioidomycosis with an evolution longer than 8 months, cough, hemoptysis, radiological evidence of a cavitary lesion, and type 2 diabetes mellitus, develop parasitic mycelial forms of Coccidioides spp. Based on microscopic images of patient specimens, we propose incorporating mycelial forms into the parasitic phase of Coccidioides spp. in patients with type 2 diabetes mellitus and chronic and cavitary pulmonary coccidioidomycosis.

APP processing and the APP-KPI domain involvement in the amyloid cascade.

Alternative APP mRNA splicing can generate isoforms of APP containing a Kunitz protease inhibitor (KPI) domain. KPI is one of the main serine protease inhibitors. Protein and mRNA KPI(+)APP levels are elevated in Alzheimer's disease (AD) brain and are associated with increased amyloid beta deposition. In the last years increasing evidence on multiple points in the amyloid cascade where KPI(+)APP is involved has been accumulated, admitting an outstanding position in the pathogenesis of AD to the KPI domain. This review focuses on the APP processing, the molecular activity of KPI and its physiological and pathological roles and the KPI involvement in the amyloid cascade through the nerve growth factor, the lipoprotein receptor-related protein, the tumor necrosis factor-alpha converting enzyme and the Notch1 protein.

Relatedness analyses of Histoplasma capsulatum isolates from Mexican patients with AIDS-associated histoplasmosis by using histoplasmin electrophoretic profiles and randomly amplified polymorphic DNA patterns.

The present paper analyzes the histoplasmin electrophoretic profiles and the randomly amplified polymorphic DNA (RAPD) patterns of the fungus Histoplasma capsulatum isolated from Mexican patients with AIDS-associated histoplasmosis. Clinical isolates from Guatemala, Colombia, and Panama, as well as H. capsulatum isolates from different sources in nature, were also processed. All histoplasmin samples shared four antigenic fractions of 200, 49, 10.5, and 8.5 kDa in sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). According to their percentage of relatedness, based on SDS-PAGE histoplasmin electrophoretic image analysis, H. capsulatum isolates were divided in two groups: group A contained all AIDS-associated isolates studied and two human reference strains from Mexican histoplasmosis patients without AIDS; group B included bat guano, infected bat, and cock excreta isolates from the State of Guerrero, Mexico, plus three human histoplasmosis strains from Guatemala, Panama, and Colombia. Polymorphic DNA patterns evaluated by RAPD-PCR showed three major bands of 4.4, 3.2, and 2.3 kb in most H. capsulatum isolates studied. Four groups were related by DNA polymorphisms: group I was formed by most of the AIDS-associated H. capsulatum isolates studied, one human histoplasmosis strain from Colombia, two human reference strains from Mexican patients without AIDS, and one human histoplasmosis strain from Guatemala. Group II consisted of only a single strain from Panama. Group III included three strains: one from a Mexican patient with AIDS and two isolated from nature in Guerrero (cock excreta and bat guano). The last, group IV, consisted of only one strain isolated from an infected bat, captured in Guerrero. A tight relationship between phenotypic and genotypic characterization was observed, and both analyses could be useful tools for typing H. capsulatum from different sources and geographic origins.