Antidepresivos en la enfermedad de Parkinson. Recomendaciones del grupo de trastornos del movimiento de la Asociación Madrileña de Neurología / Antidepressants in Parkinson's disease. Recommendations by the movement disorder study group of the Neurological Association of Madrid

INTRODUCCIÓN: El uso de antidepresivos está muy extendido en la enfermedad de Parkinson (EP), aunque existen pocos estudios de calidad que aclaren su eficacia. DESARROLLO: La metodología para esta guía clínica se ha basado en la revisión de la literatura y en la opinión de consenso del grupo de trastornos del movimiento de la AMN, recogida mediante una encuesta. CONCLUSIONES: Según la evidencia científica, nortriptilina, venlafaxina, paroxetina o citalopram podrían ser utilizados en el tratamiento de la depresión en la EP, aunque paroxetina y citalopram con resultados contradictorios. Sin embargo, en la práctica clínica, los inhibidores selectivos de la recaptación de serotonina suelen ser los fármacos de primera elección. Por otro lado, aunque con menor evidencia, duloxetina podría ser una alternativa a venlafaxina y la asociación de venlafaxina con mirtazapina podría ser útil en casos refractarios. Además, podemos considerar el uso de citalopram para la ansiedad, atomoxetina para el tratamiento de la hipersomnia diurna, trazodona y mirtazapina para el tratamiento del insomnio y la psicosis, y bupropión para el tratamiento de la apatía. En general, los antidepresivos son fármacos bien tolerados en la EP. No obstante, es necesario considerar el efecto anticolinérgico de los tricíclicos, el efecto sobre la presión arterial de los inhibidores de la recaptación de serotonina y noradrenalina, la capacidad de los antidepresivos para desarrollar síntomas extrapiramidales y tener precaución con la asociación de inhibidores de la monoaminooxidasa B

INTRODUCTION: Although antidepressants are widely used in Parkinson's disease (PD), few well-designed studies to support their efficacy have been conducted. DEVELOPMENT: These clinical guidelines are based on a review of the literature and the results of an AMN movement disorder study group survey. CONCLUSIONS: Evidence suggests that nortriptyline, venlafaxine, paroxetine, and citalopram may be useful in treating depression in PD, although studies on paroxetine and citalopram yield conflicting results. In clinical practice, however, selective serotonin reuptake inhibitors are usually considered the treatment of choice. Duloxetine may be an alternative to venlafaxine, although the evidence for this is less, and venlafaxine plus mirtazapine may be useful in drug-resistant cases. Furthermore, citalopram may be indicated for the treatment of anxiety, atomoxetine for hypersomnia, trazodone and mirtazapine for insomnia and psychosis, and bupropion for apathy. In general, antidepressants are well tolerated in PD. However, clinicians should consider the anticholinergic effect of tricyclic antidepressants, the impact of serotonin-norepinephrine reuptake inhibitors on blood pressure, the extrapyramidal effects of antidepressants, and any potential interactions between monoamine oxidase B inhibitors and other antidepressants

Mujeres autoras de artículos editoriales en revistas españolas de Neumología / No disponible

No disponible

Antidepressants in Parkinson's disease. Recommendations by the movement disorder study group of the Neurological Association of Madrid. / Antidepresivos en la enfermedad de Parkinson. Recomendaciones del grupo de trastornos del movimiento de la Asociación Madrileña de Neurología.

INTRODUCTION: Although antidepressants are widely used in Parkinson's disease (PD), few well-designed studies to support their efficacy have been conducted. DEVELOPMENT: These clinical guidelines are based on a review of the literature and the results of an AMN movement disorder study group survey. CONCLUSIONS: Evidence suggests that nortriptyline, venlafaxine, paroxetine, and citalopram may be useful in treating depression in PD, although studies on paroxetine and citalopram yield conflicting results. In clinical practice, however, selective serotonin reuptake inhibitors are usually considered the treatment of choice. Duloxetine may be an alternative to venlafaxine, although the evidence for this is less, and venlafaxine plus mirtazapine may be useful in drug-resistant cases. Furthermore, citalopram may be indicated for the treatment of anxiety, atomoxetine for hypersomnia, trazodone and mirtazapine for insomnia and psychosis, and bupropion for apathy. In general, antidepressants are well tolerated in PD. However, clinicians should consider the anticholinergic effect of tricyclic antidepressants, the impact of serotonin-norepinephrine reuptake inhibitors on blood pressure, the extrapyramidal effects of antidepressants, and any potential interactions between monoamine oxidase B inhibitors and other antidepressants.

Structural, spectroscopic and electrical studies of nanostructured porous ZnO thin films prepared by pulsed laser deposition.

ZnO thin films are grown on quartz substrates at various substrate temperatures (ranging from 573 to 973 K) under an oxygen ambience of 0.02 mbar by using pulsed laser ablation. Influence of substrate temperature on the structural, morphological, optical and electrical properties of the ZnO thin films are investigated. The XRD and micro-Raman spectra reveal the presence of hexagonal wurtzite structure of ZnO with preferred orientation (002). The particle size is calculated using Debye-Scherer equation and the average size of the crystallites are found to be in the range 17-29 nm. The AFM study reveals that the surface morphology of the film depends strongly on the substrate temperature. UV-Visible transmittance spectra show highly transparent nature of the films in visible region. The calculated optical band gap energy is found to be decrease with increase in substrate temperatures. The complex dielectric constant, the loss factor and the distribution of the volume and surface energy loss of the ZnO thin films prepared at different substrate temperatures are calculated. All the films are found to be highly porous in nature. The PL spectra show very strong emission in the blue region for all the films. The dc electrical resistivity of the film decreases with increase in substrate temperature. The temperature dependent electrical measurements done on the film prepared at substrate temperature 573 K reveals that the electric conduction is thermally activated and the activation energy is found to be 0.03911 eV which is less than the reported values for ZnO films.

A modification of QuEChERS method to analyse anticoagulant rodenticides using small blood samples

El uso de rodenticidas anticoagulantes es el método más frecuentemente utilizado para el control de plagas de roedores. Debido a sus características físico-químicas y particular mecanismo de acción, la utilización de estos compuestos en zonas rurales puede suponer un riesgo de intoxicación secundaria de sus depredadores. Para evaluar el riesgo a estos compuestos para la fauna silvestre, especialmente en aves rapaces que se alimentan de roedores, se llevan a cabo los programas de biomonitorización. Se ha desarrollado un método rápido, fácil y económico que permita el análisis de pequeños volúmenes de muestra de sangre. En el presente trabajo se han comparado tres diferentes modificaciones de la metodología "QuEChERS", y posteriormente uno de ellos fue elegido para la detección y cuantificación de estos compuestos. El proceso previo al análisis de los extractos incluye dos pasos sencillos: La muestra es extraída usando un solvente orgánico y una solución salina y, posteriormente, el sobrenadante es purificado usando una técnica de extracción en fase solida dispersiva. La detección y cuantificación de los rodenticidas anticoagulantes se realizó por cromatografía líquida acoplada a un detector de masas Agilent 1100 VL con trampa de iones y fuente de electrospray para ionización. La técnica finalmente elegida permite una recuperación entre 72-134% para los siete rodenticidas objeto de estudio (warfarina, cumatetralilo, difenacoum, clorofacinona, brodifacoum, bromadiolona, difacinona), la cual es superior a la obtenida con otras técnicas que analizan compuestos similares. Además, la sensibilidad de esta técnica es mayor a la que ofrecen otras técnicas. Con el fin de comprobar la utilidad de la técnica validada, se analizaron un total de 50 muestras de sangre de búho real (Bubo bubo) capturados en su hábitat natural (AU)

The use of anticoagulant rodenticides is the most common method to control rodent plagues. Due to their physicochemical characteristics and particular mechanism of action, the application of these compounds in rural areas can pose a risk of secondary poisoning for their predators. In order to evaluate the risk of these compounds for wildlife, especially raptors that feed on rodents, biomonitoring programmes are undertaken. A fast, easy and low cost technique was needed to analyse small volumes of blood samples. Therefore, three different modifications of QuEChERS methodology have been compared, and one of them selected to detect and quantify these compounds. The process prior to analysis of the extracts involves two simple steps: the sample is extracted and partitioned using an organic solvent and salt solution. The supernatant is then cleaned using a dispersive solid phase extraction (dSPE) technique. Detection and quantification of the anticoagulant rodenticides were performed by LC-MSMS on an Agilent 1100 VL Series ESI/LC/MSD, with an electrospray ionisation (ESI) source and ion trap analyser. The method finally chosen provides a 72-134% recoveries for the seven rodenticides (warfarin, coumatetralyl, brodifacoum, bromadiolone, difenacoum, chlorophacinone, diphacinone), higher than in other methods to analyse similar compounds. Sensitivity of our method is also higher than in other methods. In order to prove the utility of the technique, a total of 50 blood samples of free-living Eagle owls (Bubo bubo) were analysed (AU)

Effect of zinc oxide doping on the structural and optical characterization of nanostructured molybdenum oxide films.

Undoped and zinc oxide (ZnO) doped molybdenum oxide (MoO3) films were prepared by RF magnetron sputtering technique. The influence of doping and post annealing temperature on the structural and optical properties of these films were investigated systematically using X-ray diffraction (XRD), energy dispersive X-ray analysis (EDAX), scanning electron microscopy (SEM), atomic force microscopy (AFM), UV-VIS spectroscopy and photoluminescence spectroscopy (PL). The XRD patterns indicate the presence of stoichiometric orthorhombic alpha-MoO3 phase in the annealed (573 and 673 K) undoped molybdenum oxide films and in ZnO doped molybdenum oxide film (annealed at 673 K). The crystalline grain size in the films was investigated using Debye Scherrer formula and corrected using Hall-Williamson equation. The SEM and AFM images revealed the distribution of nano leafs, nanorods and nanograins. Nanorods of length 1.4 microm and diameter 149 nm can be observed in ZnO doped films. The optical band gap energy was found to increase with increase in annealing temperature and particle size. These nanostructures show a room temperature PL emission in the UV and visible region.

Alteraciones anatomo-patológicas en un flamenco común (phoenicopterus roseus) por intoxicación aguda por plomo / Pathological alterations in the common flamingo (Phoenicopterus roseus) due to acute lead intoxication

La presencia de plomo en el medio ambiente es un hecho indiscutible. Ello es objeto de gran interés sanitario pues repercute tanto en la salud de los animales como en la del ser humano. El plumbismo es una intoxicación que puede afectar a cualquier especie animal. En el ámbito de la fauna silvestre se asocia principalmente a la actividad cinegética en los humedales y a la ingestión de plomo metálico por parte de las aves que frecuentan estos ecosistemas. En España cada año mueren decenas de miles de aves acuáticas como consecuencia de la ingesta de perdigones de plomo. En los individuos capturados enfermos se pueden observar signos clínicos, mientras que a partir de muestras de cadáveres se obtienen datos sobre niveles tisulares de plomo. Sin embargo la evaluación de lesiones anatomo-patológicas en animales de vida silvestre es difícil de realizar por la dificultad de encontrar animales recién muertos o afectados de un cuadro agudo mortal. La reproducción de esta patología en animales de experimentación se suele realizar en cisnes, palomas o patos, pero no en flamencos, por lo que no es usual disponer de datos histológicos en esta especie. En este trabajo presentamos la clínica, analítica y estudio microscópico de diferentes tejidos de un flamenco común (Phoenicopterus roseus) muerto por plumbismo(AU)

The presence of lead in the environment is an undisputable fact. Furthermore, it is a serious health concern as it affects not only the well-being of animals, but also that of human beings. Plumbism is a type of intoxication that can affect any animal species. In wild fauna, it is mostly associated with cynegetic species in wetlands and the ingestion of metallic lead by birds which frequent these ecosystems. In Spain, tens of thousands of water birds die each year as a result of ingesting lead pellet. Clinical signs may be observed in captured, sick individuals, whilst data regarding lead tissue levels are obtained from samples derived from cadavers. However, the evaluation of pathoanatomical lesions in wildlife is problematic due to the difficulty of finding recently deceased animals or those affected by terminally acute manifestations. The reproduction of this pathology in experimental animals is usually performed in swans, pigeons or ducks, not in flamingos and as such, histological data from this species is not commonly available. In this paper, we present the clinical, analytical and microscopical study of tissues derived from common flamingos (Phoenicopterus roseus) having died of plumbism(AU)

Frequency of Hoover's sign in stable patients with chronic obstructive pulmonary disease.

Hoover's sign (the inward motion of the lower lateral rib cage with inspiration) is conventionally considered to be a sign of severe disease in chronic obstructive pulmonary disease (COPD). However, no studies have been done regarding the frequency of Hoover's sign in patients with stable COPD. We aim to establish the frequency of Hoover's sign in a large series of stable patients with COPD and to analyse the characteristics associated with its presence. One hundred and fifty-seven consecutive patients with COPD, 150 of whom were men (95%), with a mean (standard deviation) age of 68 (8) years were included. Seventy-one patients had Hoover's sign (45%) on clinical examination. Hoover's sign was not detected in mild COPD patients, and it was present in 36% of moderate, 43% of severe and 76% of very severe COPD patients. In the multivariate analysis, dyspnea, body mass index (BMI), number of exacerbations and number of prescribed drugs were independently associated with the presence of Hoover's sign in COPD. Hoover's sign is a frequent finding in COPD, and the frequency increases with severity. Its presence is independently related to higher values of dyspnea, BMI, number of exacerbations and number of prescribed drugs.

Aspectos clínicos y forenses del envenenamiento de aves silvestres: diferencias entre aldicarb y estricnina / Clinical and forensic aspects of the poisoning of wild birds: differences between aldicarb and strychnine

Aldicarb y estricnina son frecuentemente usados para envenenar fauna silvestre y doméstica. La estricnina se utilizó ampliamente hace algunos años hasta que fue prohibido su uso en 1994, siendo sustituida por otros plaguicidas carbamatos como el aldicarb o el carbofurano. En los últimos años se ha producido un aumento de envenenamientos por estricnina. Los síntomas de la intoxicación por estricnina y carbamatos están ampliamente descritos en mamíferos, pero no en aves. En la mayoría de los casos forenses la única información disponible es el análisis químico-toxicológico del cadáver o del cebo. Esta carencia de información es debida, en gran medida, a un inadecuado manejo y procesado de la escena del crimen, la inadecuada formación de los agentes para tomar y embalar las muestras, y/o la falta de formación toxicológica y/o forense de los veterinarios. La escena del crimen es solo uno de los componentes de la investigación pero necesita ser coordinada con los otros aspectos de la investigación. La escena del crimen debe ser estudiada hasta el más mínimo detalle para establecer un correcto diagnóstico. En este trabajo, utilizando como referencia el envenenamiento por aldicarb y estricnina, enfatizamos algunos aspectos clínicos y forenses que deben ser tenidos en cuenta en la investigación del envenenamiento de aves silvestres

Aldicarb and strychnine are frequently used to poison wild and domestic animals. Strychnine was widely used until it was banned in 1994, being substituted for carbamates such as aldicarb or carbofuran. Recently, an increase of deliberated poisonings using strychnine has been observed. Symptoms of aldicarb and strychnine poisonings have been widely described in mammals, however they have been poorly reported in birds. In most forensic cases the only available data is the chemical analysis realized on baits or tissues from dead animals. This scarcity of information is due usually to an inadequate management and processing of the crime scene, an unsuitable training of the first officer to collect and package the physical evidences, and/or unsuitable toxicological and forensic training of the veterinarians. Is should be recognized the crime scene is only one component of an investigation and needs to be coordinated with other aspects of the investigation. The crime scene should be investigated down to the last detail in order to establish an accurate diagnosis. In this work, using aldicarb and strychnine poisonings as references, we emphasize some clinical and forensic aspects which should be taken into account in the investigation of poisoning of wild birds

[Chronic idiopathic lithoptysis]. / Litoptisis crónica idiopática.

Broncholiths, which usually arise from calcified peribronchial lymph nodes, can be found by radiography or bronchoscopy. We describe the case of a 19-year-old man who had experienced lithoptysis of bronchial hydroxyapatite calculi for over 6 months and who reported having sandy expectoration since childhood. Exhaustive clinical, radiographic, and endoscopic diagnostic studies detected no calcified lesions in the thorax that could explain the origin of the broncholiths. Therefore, we propose that broncholiths may form by mechanisms similar to those involved in calculi formation in other locations.

Litoptisis crónica idiopática / Chronic idiopathic lithoptysis

No disponible

[Paradoxical costal shift throughout inspiration (Hoover's sign) in patients admitted because of dyspnea]. / Movimiento costal paradójico durante la inspiración (signo de Hoover) en pacientes hospitalizados por disnea.

OBJECTIVE: To study the frequency and diagnostic usefulness of Hoover's sign (paradoxical costal shift throughout inspiration) in patients admitted because of dyspnea. PATIENTS AND METHODS: 268 patients admitted because of dyspnea in an Internal Medicine Department were included in the study. Physical examination was carried out on the first day of admission to establish the presence of Hoover's sign. RESULTS: Hoover's sign was present in 62 patients of 82 with a diagnosis of chronic obstructive pulmonary disease (COPD) (sensitivity: 76%), in 3 patients of 101 (3%) with a diagnosis of congestive heart failure, in 3 patients of 23 (13%) with a diagnosis asthma, and in 6 patients of 62 (10%) with other diagnoses. Specificity of Hoover's sign for EPOC diagnosis was 94%. CONCLUSIONS: Hoover's sign is a frequent finding in patients admitted because of EPOC and is found only rarely in patients without obstructive pulmonary disease. This sign contributes useful information for the evaluation of patients admitted because of dyspnea.

Movimiento costal paradójico durante la inspiración (signo de Hoover) en pacientes hospitalizados por disnea / Paradoxical costal shift throughout inspiration (Hoover’s sign) in patients admitted because of dyspnea

Objetivo. Estudiar la frecuencia y utilidad diagnóstica del signo de Hoover (movimiento costal paradójico durante la inspiración) en pacientes hospitalizados por disnea. Material y métodos. Se incluyeron en el estudio 268 pacientes que ingresaron por disnea en un servicio de Medicina Interna. Los pacientes fueron explorados el primer día del ingreso para determinar la presencia del signo de Hoover. Resultados. El signo de Hoover estaba presente en 62 de los 82 pacientes diagnosticados de enfermedad pulmonar obstructiva crónica (EPOC) (sensibilidad: 76%), en 3 de 101 (3%) con insuficiencia cardíaca congestiva, en 3 de 23 (13%) con asma y en 6 de 62 (10%) con otros diagnósticos. La especificidad del signo de Hoover para diagnosticar EPOC fue del 94%. Conclusiones. El signo de Hoover es un hallazgo frecuente en pacientes hospitalizados con EPOC y está presente muy pocas veces en pacientes sin enfermedad pulmonar obstructiva. Este signo aporta información útil en la evaluación de pacientes hospitalizados por disnea

Objective. To study the frequency and diagnostic usefulness of Hoover’s sign (paradoxical costal shift throughout inspiration) in patients admitted because of dyspnea. Patients and methods. 268 patients admitted because of dyspnea in an Internal Medicine Department were included in the study. Physical examination was carried out on the first day of admission to establish the presence of Hoover’s sign. Results. Hoover’s sign was present in 62 patients of 82 with a diagnosis of chronic obstructive pulmonary disease (COPD) (sensitivity: 76%), in 3 patients of 101 (3%) with a diagnosis of congestive heart failure, in 3 patients of 23 (13%) with a diagnosis asthma, and in 6 patients of 62 (10%) with other diagnoses. Specificity of Hoover’s sign for EPOC diagnosis was 94%. Conclusions. Hoover’s sign is a frequent finding in patients admitted because of EPOC and is found only rarely in patients without obstructive pulmonary disease. This sign contributes useful information for the evaluation of patients admitted because of dyspnea

Mesotelioma, adenosindesaminasa y proteína C reactiva / Mesothelioma, adenosine deaminase, and C-rective protein

No disponible