Near infrared hyperspectral imaging as a sorting tool for deoxynivalenol reduction in wheat batches.

The present study aimed to evaluate the feasibility of using near-infrared hyperspectral imaging (NIR-HSI) and chemometrics for classification of individual wheat kernels according to their deoxynivalenol (DON) level. In total, 600 wheat kernels from samples naturally contaminated over the maximum EU level were collected, and the DON content in each individual wheat kernel was analyzed by UHPLC. Linear discriminant analysis (LDA) was employed for building classification models of DON using the EU maximum level as cut off level, and they were tested on balanced and imbalanced test sets. The results showed that the models presented a balanced accuracy of 0.71, that would allow to obtain safe batches from contaminated batches once the unsafe kernels had been rejected, but often more than 30% of the batch would be rejected. The work confirmed that NIR-HSI could be a feasible method for monitoring DON in individual kernels and removing highly contaminated kernels prior to food chain entry.

[Prognostic factors and profile in traumatic brain injury in the paediatric age]. / Perfil y factores pronósticos en el traumatismo craneoencefálico en la edad pediátrica.

INTRODUCTION: Traumatic brain injury (TBI) is a common cause of death and disability in the paediatric population, although the literature on the Spanish population is scarce. From the perspective of early vulnerability, recent research findings suggest that early brain injury has worse sequelae and a higher risk of impact. AIMS: To analyse the intelligence profile, executive functions and behaviour, and examine the association between age at the time of the injury, severity of the TBI and environmental factors for cognitive and behavioural outcomes. PATIENTS AND METHODS: Seventy-one participants with moderate to severe TBI, from 6 to 16 years of age, were assessed with measures of intelligence (intelligence quotient), executive functions and behaviour. RESULTS: Children with TBI are at increased risk of disability in all aspects of intelligence, executive functions and behaviour. Children who suffered a traumatic brain injury in infancy and the preschool period had more overall effects on intelligence quotient and some aspects of the executive functions. CONCLUSIONS: Socioeconomic and cultural factors are the best predictors for intelligence quotient and behaviour. These findings contribute to a better understanding of the sequelae of TBI in children, which will help in rehabilitation planning and re-adaptation to functional life.

TITLE: Perfil y factores pronósticos en el traumatismo craneoencefálico en la edad pediátrica.Introducción. El traumatismo craneoencefálico (TCE) es una causa común de muerte y discapacidad en la población pediátrica, aunque la bibliografía en población española sea escasa. Desde la perspectiva de la vulnerabilidad temprana, los hallazgos de investigaciones recientes sugieren que la lesión cerebral temprana tiene peores secuelas y un mayor riesgo de impacto. Objetivos. Analizar el perfil de la inteligencia, las funciones ejecutivas y el comportamiento, y examinar la asociación de la edad a la lesión, la gravedad del TCE y los factores ambientales para los resultados cognitivos y conductuales. Pacientes y métodos. Setenta y un participantes con TCE moderado a grave, con edades entre 6 y 16 años, fueron evaluados con medidas de inteligencia (cociente intelectual), funciones ejecutivas y comportamiento. Resultados. Los niños con TCE tienen un mayor riesgo de discapacidad en todos los aspectos de inteligencia, funciones ejecutivas y comportamiento. Los niños que sufrieron una lesión cerebral traumática en la infancia y preescolar registraron más efectos globales en el cociente intelectual y algunos aspectos de las funciones ejecutivas. Conclusiones. Los factores socioeconómicos y culturales son los mejores predictores para el cociente intelectual y el comportamiento. Estos hallazgos contribuyen a una mejor comprensión de las secuelas de TCE en los niños para ayudar en la planificación de rehabilitación y la readaptación a la vida funcional.

Efficacy of a new parent and school-supported intervention after moderate and severe childhood traumatic brain injury. / Eficacia de una nueva intervencion de apoyo a padres y escuelas despues de un traumatismo craneoencefalico moderado o grave.

INTRODUCTION: Traumatic brain injury is a common cause of acquired disability during childhood. Early interventions focusing on parenting practices may prove effective at reducing negative child outcomes. AIM: To determine the efficacy of a new counselling program aimed at parents and schools compared to a control group. PATIENTS AND METHODS: The main study sample was obtained from a paediatric hospital. The final sample consisted of 42 children aged between 6 and 16 years old. RESULTS: Comparing with normative data, pre-post comparisons between groups showed a significant improvement in the parent group with respect to the control group. CONCLUSIONS: The superiority of the parental intervention group over those of the control group was not only statistically significant, but also clinically substantial and meaningful. The results of this study suggest that children with moderate to severe traumatic brain injury can benefit from an intensive supported family treatment.

TITLE: Eficacia de una nueva intervencion de apoyo a padres y escuelas despues de un traumatismo craneoencefalico moderado o grave.Introduccion. El traumatismo craneoencefalico es una causa habitual de discapacidad adquirida durante la infancia. Las intervenciones tempranas que se centran en la participacion de los padres pueden resultar efectivas para reducir las disfunciones del niño. Objetivo. Determinar la eficacia de un nuevo programa de asesoramiento dirigido a padres y escuelas en comparacion con un grupo control. Pacientes y metodos. La muestra principal del estudio se obtuvo de un hospital pediatrico. La muestra final consistio en 42 niños de 6 a 16 años. Resultados. Comparando con los datos normativos, las comparaciones pre y post intragrupos mostraron una mejora significativa en el grupo de intervencion parental con respecto al grupo control. Conclusiones. La superioridad del grupo de intervencion parental sobre el grupo control no solo fue estadisticamente significativa, sino tambien clinicamente sustancial y relevante. Los resultados del estudio sugieren que los niños con traumatismo craneoencefalico moderado o grave pueden beneficiarse de un tratamiento familiar intensivo de apoyo.

Anxiety and depression in women with breast cancer: Social and clinical determinants and influence of the social network and social support (DAMA cohort).

BACKGROUND: Anxiety and depression are the most prevalent mental health pathologies among women with breast cancer. Social, clinical and contextual variables may influence emotional stress among women with breast cancer. The aim of this work is to study anxiety and depression in a cohort of women diagnosed with breast cancer between 2003 and 2013 in Barcelona. We evaluate social and clinical determinants. METHODS: We performed a mixed cohort study (prospective and retrospective) using a convenience sample of women diagnosed with breast cancer. The information sources were the Hospital Anxiety and Depression questionnaire and hospital medical records. Dependent variables were anxiety and depression; independent variables were social class, age, employment status, tumour stage at diagnosis, time since diagnosis, social network and social support. We performed a descriptive analysis, a bivariate analysis, and a multivariate logistic regression analysis. RESULTS: A total of 1086 (48.6%) women had some degree of anxiety-related problem. As for depression. In the case of depression, 225 (15%) women had some degree of depression-related problem. Low emotional support and social isolation were clear risk factors for having more anxiety and depression. Low social class was also a risk factor, and age also played a role. DISCUSSION: Our results show that women long period of cancer survival have high prevalences of anxiety than depression, and this prevalence of anxiety is higher than the general population. In addition, we found inequalities between social classes and the isolation and social support are worse too in low social class.

[Current state of the attention deficit hyperactivity disorder approach in neuropediatrics]. / Estado actual del enfoque del trastorno por deficit de atencion/hiperactividad en neuropediatria.

AIM: To know the current state of the approach of attention deficit hyperactivity disorder (ADHD) in neuropediatricians. SUBJECTS AND METHODS: A telematic survey was carried out to collect preliminary information on the interest, difficulties in the management and treatment of ADHD to the 437 fellowship of the Neuropediactric Spanish Society (SENEP). RESULTS: Only 32.49% of the sent questionnaires were answered, with important geographic variability. 97.89% stated that 50% of their consultations were children with learning disabilities and ADHD. Regarding who started treatment for ADHD in their area, the majority answered that the neuropediatrician (57.97%), followed by the child psychiatrist (34.78%) and the primary care pediatrician (5.31%). The lack of a psycho-pedagogical study by the school (49.79%), followed by the lack of time in the consultation (29.11%), was cited as the greatest difficulty in the initial assessment of children with suspected ADHD. Concerning the difficulties in the follow-up, the biggest complaint was the lack of coordination between professionals, the school and parents. And, lastly, regarding the type of treatment use, most patients were on prolonged-release methylphenidate, a stable percentage using immediate release methylphenidate as a single or combined treatment, and in a lower range was the use of clonidine and atomoxetine, and an incipient use of lisdexamphetamine were observed. 80% of the patient showed adherence to pharmacological treatment after one year. CONCLUSIONS: It is necessary to advance in the training and continuous education of our neuropediatric specialists in ADHD and to homogenize the clinical practice and coordination with education system in the Spanish territory.

TITLE: Estado actual del enfoque del trastorno por deficit de atencion/hiperactividad en neuropediatria.Objetivo. Conocer el estado actual del enfoque del trastorno por deficit de atencion/hiperactividad (TDAH) entre los neuropediatras. Sujetos y metodos. Se realizo una encuesta telematica que recogia informacion preliminar sobre el interes, las dificultades en el manejo y el tratamiento del TDAH a los 437 socios de la Sociedad Española de Neurologia Pediatrica. Resultados. Respondio un 32,49% de los cuestionarios enviados, con una importante variabilidad geografica. El 97,89% afirmo que el 50% de sus consultas eran niños con trastornos de aprendizaje y TDAH. Respecto a quien iniciaba el tratamiento para el TDAH en su area, la mayoria contesto que el neuropediatra (57,97%), seguido del psiquiatra infantil (34,78%) y del pediatra de atencion primaria (5,31%). Respecto a las mayores dificultades para la valoracion inicial de los niños con sospecha de TDAH, se citaron la falta de un estudio psicopedagogico por parte de la escuela (49,79%), seguido de la falta de tiempo en la consulta (29,11%). Sobre las dificultades en el seguimiento, la mayor queja se produjo por la falta de coordinacion entre los profesionales, la escuela y los padres. Respecto a la medicacion, la mayoria de los pacientes se encontraba en tratamiento con algun tipo de metilfenidato de liberacion prolongada, un porcentaje estable utilizaba metilfenidato de liberacion inmediata como tratamiento unico o combinado, y se observo en un rango inferior el uso de clonidina y atomoxetina, y un incipiente uso de lisdexanfetamina. La adhesion al tratamiento farmacologico al año fue alrededor del 80%. Conclusiones. Es necesario avanzar en la capacitacion y educacion continua de nuestros especialistas neuropediatricos en el manejo del TDAH, y en homogeneizar la practica clinica y la coordinacion con educacion en el territorio español.

Phonon-Modulated Magnetic Interactions and Spin Tomonaga-Luttinger Liquid in the p-Orbital Antiferromagnet CsO2.

The magnetic response of antiferromagnetic CsO2, coming from the p-orbital S=1/2 spins of anionic O2(-) molecules, is followed by 133Cs nuclear magnetic resonance across the structural phase transition occurring at T(s1)=61 K on cooling. Above T(s1), where spins form a square magnetic lattice, we observe a huge, nonmonotonic temperature dependence of the exchange coupling originating from thermal librations of O2(-) molecules. Below T(s1), where antiferromagnetic spin chains are formed as a result of p-orbital ordering, we observe a spin Tomonaga-Luttinger-liquid behavior of spin dynamics. These two interesting phenomena, which provide rare simple manifestations of the coupling between spin, lattice, and orbital degrees of freedom, establish CsO2 as a model system for molecular solids.

[Gastroschisis. Preterm elective cesarean and immediate primary closure: our experience]. / Gastrosquisis. Cesárea electiva pretérmino y cierre primario inmediato; nuestra experiencia.

PURPOSE: Our experience en treatment of gastroschisis using a protocol with elective preterm delivery by caesarean section at 34-35 weeks and immediate primary abdominal wall closure. METHODS: During a period of 18 month we treated 5 patients with gastroschisis using the following management pathway: Starting at 30th week of gestation, weekly ultrasound evaluation of fetal gut and pulmonary maturation with corticosteroids. Delivery by elective caesarean section between 34-35 weeks or earlier if evidence of bowel compromise was reported en ultrasound study. Immediate surgical correction after birth with primary closure was preformed under control of abdominal pressure. RESULTS: Mean gestational age of our patient was 33,94 weeks, and mean birth weight was 2154 gr. None of the cases present inflammatory peel and we found no difficulties for reduction of the gut at time of surgery. Two patients presented an intestinal malrotation. Extubation was preformed 36-48 hours after surgery. We started a trofic diet at 3,6 days and parental nutrition was retired after a mean period of 15,8 days. The mean time of hospital stay was 33,4 days. One patient with intestinal obstruction had a consideriously increased length of hospital stay of 74 days. CONCLUSIONS: A management pathway for gastroschisis with selective preterm delivery by caesarean section and immediate surgical treatment probably reduces the experience of inflammatory peel. This pathway permits a early initiation of oral feeding, reduces times of parenteral nutrition and need of central catheters, and shortens length of hospital stay.

[Genetic bases of attention deficit hyperactivity disorder]. / Bases geneticas del trastorno por deficit de atencion/hiperactividad.

AIMS: The purpose of this study is to update the information available on the main group of genes that have been related with a susceptibility to attention deficit hyperactivity disorder (ADHD) or with the pharmacological response to different drugs used in the treatment of ADHD, in a number of different association and meta-analysis studies. DEVELOPMENT: Different studies have provided evidence of the importance of the genetic load in the susceptibility to ADHD. The work carried out to date point to genes in the dopaminergic system, such as the gene that codes for the dopamine transporter (DAT1 or SLC6A3) and for the dopamine receptor D4 (DRD4); in the noradrenergic system, like the gene coding for the adrenergic alpha-2A receptor (ADRA2A), the COMT gene, which codes for the enzyme catechol-O-methyltransferase and the gene that codes for latrophilin 3 (LPHN3), as genes that are candidates for playing a part in the susceptibility to ADHD, and being involved in the pharmacological response as well as in the risk of presenting associated behavioural disorders. On the other hand, the genes involved in regulating the metabolism of the drugs used in the treatment of ADHD, such as the gene CYP2D6 and gene CES1, play a role in the efficiency and tolerance of these psycho-pharmaceuticals. CONCLUSIONS: Although in recent years there has been an increase in the number of pharmacogenetic studies conducted on ADHD, findings differ significantly from one study to another. Integrating and meta-analytical studies are needed to be able to develop a more personalised treatment for ADHD.

Gastrosquisis. Cesárea electiva pretérmino y cierre primario inmediato; nuestra experiencia / Gastroschisis. preterm elective cesarean and immediate primary closure: our experience

Objetivos. Presentar nuestra experiencia de 5 casos de gastrosquisis con un protocolo de parto por cesárea electiva entre las 34-35 semanas de gestación y cierre primario inmediato en una nota clínica. Material y métodos. En un periodo de 18 meses se han tratado 5pacientes con gastrosquisis con el siguiente protocolo: monitorización ecográfica semanal a partir de los 30 semanas y maduración pulmonar fetal; cesárea electiva entre las 34 y 35 semanas o ante la presencia de signos ecográficos de sufrimiento intestinal; corrección quirúrgica inmediata postparto con cierre primario de la pared bajo control de la presión abdominal. Resultados. La edad gestacional media de los pacientes ha sido de33,94 semanas, el peso medio fue de 2.154 g. No observamos engrosamiento de las asas (peel) en ninguno de los casos y no objetivamos dificultad para la reducción de las asas en la cavidad abdominal. Dos pacientes presentaron una mal rotación intestinal asociada. Se logró la extubación entre las 36 y 48 horas. Instauramos una dieta trófica a los3,6 días de media. La retirada de la nutrición parenteral fue posible a los15,8 días de media y el alta hospitalaria, a los 33,4 días de media. Un caso de oclusión intestinal pre-alta alargó considerablemente la estancia hospitalaria de este paciente (74 días).Conclusiones. Nuestra experiencia apoya el manejo terapéutico de las gastrosquisis mediante cesárea electiva pretérmino y tratamiento quirúrgico inmediato, probablemente sirve para evitar la aparición del temido peel. Este protocolo permite iniciar una dieta oral precozmente ,reduce el tiempo de nutrición parenteral, la necesidad de vías centrales con el riesgo de sepsis y acorta la estancia hospitalaria (AU)

Purpose. Our experience en treatment of gastroschisis using a protocol with elective preterm delivery by caesarean section at 34-35 weeks and immediate primary abdominal wall closure. Methods. During a period of 18 month we treated 5 patients with gastroschisis using the following management pathway: Starting at 30thweek of gestation, weekly ultrasound evaluation of fetal gut and pulmonary maturation with corticosteroids. Delivery by elective caesarean section between 34-35 weeks or earlier if evidence of bowel compromise was reported en ultrasound study. Immediate surgical correction afterbirth with primary closure was preformed under control of abdominal pressure. Results. Mean gestational age of our patient was 33,94 weeks, and mean birth weight was 2154 gr. None of the cases present inflamatory peel and we found no difficulties for reduction of the gut at time of surgery. Two patients presented an intestinal malrotation. Extubation was preformed 36-48 hours after surgery. We started atrophic diet at 3,6 days and parental nutrition was retired after a mean period of 15,8 days. The mean time of hospital stay was 33,4 days. One patient with intestinal obstruction had a consideriously increased length of hospital stay of 74 days. Conclusions. A management pathway for gastroschisis with selective preterm delivery by caesarean section and immediate surgical treatment probably reduces the experience of infl ammatory peel. This pathway permits a early initiation of oral feeding, reduces times of parenteral nutrition and need of central catheters, and shortens lengthof hospital stay (AU)

Perfil neuropsicológico de niños adoptados internacionalmente en Cataluña / Neuropsychological profile of internationally adopted children in Catalonia

Introducción: En los últimos años la adopción internacional ha aumentado considerablemente en nuestro país. China, Federación Rusa, Colombia y Etiopía suponen el 77% del total de las adopciones internacionales en España. Los aspectos cognitivos y conductuales son un factor muy importante para la adecuada adaptación social, familiar y escolar de estos niños. Objetivo: Describir los perfiles neuropsicológicos de un grupo de niños adoptados internacionalmente en Cataluña procedentes de China, Rusia, Colombia y Etiopía. Pacientes y métodos: Exploración neuropsicológica de 49 niños procedentes de adopción internacional (6 de origen chino, 24 de origen ruso, 13 de origen colombiano y 6 de origen etíope). Resultados: El grupo de origen chino muestra normalidad en todas las funciones evaluadas. El grupo de origen ruso presenta alteración en atención selectiva, fluencia verbal fonética, control de la impulsividad, mecánica y comprensión lectora y ortografía. El grupo de origen colombiano presenta alteración en el control de la impulsividad. El grupo de origen etíope muestra normalidad en todas las funciones evaluadas exceptuando un bajo dominio ortográfico. Conclusión: Los niños adoptados procedentes de Rusia presentan mayores dificultades neuropsicológicas que el resto. La mayoría de antecedentes previos a la adopción se desconocen, por lo que no podemos justificar el origen de estas dificultades. Algunas hipótesis relacionan el consumo materno de alcohol durante la gestación y la estancia en instituciones como posibles factores influyentes. Recomendamos la inclusión de valoraciones neuropsicológicas en los protocolos de salud de estos niños en caso de presentar signos sugestivos de trastorno cognitivo y/o conductual (AU)

Introduction: During the last years, International adoption has increased significantly in our country over the last few years. China, Russia, Colombia and Ethiopia represent 77% of international adoptions in Spain. Cognitive and behavioural aspects are very important for an adequate social, family and school integration of these children. Objective: To describe the neuropsychological profiles of a group of internationally adopted children in Catalonia from China, Russia, Colombia and Ethiopia.Patients and methods: Neuropsychological examination of 49 children from international adoption (6 of Chinese origin, 24 from Russia, 13 from Colombia and 6 of Ethiopian origin). Results: The group of Chinese origin obtained average scores of all functions evaluated. The Russian origin group was below the average for, selective attention, phonetic verbal fluency, control of impulsivity, mechanics and reading comprehension, and spelling. Scores on the impulse controlin the Colombian origin group were below average. The group of Ethiopian origin obtained average scores in all functions evaluated except for spelling difficulties. Conclusion: Children adopted from Russia have greater neuropsychological difficulties than the others. Most pre-adoption history is unknown; therefore we are unable to determine the origin of these difficulties. Maternal alcohol consumption during pregnancy and the institutional environment could be influencing factors in neuropsychological delay. Inclusion of neuropsychological assessment in health protocols for these children is recommended if they develop suggestive signs of cognitive and/or behavioral impairment (AU)

[Neuropsychological profile of internationally adopted children in Catalonia]. / Perfil neuropsicológico de niños adoptados internacionalmente en Cataluña.

INTRODUCTION: During the last years, International adoption has increased significantly in our country over the last few years. China, Russia, Colombia and Ethiopia represent 77% of international adoptions in Spain. Cognitive and behavioural aspects are very important for an adequate social, family and school integration of these children. OBJECTIVE: To describe the neuropsychological profiles of a group of internationally adopted children in Catalonia from China, Russia, Colombia and Ethiopia. PATIENTS AND METHODS: Neuropsychological examination of 49 children from international adoption (6 of Chinese origin, 24 from Russia, 13 from Colombia and 6 of Ethiopian origin). RESULTS: The group of Chinese origin obtained average scores of all functions evaluated. The Russian origin group was below the average for, selective attention, phonetic verbal fluency, control of impulsivity, mechanics and reading comprehension, and spelling. Scores on the impulse control in the Colombian origin group were below average. The group of Ethiopian origin obtained average scores in all functions evaluated except for spelling difficulties. CONCLUSION: Children adopted from Russia have greater neuropsychological difficulties than the others. Most pre-adoption history is unknown; therefore we are unable to determine the origin of these difficulties. Maternal alcohol consumption during pregnancy and the institutional environment could be influencing factors in neuropsychological delay. Inclusion of neuropsychological assessment in health protocols for these children is recommended if they develop suggestive signs of cognitive and/or behavioral impairment.

Analysis of relapses in anti-NMDAR encephalitis.

OBJECTIVE: The clinical characteristics of patients with relapsing anti-NMDA receptor (NMDAR) encephalitis are not well-defined. In this study, we report the clinical profile and outcome of relapses in a series of anti-NMDAR encephalitis. METHODS: We did a retrospective review of relapses that occurred in 25 patients with anti-NMDAR encephalitis. Relapses were defined as any new psychiatric or neurologic syndrome, not explained by other causes, which improved after immunotherapy or, less frequently, spontaneously. RESULTS: A total of 13 relapses were identified in 6 patients. Four of them had several, 2 to 4, relapses. There was a median delay of 2 years (range 0.5 to 13 years) for the first relapse. Median relapse rate was 0.52 relapses/patient-year. Relapse risk was higher in patients who did not receive immunotherapy in the first episode (p = 0.009). Most cases (53%) presented partial syndromes of the typical anti-NMDAR encephalitis. Main symptoms of relapses were speech dysfunction (61%), psychiatric (54%), consciousness-attention disturbance (38%), and seizures (31%). Three relapses (23%) presented with isolated atypical symptoms suggestive of brainstem-cerebellar involvement. An ovarian teratoma was detected at relapse in only 1 patient (17%). Relapses did not add residual deficit to that caused by the first episode. CONCLUSIONS: Relapses in anti-NMDAR encephalitis are common (24%). They may occur many years after the initial episode. Relapses may present with partial aspects or with isolated symptoms of the full-blown syndrome. Immunotherapy at first episode reduces the risk of relapses.

[Predictive variables for mental retardation in a Pediatric Epilepsy Monitoring Unit. Neuropsychological assessment]. / Variables predictoras de retraso mental en una unidad de monitorización videoelectroencefalográfica pediátrica. Evaluación neuropsicológica.

AIM: We sought to describe the epidemiological and clinical data from our patients in the Pediatric Epilepsy Monitoring Unit (PEMU) of the Sant Joan de Deu Hospital of Barcelona, and determine the variables of risk for mental retardation. PATIENTS AND METHODS: A retrospective review of PEMU reports and hospital discharge summaries from March 2005 to December 2008 was conducted. The data from patients with intelligence quotient (IQ) estimated, older than 3 years of age and with epileptic electroencephalography (EEG) activity was analyzed in 158 patients (8.8 +/- 5.2 years; 55.1% boys). Of those pediatric patients, 63 had IQ less than 70 and 47 an IQ greater than or equal to 70. Intractable epilepsy was present in all of them. RESULTS: The percentage of the patients with mental retardation is significantly higher in patients with onset of epilepsy before 24 months (68.3%) than patients with later onset (27.7%). Onset of seizures, EEG findings and epilepsy etiology are significant risk factors for mental retardation. CONCLUSIONS: Early age at seizure, multifocal epilepsy and cryptogenic etiology are factors of worse prognosis to normal development of cognitive functions in pediatric intractable epilepsy.

[Neuropsychological aspects of acquired diffuse brain injury in paediatric childhood]. / Aspectos neuropsicológicos del daño cerebral difuso adquirido en la edad pediátrica.

INTRODUCTION AND DEVELOPMENT: Acquired brain injury is one of the most common causes of long-term disability in childhood and traumatisms are the most prevalent cause. Diffuse axonal injury is associated with poor neuropsychological outcome. In contrast to early focal lesions, young age confers no advantage in the outcome of severe diffuse brain injury. Plasticity is incomplete for structural and functional deficits in children. The traditional view of enhanced reorganization of function after localized brain injury it can't be applied in early severe diffuse brain injury. In the paediatric population where the central nervous system is in a rapid state of growth, developmental factors may mask the difficulties and deficits in certain skills may not be evident until that skill is expected to emerge at a certain age. CONCLUSION: Like in adults the neuropsychological domains more affected in childhood are psychomotor speed, memory, attention and executive functioning. In childhood neuropsychological deficits will affect learning and adaptive behaviour. Sometimes deficits will be cumulative over time.

[Non-verbal learning disorder: cognitive-behavioural characteristics and neuropsychological aspects]. / Trastorno de aprendizaje no verbal: características cognitivo-conductuales y aspectos neuropsicológicos.

INTRODUCTION AND DEVELOPMENT: Non verbal learning disorder is a neurological condition which is considered to be a developmental disability. It is characterised by a specific dysfunction in motor, visuospatial and social skills in patients with a normal intellect and development of language. Warning signs in school are poor psychomotor coordination, arithmetic skills and drawing activities. Social judgment and social problem solving are also typically impaired. Furthermore, these patients seem to have increasing risk of emotional disorders. CONCLUSIONS: Current evidence and theories suggest that dysfunction of white matter in the right hemisphere could be the cause. The clinical characteristics and the diagnostic criteria have not fully agreed on. A comprehensive neuropsychological evaluation reveals specific and heterogeneous patterns of difficulties for each child that would make possible to address and accommodate an educational program.

Aspectos neuropsicológicos del daño cerebral difuso adquirido en la edad pediátrica / Neuropsychological aspects of acquired iffuse brain injury in paediatric childhood

Introducción y desarrollo. El daño cerebral adquirido (DCA) es causa de discapacidad en la edad pediátrica. El traumatismo craneoencefálico grave constituye la causa más frecuente de DCA. El pronóstico vital del DCA es más favorable en el niño que en el adulto. No sucede así con el pronóstico neuropsicológico, que es más desfavorable cuanto menor es la edad en el momento de producirse la lesión. En el daño cerebral difuso la plasticidad y capacidad de reorganización cerebral tienen un efecto limitado en la compensación de los déficit cognitivos y conductuales. Debido al proceso de desarrollo del sistema nervioso del niño, la repercusión del DCA puede tardar años en ser evidente. Las demandas crecientes en la escuela, de autonomía y de adaptación social, harán que las dificultades puedan ser progresivas con la edad. Conclusión. Las funciones neuropsicológicas más afectadas, igual que en la edad adulta, son la velocidad psicomotora, memoria, funciones ejecutivas y atencionales. El proceso de desarrollo y aprendizaje del niño hará que la repercusión sea mucho mayor (AU)

Introduction and development. Acquired brain injury is one of the most common causes of long-term disability in childhood and traumatisms are the most prevalent cause. Diffuse axonal injury is associated with poor neuropsychological outcome. In contrast to early focal lesions, young age confers no advantage in the outcome of severe diffuse brain injury. Plasticity is incomplete for structural and functional deficits in children. The traditional view of enhanced reorganization of function after localized brain injury it can’t be applied in early severe diffuse brain injury. In the paediatric population where the central nervous system is in a rapid state of growth, developmental factors may mask the difficulties and deficits in certain skills may not be evident until that skill is expected to emerge at a certain age. Conclusion. Like in adults the neuropsychological domains more affected in childhood are psychomotor speed, memory, attention and executive functioning. Inchildhood neuropsychological deficits will affect learning and adaptive behaviour. Sometimes deficits will be cumulative over time (AU)

Trastorno de aprendizaje no verbal: características cognitivo-conductuales y aspectos neuropsicológicos / Non-Verbal learning disorder: Cognitive behavioural characteristics and neuropsychological aspects

Introducción y desarrollo. El trastorno de aprendizaje no verbal es un trastorno de base neurobiológica que se caracteriza por una disfunción específica en habilidades motrices y visuoespaciales/visuoconstructivas y por dificultades en las relaciones sociales, en pacientes con una inteligencia general y habilidades lingüísticas preservadas. En la escuela, los niños afectados presentan alteraciones en la psicomotricidad y en tareas de dibujo, plástica y cálculo. Con frecuencia se asocian dificultades en la relación social (percepción social, juicio y habilidades de interacción social) y existe una predisposición a padecer problemas emocionales. Conclusiones. Fisiopatológicamente se ha relacionado con una disfunción hemisférica cerebral derecha en la sustancia blanca. Las características clínicas y los criterios diagnósticos no están totalmente definidos. La exploración neuropsicológica pone de manifiesto perfiles clínicos diferentes. Es importante una temprana identificación para poner en marcha las estrategias educativas adecuadas en cada caso (AU)

Introduction and development. Non verbal learning disorder is a neurological condition which is considered to be a developmental disability. It is characterised by a specific dysfunction in motor, visuospatial and social skills in patients with a normal intellect and development of language. Warning signs in school are poor psychomotor coordination, arithmetic skills and drawing activities. Social judgment and social problem solving are also typically impaired. Furthermore, these patients seem to have increasing risk of emotional disorders. Conclusions. Current evidence and theories suggest that dysfunction of white matter in the right hemisphere could be the cause. The clinical characteristics and the diagnostic criteria have not fully agreed on. A comprehensive neuropsychological evaluation reveals specific and heterogeneous patterns of difficulties for each child that would make possible to address and accommodate an educational program (AU)

[Retrospective diagnosis of congenital infection by cytomegalovirus in the case of one infant]. / Diagnóstico retrospectivo de infección congénita por citomegalovirus en un caso clínico infantil.

INTRODUCTION: 10-15% of asymptomatic congenital infections by cytomegalovirus (CMV) in the neonatal period develop persistent problems with varying degrees of severity, fundamentally involving neurological disorders, neurosensory hypoacusis and hypovision, which appear from the age of 6-9 months onwards, when a diagnosis is no longer possible. The PCR (polymerase chain reaction) technique can detect DNA of CMV in blood samples on filter paper used for screening hypothyroidism and metabolic pathologies that were kept from the neonatal period. CASE REPORT: A child aged 3 years and 8 months with delayed intrauterine growth, autism, mental retardation, microcephalus and neurosensory hypoacusis; periventricular calcifications, leukoencephalopathy and bilateral malformation of the temporal lobe; and a diagnosis of congenital CMV confirmed by detection of DNA by PCR in the blood sample on filter paper saved from the neonatal period. CONCLUSIONS: The retrospective study of congenital infection by CMV should be considered when faced with severity and varying association of delayed intrauterine growth, microcephalus, neurosensory hypoacusis, chorioretinitis, mental retardation, autism or other behavioural disorders, intracranial calcifications, encephaloclastic alterations, leukoencephalopathy, cortical dysplasia and malformations of the temporal lobe and the hippocampus. Since the filter papers from neonatal screening are not kept for ever, perhaps the idea of doing so ought to be considered, given the possibilities they offer for retrospective studies.