The association between social phobia, social anxiety cognitions and paranoid symptoms.

OBJECTIVE: Previous research suggests high levels of comorbidity between social phobia and paranoid symptoms, although the nature of this association remains unclear. METHOD: Data were derived from the Early Developmental Stages of Psychopathology study, a 10-year longitudinal study in a representative German community sample of 3021 participants aged 14-24 years at baseline. The Munich-Composite International Diagnostic Interview was used to assess social phobia and paranoid symptoms, along with data on social phobia features. Cross-sectional and longitudinal analyses were conducted. Differential associations with environmental risk factors and temperamental traits were investigated. RESULTS: Lifetime social phobia and paranoid symptoms were associated with each other cross-sectionally (OR = 1.80, 95% CI = 1.31-2.47). Lifetime paranoid symptoms were associated specifically with social anxiety cognitions. Lifetime cognitions of negative evaluation predicted later onset of paranoid symptoms, whereas onset of social phobia was predicted by cognitions of loss of control and fear/avoidance of social situations. Lifetime social phobia and paranoid symptoms shared temperamental traits of behavioural inhibition, but differed in environmental risks. CONCLUSIONS: The present study showed that paranoid symptoms and social phobia share similarities in cognitive profile and inhibited temperament. Avoidance appears to be important in the development of social phobia, whereas cannabis use and traumatic experiences may drive paranoid thinking in vulnerable individuals.

Adolescent development of psychosis as an outcome of hearing impairment: a 10-year longitudinal study.

BACKGROUND: It has long been acknowledged that hearing impairment may increase the risk for psychotic experiences. Recent work suggests that young people in particular may be at risk, indicating a possible developmental mechanism. METHOD: The hypothesis that individuals exposed to hearing impairment in early adolescence would display the highest risk for psychotic symptoms was examined in a prospective cohort study of a population sample of originally 3021 adolescents and young adults aged 14-24 years at baseline, in Munich, Germany (Early Developmental Stages of Psychopathology Study). The expression of psychosis was assessed at multiple time points over a period of up to 10 years, using a diagnostic interview (Munich Composite International Diagnostic Interview; CIDI) administered by clinical psychologists. RESULTS: Hearing impairment was associated with CIDI psychotic symptoms [odds ratio (OR) 2.04, 95% confidence interval (CI) 1.10-3.81], particularly more severe psychotic symptoms (OR 5.66, 95% CI 1.64-19.49). The association between hearing impairment and CIDI psychotic symptoms was much stronger in the youngest group aged 14-17 years at baseline (OR 3.28, 95% CI 1.54-7.01) than in the older group aged 18-24 years at baseline (OR 0.82, 95% CI 0.24-2.84). CONCLUSIONS: The finding of an age-specific association between hearing impairment and psychotic experiences suggests that disruption of development at a critical adolescent phase, in interaction with other personal and social vulnerabilities, may increase the risk for psychotic symptoms.

New nanostructured electrochemical biosensors based on three-dimensional (3-mercaptopropyl)-trimethoxysilane network.

The design and characterization of a new nanostructured organic-inorganic hybrid material and its application to L-lactic acid determination are described. This material is based on the integration of the enzyme lactate oxidase (LOx) and gold nanoparticles (AuNPs) into a sol-gel 3D polymeric network derived from (3-mercaptopropyl)-trimethoxysilane (MPTS) previously formed onto a gold surface. MPTS presents the advantage of forming a 3D polymeric network containing a large number of thiol tail groups distributed throughout its structure that enable both its anchoring onto gold surfaces and the AuNPs incorporation. Moreover, this matrix provides a biocompatible environment that preserves the catalytic activity of LOx after its immobilization and allows the incorporation of a high amount of enzyme, which is expected to improve the sensitivity of the final biosensing device. Characterization of the designed biosensing platform was performed using quartz crystal microbalance (QCM), scanning electron microscopy (SEM) and atomic force microscopy (AFM) techniques. From the conjunction of these techniques, information about (i) the kinetic of LOx adsorption process in real time, (ii) the amount of LOx incorporated into the network, and (iii) the morphological characteristics at the nanometre level of the designed biosensing material was obtained. This information is very useful on the development of successful biosensing devices. Finally, the response of the biosensor to L-lactic acid was evaluated. The biosensor responds linearly to L-lactic acid in the range of 50 µM to 0.25 mM, with a sensitivity of 3.4 µA mM(-1) and a detection limit of 4.0 µM.

One-step covalent microcontact printing approach to produce patterns of lactate oxidase.

A comparative study of three different strategies to pattern lactate oxidase (LOx) onto bare gold substrates by microcontact printing (muCP) is presented. The quality of the resulting patterns in terms of homogeneity, compactness and stability has been evaluated by atomic force microscopy in both air and aqueous conditions. The following approaches have been tested: (i) LOx was directly stamped to a bare gold surface; (ii) LOx was previously covalently bonded to a thiolated molecule, dithiodipropionic acid di(N-succinimidyl ester) (DTSP), and this conjugate (LOx/DTSP) was transferred from an elastomeric stamp to a bare gold substrate; (iii) formation of a LOx/DTSP micropattern on a bare gold surface (as described in approach ii) was followed by exposure to a solution containing hexadecylmercaptane (HDM). In all cases, the catalytic activity of the final LOx patterns has been assessed by electrochemical measurements. From comparison of the three strategies, it can be concluded that the third one gives rise to LOx patterns that present a high stability and compactness, also offering the advantage of reducing the number of microcontact printing steps to one.

Diamond nanoparticles as a way to improve electron transfer in sol-gel L-lactate biosensing platforms.

In the present work, we have included for the first time diamond nanoparticles (DNPs) in a sol-gel matrix derived from (3-mercaptopropyl)-trimethoxysilane (MPTS) in order to improve electron transfer in a lactate oxidase (LOx) based electrochemical biosensing platform. Firstly, an exhaustive AFM study, including topographical, surface potential (KFM) and capacitance gradient (CG) measurements, of each step involved in the biosensing platform development was performed. The platform is based on gold electrodes (Au) modified with the sol-gel matrix (Au/MPTS) in which diamond nanoparticles (Au/MPTS/DNPs) and lactate oxidase (Au/MPTS/DNPs/LOx) have been included. For the sake of comparison, we have also characterized a gold electrode directly modified with DNPs (Au/DNPs). Secondly, the electrochemical behavior of a redox mediator (hydroxymethyl-ferrocene, HMF) was evaluated at the platforms mentioned above. The response of Au/MPTS/DNPs/LOx towards lactate was obtained. A linear concentration range from 0.053 mM to 1.6 mM, a sensitivity of 2.6 µA mM(-1) and a detection limit of 16 µM were obtained. These analytical properties are comparable to other biosensors, presenting also as advantages that DNPs are inexpensive, environment-friendly and easy-handled nanomaterials. Finally, the developed biosensor was applied for lactate determination in wine samples.

Electrocatalytic processes promoted by diamond nanoparticles in enzymatic biosensing devices.

We have developed a biosensing platform for lactate determination based on gold electrodes modified with diamond nanoparticles of 4nm of nominal diameter, employing the enzyme lactate oxidase and (hydroxymethyl)ferrocene (HMF) as redox mediator in solution. This system displays a response towards lactate that is completely different to those typically observed for lactate biosensors based on other nanomaterials, such as graphene, carbon nanotubes, gold nanoparticles or even diamond nanoparticles of greater size. We have observed by cyclic voltammetry that, under certain experimental conditions, an irreversible wave (E(0)=+0.15V) appears concomitantly with the typical Fe(II)/Fe(III) peaks (E(0)=+0.30V) of HMF. In this case, the biosensor response to lactate shows simultaneous electrocatalytic peaks at +0.15V and +0.30V, indicating the concurrence of different feedback mechanisms. The achievement of a biosensor response to lactate at +0.15V is very convenient in order to avoid potential interferences. The developed biosensor presents a linear concentration range from 0.02mM to 1.2mM, a sensitivity of 6.1µAmM(-1), a detection limit of 5.3µM and excellent stability. These analytical properties compare well with those obtained for other lactate-based biosensors that also include nanomaterials and employ HMF as redox mediator.

Diamond nanoparticles based biosensors for efficient glucose and lactate determination.

In this work, we report the modification of a gold electrode with undoped diamond nanoparticles (DNPs) and its applicability to the fabrication of electrochemical biosensing platforms. DNPs were immobilized onto a gold electrode by direct adsorption and the electrochemical behavior of the resulting DNPs/Au platform was studied. Four well-defined peaks were observed corresponding to the DNPs oxidation/reduction at the underlying gold electrode, which demonstrate that, although undoped DNPs have an insulating character, they show electrochemical activity as a consequence of the presence of different functionalities with unsaturated bonding on their surface. In order to develop a DNPs-based biosensing platform, we have selected glucose oxidase (GOx), as a model enzyme. We have performed an exhaustive study of the different steps involved in the biosensing platform preparation (DNPs/Au and GOx/DNPs/Au systems) by atomic force microscopy (AFM), field emission scanning electron microscopy (FE-SEM) and cyclic voltammetry (CV). The glucose biosensor shows a good electrocatalytic response in the presence of (hydroxymethyl)ferrocene as redox mediator. Once the suitability of the prototype system to determine glucose was verified, in a second step, we prepared a similar biosensor, but employing the enzyme lactate oxidase (LOx/DNPs/Au). As far as we know, this is the first electrochemical biosensor for lactate determination that includes DNPs as nanomaterial. A linear concentration range from 0.05 mM to 0.7 mM, a sensitivity of 4.0 µA mM(-1) and a detection limit of 15 µM were obtained.

One-stage immediate reconstruction of partial auricular amputation by dog bite.

A case of one-stage immediate reconstruction of partial auricular amputation secondary to dog bite is presented. Primary reconstruction was performed using the cartilage of the avulsed portion of the ear nourished by means of a pedicled temporofascial flap and split-thickness skin graft. The perioperative antimicrobial protocol is also detailed.

[Drug administration schedules in geriatric patients]. / Análisis de las pautas de dosificación de medicamentos en pacientes geriátricos.

BACKGROUND: In this study the prescription of drugs in an outpatients geriatric population was evaluated in terms of age and body weight. METHODS: From a wide survey carried out on 500 geriatric outpatients, all the prescriptions corresponding to H-2 antagonists, digoxin, theophylline, bromazepam, diazepam, lorazepam and triazolam were analyzed. The patients studied were of 60 or more years of age. For each drug patients were stratified into groups according to intervals of body weight with mean age of the patient being determined in each of the intervals as well as the doses received in mg/kg. RESULTS: Two hundred eighty prescriptions were analyzed with 12% corresponding to the H-2 antagonists, 29% to digoxin, 23% to theophylline and 35% to benzodiazepines. There was no significant correlation between age and the doses received. In general, the lowest body weight corresponded with a higher mean age and a marked increase in the mean dose of cimetidine, ranitidine, theophylline, bromazepam, lorazepam, and triazolam administered. There was a tendency to an adjustment in the doses of digoxin in the most elderly patients. CONCLUSIONS: The data found concerning the prescription of drugs to a geriatric outpatients population indicate that in elderly patients adjustments are not made in the doses of drugs administered according to the age and body weight of the patient. Low body weight of the elderly is a overdosage risk factor.

Laccase biosensors based on different enzyme immobilization strategies for phenolic compounds determination.

Different enzyme immobilization approaches of Trametes versicolor laccase (TvL) onto gold surfaces and their influence on the performance of the final bioanalytical platforms are described. The laccase immobilization methods include: (i) direct adsorption onto gold electrodes (TvL/Au), (ii) covalent attachment to a gold surface modified with a bifunctional reagent, 3,3'-Dithiodipropionic acid di (N-succinimidyl ester) (DTSP), and (iii) integration of the enzyme into a sol-gel 3D polymeric network derived from (3-mercaptopropyl)-trimethoxysilane (MPTS) previously formed onto a gold surface (TvL/MPTS/Au). The characterization and applicability of these biosensors are described. Characterization is performed in aqueous acetate buffer solutions using atomic force microscopy (AFM), providing valuable information concerning morphological data at the nanoscale level. The response of the three biosensing platforms developed, TvL/Au, TvL/DTSP/Au and TvL/MPTS/Au, is evaluated in the presence of hydroquinone (HQ), used as a phenolic enzymatic substrate. All systems exhibit a clear electrocatalytic activity and HQ can be amperometrically determined at -0.10 V versus Ag/AgCl. However, the performance of biosensors - evaluated in terms of sensitivity, detection limit, linear response range, reproducibility and stability - depends clearly on the enzyme immobilization strategy, which allows establishing its influence on the enzyme catalytic activity.

Evidence that onset of clinical psychosis is an outcome of progressively more persistent subclinical psychotic experiences: an 8-year cohort study.

This study examined the hypothesis that developmental expression of psychometric risk in the form of subclinical psychotic experiences in the general population is usually transitory but in some instances may become abnormally persistent and progress to a clinical psychotic state. A prospective cohort study was conducted in a general population sample of 845 adolescents, aged 14-17 years, in Munich, Germany (Early Developmental Stages of Psychopathology Study). Expression of psychosis was assessed 4 times (T0-T3) over a period of 8.4 years. Transition from subclinical psychosis at T0-T2 to clinical psychosis in terms of impairment at T3 was examined as a function of the level of prior persistence of subclinical psychosis (present never, once, twice, or thrice). The more the subclinical psychosis persisted over the period T0-T2, the greater the risk of transition to clinical psychosis at T3 in a dose-response fashion (subclinical psychosis expression once over T0-T2: odds ratio [OR] = 1.5 [95% confidence interval {CI} = 0.6-3.7], posttest probability [PP] = 5%; twice: OR = 5.0 [95% CI = 1.6-15.9], PP = 16%; at all 3 measurements: OR = 9.9 [95% CI = 2.5-39.8], PP = 27%). Of all clinical psychosis at T3, more than a third (38.3%) was preceded by subclinical psychotic experiences at least once and a fifth (19.6%) at least twice. Consequently, a significant proportion of psychotic disorder may be conceptualized as the rare poor outcome of a common developmental phenotype characterized by persistence of psychometrically detectable subclinical psychotic experiences. This may be summarized descriptively as a psychosis proneness-persistence-impairment model of psychotic disorder.

Gold nanoparticles-induced enhancement of the analytical response of an electrochemical biosensor based on an organic-inorganic hybrid composite material.

The design and characterization of a new organic-inorganic hybrid composite material for glucose electrochemical sensing are described. This material is based on the entrapment of both gold nanoparticles (AuNPs) and glucose oxidase, which was chosen as a model, into a sol-gel matrix. The addition of spectroscopic grade graphite to this system, which confers conductivity, leads to the development of a material particularly attractive for electrochemical biosensor fabrication. The characterization of the hybrid composite material was performed using atomic force microscopy and scanning electron microscopy techniques. This composite material was applied to the determination of glucose in presence of hydroxymethylferrocene as a redox mediator. The system exhibits a clear electrocatalytic activity towards glucose, allowing its determination at 250 mV vs Ag/AgCl. The performance of the resulting enzyme biosensor was evaluated in terms of sensitivity, detection limit, linear response range, stability and accuracy. Finally, the enhancement of the analytical response of the resulting biosensor induced by the presence of gold nanoparticles was evaluated by comparison with a similar organic-inorganic hybrid composite material without AuNPs.

Application of new sol-gel electrochemical sensors to the determination of trace mercury.

The aim of this work was the synthesis and characterization of new modified sol-gel carbon composite electrodes and their application to the determination of trace mercury species with positive charge. Two types of modified electrodes were synthesized, sol-gel and sol-gel-PVSA carbon composite electrodes. In the last ones, poly(vinylsulfonic acid) (PVSA) was used as a functional polymer entrapped within the sol-gel material due to its cationic exchange properties. In a first stage, parameters affecting both, the sol-gel process and the electrode preparation were optimized. In a second stage, usefulness of developed electrodes applied to the determination of cationic mercury species was evaluated, optimizing the activation, preconcentration, measurement and regeneration steps. Developed electrodes showed very favourable electroanalytical properties for their use as amperometric sensors, such as small size, low cost, simple fabrication and handling, renewability and reusability. By means of an easy and low-cost methodology, satisfactory experimental results were obtained in Hg2+ determination. In this sense, developed analytical methodology showed adequate response times, linear concentration range up to three orders of magnitude (from 5.0 x 10(-8) to 5.0 x 10(-5)M) and detection limits of 1.5 x 10(-8)M (3.0 microg L(-1)). These results suggest that the incorporation of different receptor molecules at the sol-gel carbon composite material in combination with a selected electrochemical reaction could improve the detection limit achieved and obtain electrochemical sensors adapted to the determination of different species of mercury and other heavy metals.

Application of chemical, physical and chemometric analytical techniques to the study of ancient ceramic oil lamps.

A chemical, mineralogical and morphological characterization of 54 fragments of oil lamps found in two Spanish archaeological sites (Cordoba and Herrera de Pisuerga (Palencia)) has been performed. Flame atomic absorption and emission spectrometry were used for the determination of Al(2)O(3), CaO, Fe(2)O(3), K(2)O, MgO, MnO, Na(2)O and TiO(2) as major constituents and Cu, Cr, Ni, Pb and Zn as minor and trace selected elements. Physical, mineralogical and morphological analyses were made by using dilatometry at constant heating rate for the thermal behaviour, X-ray diffraction spectrometry for the mineralogical composition and, in a group of selected samples, scanning electron microscopy and polarizing petrographic microscopy for the observation of thin layers and mineral identification. Separations of light and heavy minerals were carried out with bromoform and X-ray diffraction analysis was applied to both fractions. Multivariate statistical analysis was used to establish correlations between variables and to deduce factors which allow the gathering of oil lamp samples in groups as a function of their composition. The results of these analyses allow the comparison among pieces and the establishment of conclusions about several aspects of their manufacture, the origin of the raw materials and the provenance of the oil lamps (local or imported). They provide information supporting certain archaeological hypothesis. For example, some oil lamps found in Herrera de Pisuerga showed a clearly different physicochemical composition. They were probably brought from Italy by the Roman Legions together with their initial furniture household.

[Modification of the vaccination technique with DTP in nursing infants after 1 intervention]. / Modificación de la técnica vacunal con DTP en el lactante tras una intervención.

OBJECTIVES: To evaluate alterations in techniques of DTP vaccination of nursing children after a two-year intervention and analyse the reasons for reluctance to change the norms. DESIGN: A longitudinal and prospective study, with intervention before and after. Evaluation through two anonymous questionnaires of staff in charge of the vaccinations: a general survey for each centre and an individual one for each nurse. SETTING: Primary care. PARTICIPANTS: The professionals in charge of vaccinations of nursing children in the 13 health centres and clinics in areas 11 and 12 of the Valencian Community in 1993. INTERVENTION: Informative meetings with paediatricians and nurses to pass on the recommendations of experts on vaccination techniques, supported by written information to the person in charge of vaccinations at each centre. MEASUREMENTS AND MAIN RESULTS: Out of the 13 centres 12 returned the general survey in 1993 and 11 in 1995. The individual questionnaire was returned by 49 nurses. From the 12 centres injecting in the gluteus in 1993, 5 changed to the thigh and all now use 25 mm-long needles. The reasons for not changing the site of the injection were basically the greater number of side-effects and that the paediatricians did not consider it necessary. CONCLUSIONS: Vaccination techniques are usually altered after the intervention, though still not sufficiently.

MCF fast derivatization procedure for the identification of resinous deposit components from the inner walls of roman age amphorae by GC-MS.

Resinous deposits from the inner walls of Roman age amphorae have been analysed by GC-MS. A simple dissolution of the sample in chloroform was carried out without any previous treatment of the sample. A new method for derivatization of carboxylic groups in these type of compounds was tested using methylchloroformate (MCF) in the optima conditions, giving good results with a short derivatization time. Some diterpenoid components of conifer resin have been identified, as well as other monoterpenoid components of essential oils. Results obtained allowed to know the nature and origin of these resinous deposits and the early Roman age technological practices in Spain.

[Drug use pattern in an ambulatory geriatric population]. / Patrón de utilización de medicamentos en una población geriátrica ambulatoria.

AIM: To provide an update of drug utilization patterns of 500 ambulatory subjects over 60 years of age. METHODS: Subjects were asked about their prescribed and nonprescribed medications an a detailed questionnaire was fulfilled. The case records and prescription sheets, when available, were examined. RESULTS: Drug histories were obtained on 313 women and 187 men. the mean age was 71 years (range 60-96). Of these participants 1.8% were taking no medications. The average number of drugs used was 4.8 (range from 0-16) nevertheless, the mean number of pharmacological active ingredients was much higher (7.3). The mean number of nonprescribed medications was 0.11, the majority with only an active ingredient. 87% had been used for longer than three months, and were taken daily (84%). The most commonly prescribed medications in this population were paracetamol, digoxin, hydrochlorothiazide, amiloride, nifedipine and captopril. CONCLUSIONS: The elderly are, in fact, receiving an increasing number of medications with a narrow therapeutic index and chronically.

Hiperactivos sin tratamiento, ¿fracaso escolar y futuros inadaptados? Papel del médico de Atención Primaria: a propósito de un caso / No disponible

El trastorno por déficit de atención e hiperactividad (TDAH) es la enfermedad psiquiátricamás frecuente en pediatría y la causa principal de fracaso escolar. Es causa y coexiste enocasiones con procesos más graves como el trastorno oposicional desafiante (TOD) y el trastornodisocial (TC). Este último se presenta en menores de 10 años y adolescentes y producefalta de integración escolar, ruptura de normas sociales e incluso comisión de actos delictivos.Se presenta el caso clínico de un niño de 10 años que consulta por fracaso escolar y alteracionesde la conducta en casa y en el colegio. Con el diagnóstico preliminar de trastorno deconducta disruptiva, se deriva a la Unidad de Salud Mental Infanto-Juvenil donde se estableceel diagnóstico definitivo de trastorno disocial en niño no socializado. El tratamiento conmetilfenidato mejora notablemente tanto su rendimiento académico como su comportamiento.El papel del pediatra de Atención Primaria ante el TDAH debe consistir en la detecciónprecoz, el inicio del tratamiento cuando sea oportuno y el seguimiento para verificar larespuesta terapéutica. En este proceso es esencial un diagnóstico precoz ya que puede facilitarel desarrollo normal del paciente y evitar la evolución hacia un trastorno más grave

Attention deficit/hyperactivity disorder (ADHD) is the most common psychiatric diseasein childhood and the first cause of scholar failure. It is the cause and coexist sometimes withother severe conditions like oppositional-deafiant disorder (ODD) and conduct disorder (CD).The last one appears in adolescents and in children younger than 10 years and causes lack ofschool integration, rupture of social norms and even commission of criminal acts. Case report:a 10 year-old boy with scholar failure, home and school disturbances in behaviour that includedphysic violence directed to mates and teachers. A preliminary diagnosis of disruptive behaviour disorder was made and the patient was referred for specialized psychiatric evaluation.The final diagnosis was dissocial behavior disorder in an unsocialized child. Metylphenidatetreatment resulted in an evident improvement of behaviour and academic performance.When faced with a possible ADHD case, the Primary Care pediatrician’s role should be earlydetection, starting of treatment when indicated and assessment of therapeutic results. Earlydiagnosis is of the most importance in this disorder because it can drives to a normal developmentof the patient avoiding the evolution to a more severe condition

Historia clínica informatizada en rehabilitación y medicina física / Computerized clinical history in rehabilitation and physical medicine

No disponible