Effects of non-pharmacological therapy on normal ageing and on cognitive decline: reflections on treatment objectives.

INTRODUCTION: Non-pharmacological therapies for normal ageing and dementia are a set of treatment programmes intended to improve the performance of cognitive processes, improve emotional well-being, promote independence in daily life activities, and ultimately increase patients' quality of life. METHODS: We applied a battery of tests assessing four major domains (general mental state, emotional well-being, quality of life, and daily life activities) to a sample of 317 adults older than 64 (240 with normal ageing and 77 with cognitive impairment). They were then assigned either to non-pharmacological therapy groups according to their abilities or to other non-specific activities. Progress was assessed 9 months later using the same test battery. RESULTS: The results show a general improvement in mental state in the group with normal ageing and absence of disease progression in the group with pathological ageing. In both groups, emotional well-being (anxiety and depression) and self-identified quality of life both benefited from non-pharmacological therapy. However, other aspects commonly included among the therapeutic targets did not seem to improve, including independence in daily life activities. CONCLUSIONS: This study provides evidence that non-pharmacological therapy in ageing patients can produce positive results. It must be stressed that benefits are greater in individuals with cognitive impairment, although generalising use of this therapy could prove to be an excellent primary programme for preventing cognitive and emotional disorders.

[Ten years of the prefrontal symptoms inventory (PSI). A systematic review]. / Diez años del inventario de síntomas prefrontales (ISP). Una revisión sistemática.

INTRODUCTION: Ten years ago, Revista de Neurologia published the validation of a new free tool: the Prefrontal Symptoms Inventory (PSI), from which an abbreviated version (PSI-20) was subsequently extracted. Over this decade, authors have demonstrated its excellent psychometric properties and clinical usefulness. This systematic review, conducted in accordance with the PRISMA statement, aims to analyse the body of research that has used the PSI or PSI-20 in order to assess its relevance in other research teams, other clinical populations and even other cultures. MATERIALS AND METHODS: A search was conducted to find articles written in Spanish, English, French and Portuguese that have used the inventory to carry out empirical research. Finally, 56 articles were selected. RESULTS: The results show that the PSI and the PSI-20 have been widely used in Spain as well as in other Spanish-speaking countries (Argentina, Chile, Colombia, Cuba, Ecuador or Venezuela) and employed to a moderate extent in non-Spanish-speaking countries (Belgium, Brazil, Sweden or Switzerland). The clinical populations in which they have been used range from acquired brain injury and degenerative dementias to chronic pain, fibromyalgia, addictive behaviours or personality disorders. Given their versatility, they have also been used with the general population, including prison inmates, women in rural areas, university students or to study cognitive reserve. CONCLUSIONS: The PSI and PSI-20 are useful instruments for research and clinical use, and the next challenge is to validate an English version, which is currently being worked on.

TITLE: Diez años del inventario de síntomas prefrontales (ISP). Una revisión sistemática.Introducción. Hace 10 años, Revista de Neurología publicaba la validación de una nueva herramienta gratuita: el inventario de síntomas prefrontales (ISP), de la que posteriormente se extrajo su versión abreviada (ISP-20). Durante esta década, los autores han acreditado sus excelentes propiedades psicométricas y su utilidad clínica. La presente revisión sistemática, sometida a la declaración PRISMA, tiene el objetivo de analizar el corpus de investigación que ha utilizado el ISP o el ISP-20, para valorar su trascendencia en otros equipos de investigación, en otras poblaciones clínicas e incluso en otras culturas. Materiales y métodos. Se buscaron artículos que hayan utilizado el inventario para realizar trabajos empíricos, en español, inglés, francés y portugués. Finalmente, se seleccionaron 56 trabajos. Resultados. Los resultados muestran que el ISP y el ISP-20 han tenido un uso elevado en España, así como en otros países de habla hispana (Argentina, Chile, Colombia, Cuba, Ecuador o Venezuela), y un uso moderado en países de habla no hispana (Bélgica, Brasil, Suecia o Suiza). Las poblaciones clínicas en las que se han utilizado abarcan desde el daño cerebral adquirido y las demencias degenerativas hasta el dolor crónico, la fibromialgia, las conductas adictivas o los trastornos de la personalidad. Dada su versatilidad, también se han usado con población general, incluyendo población reclusa, mujeres en entorno rural, estudiantes universitarios o para el estudio de la reserva cognitiva. Conclusiones. El ISP y el ISP-20 son instrumentos útiles para la investigación y la clínica, cuyo siguiente desafío es la validación de una versión en inglés, en la que se está trabajando.

High-Temperature XAS Study of Fe2SiO4 Liquid: Reduced Coordination of Ferrous Iron.

X-ray absorption spectroscopy (XAS) of Fe(2+) in Fe(2)SiO(4) liquid at 1575 kelvin and 10(-4) gigapascal (1 bar) shows that the Fe(2+) -O bond length is 1.98 +/- 0.02 angstroms compared with approximately 2.22 angstroms in crystalline Fe(2)SiO(4) (fayalite) at the melting point (1478 kelvin), which indicates a decrease in average Fe(2+) coordination number from six in fayalite to four in the liquid. Anharmonicity in the liquid was accounted for using a data analysis procedure. This reduction in coordination number is similar to that observed on the melting of certain ionic salts. These results are used to develop a model of the medium-range structural environment of Fe(2+) in olivine-composition melts, which helps explain some of the properties of Fe(2)SiO(4) liquid, including density, viscosity, and the partitioning of iron and nickel between silicate melts and crystalline olivines. Some of the implications of this model for silicate melts in the Earth's crust and mantle are discussed.

[Prefrontal symptoms in daily life: normalization and standardization of the Prefrontal Symptoms Inventory in the Spanish population]. / Sintomas prefrontales en la vida diaria: normalizacion y estandarizacion del inventario de sintomas prefrontales abreviado en poblacion española.

INTRODUCTION: The short Prefrontal Symptoms Inventory (PSI-20) is a questionnaire that investigates symptoms of prefrontal malfunctioning in daily life. It has been shown to have good psychometric properties and has been applied in the general population and clinical samples from Spain and other Spanish-speaking countries. AIMS: To normalise and standardise the PSI-20 in a broad sample of subjects of all ages in a Spanish population. SUBJECTS AND METHODS: The PSI-20 was administered to 4704 subjects: in one sample made up of 2474 subjects from the Spanish general population, over 18 years of age, and in another consisting of 2230 school-age subjects (15-17 years old), representative of the population of Madrid. RESULTS: The effect of the interaction of sex, age and level of education on the scores was observed, although the effect of level of education was low. As expected, the adolescents, still undergoing their process of maturation, obtained higher scores on all the subscales and the questionnaire as a whole. Females scored significantly higher on symptoms of poor emotional control, and males achieved higher scores on symptoms of poor control over social behaviour. Tables were developed differentiated by sex and for those above and below 18 years of age. CONCLUSION: The data presented allow us to interpret the scores obtained in the PSI-20 in the Spanish population, including subjects under 18 and adults.

TITLE: Sintomas prefrontales en la vida diaria: normalizacion y estandarizacion del inventario de sintomas prefrontales abreviado en poblacion española.Introduccion. El inventario de sintomas prefrontales abreviado (ISP-20) es un cuestionario que investiga sintomas de mal funcionamiento prefrontal en la vida diaria. Ha mostrado buenas propiedades psicometricas y se ha aplicado en poblacion general y muestras clinicas de España y otros paises de habla hispana. Objetivo. Normalizar y estandarizar el ISP-20 en una muestra amplia de sujetos de todas las edades en poblacion española. Sujetos y metodos. Se administro el ISP-20 a 4.704 sujetos: una muestra de 2.474 sujetos de poblacion general española, mayores de edad, y otra de 2.230 menores de edad escolarizados (15-17 años), representativa de la poblacion de Madrid. Resultados. Se observo el efecto de interaccion del sexo, la edad y el nivel educativo sobre las puntuaciones, aunque el nivel de estudios presenta un efecto bajo. Los adolescentes, como era de esperar por encontrarse en pleno proceso madurativo, obtuvieron mayores puntuaciones en todas las subescalas y el cuestionario en su conjunto. Las mujeres puntuaron significativamente mas en sintomas de mal control emocional, y los varones lo hicieron mas en sintomas de mal control de la conducta social. Se configuraron tablas diferenciadas por sexo y para menores y mayores de edad. Conclusion. Los datos presentados permiten interpretar las puntuaciones obtenidas en el ISP-20 en poblacion española, incluyendo los menores de edad y los adultos.

[The role of the cognitive reserve in the cognitive recovery of patients who have suffered a severe addiction to substances]. / Papel de la reserva cognitiva en la recuperacion cognitiva de pacientes que han sufrido una adiccion grave a sustancias.

INTRODUCTION: Cognitive reserve has been shown to be a prognostic variable in cognitive recovery after brain damage. Few studies have addressed its role in the cognitive status after a sustained period of substance addiction. AIM: To analyse the modulating role of cognitive reserve in the relation between withdrawal time and the cognitive status of patients with severe substance addiction. PATIENTS AND METHODS: A total of 26 patients recovering from severe substance addiction were assessed using a neuropsychological assessment protocol and cognitive reserve questionnaires. Exploratory factor analysis is used to define the variables and linear regression analysis is employed to view the predictive relations. RESULTS: Three cognitive functioning factors are obtained: processing integrity, inhibitory control and verbal memory, as well as an overall reserve factor. In the regression models, predictive relations are found only in a model of a direct relation between withdrawal and verbal memory, and in a model of an independent relation between cognitive reserve and withdrawal time and verbal memory, but not in the modulation relationship or in other relations in the rest of the factors. CONCLUSION: The article discusses the role of the cognitive reserve as a mediator in the cognitive status of patients in a period of withdrawal after a serious addiction to substances. A relationship with memory is shown, but no modulation of the role of withdrawal time on that cognitive status is detected.

TITLE: Papel de la reserva cognitiva en la recuperacion cognitiva de pacientes que han sufrido una adiccion grave a sustancias.Introduccion. La reserva cognitiva resulta ser una variable de pronostico en la recuperacion cognitiva tras un daño cerebral. Pocos estudios han abordado su papel en el estado cognitivo tras un periodo sostenido de adiccion a sustancias. Objetivo. Analizar el papel modulador de la reserva cognitiva sobre la relacion entre el tiempo de abstinencia y el estado cognitivo de los pacientes con adiccion grave a sustancias. Pacientes y metodos. Se valora a un total de 26 pacientes en recuperacion tras una adiccion grave a sustancias con un protocolo de evaluacion neuropsicologica y cuestionarios de reserva cognitiva. Se emplea el analisis factorial exploratorio para conformar las variables y el analisis de regresion lineal para ver las relaciones predictivas. Resultados. Se obtienen tres factores de funcionamiento cognitivo: integridad de procesamiento, control inhibitorio y memoria verbal, asi como un factor global de reserva. En los modelos de regresion, solo se encuentran relaciones predictivas en un modelo de relacion directa entre la abstinencia y la memoria verbal, y en un modelo de relacion independiente entre la reserva cognitiva y el tiempo de abstinencia con la memoria verbal, pero no en la relacion de modulacion, ni en otras relaciones en el resto de los factores. Conclusion. Se debate el papel de la reserva cognitiva como mediadora en el estado cognitivo en los pacientes en periodo de abstinencia tras una adiccion grave a sustancias: muestra una relacion con la memoria, pero no una modulacion del papel del tiempo de abstinencia sobre ese estado cognitivo.

Green chemistry synthesis of nano-cuprous oxide.

Green chemistry and a central composite design, to evaluate the effect of reducing agent, temperature and pH of the reaction, were employed to produce controlled cuprous oxide (Cu2O) nanoparticles. Response surface method of the ultraviolet-visible spectroscopy is allowed to determine the most relevant factors for the size distribution of the nanoCu2O. X-ray diffraction reflections correspond to a cubic structure, with sizes from 31.9 to 104.3 nm. High-resolution transmission electron microscopy reveals that the different shapes depend strongly on the conditions of the green synthesis.

[Prefrontal Symptoms Inventory (PSI): ecological validity and convergence with neuropsychological measures]. / Inventario de sintomas prefrontales (ISP): validez ecologica y convergencia con medidas neuropsicologicas.

INTRODUCTION: The Prefrontal Symptoms Inventory (PSI) is a self-reported questionnaire, created in Spain, which asks about cognitive, emotional and behavioural alterations in activities of daily living and which can be applied in both the general population and in multiple clinical populations. There is a shorter 20-item version (PSI-20) with excellent psychomotor properties for screening. AIM: To study the convergent and divergent validity of the PSI and PSI-20, by analysing how their scales reflect the day-to-day consequences of real deficits found in neurological assessment performed by means of performance tests. PATIENTS AND METHODS: A sample of 52 persons undergoing treatment for substance addiction (31 males and 21 females) were administered the PSI together with an abbreviated neuropsychological examination battery focused on describing attentional, mnemonic and executive processes. RESULTS: Both versions of the PSI present optimal psychometric properties (0.78 > alpha > 0.94 for the complete 46-item version and 0.7 > alpha > 0.89 for the abbreviated 20-item version). The results confirm the hypotheses regarding their validity: the performance problems scale is related with the capacity to resolve tests that supposedly rate the executive functions of a prefrontal origin (convergent validity), whereas the scales of problems in emotional control and problems with social behaviour are not related with those cognitive capabilities (discriminant validity). CONCLUSIONS: The PSI is a test that is clinically useful, psychometrically valid and applicable in multiple clinical populations.

TITLE: Inventario de sintomas prefrontales (ISP): validez ecologica y convergencia con medidas neuropsicologicas.Introduccion. El inventario de sintomas prefrontales (ISP) es un cuestionario autoinformado creado en España que interroga sobre alteraciones cognitivas, emocionales y comportamentales en las actividades de la vida diaria y que resulta aplicable tanto en poblacion general como en multiples poblaciones clinicas. Existe una version abreviada de 20 items (ISP-20) con excelentes propiedades psicometricas para el cribado. Objetivo. Estudiar la validez convergente y divergente del ISP e ISP-20, analizando como sus escalas reflejan las consecuencias cotidianas de deficits reales hallados en evaluacion neuropsicologica mediante pruebas de ejecucion. Pacientes y metodos. Se estudiaron 52 personas con adiccion a sustancias en tratamiento (31 varones y 21 mujeres) a las que se administro el ISP junto con una bateria de exploracion neuropsicologica abreviada centrada en describir procesos atencionales, mnemicos y ejecutivos. Resultados. Ambas versiones del ISP presentan optimas propiedades psicometricas (0,78 > alfa > 0,94 para la version completa de 46 items y 0,7 > alfa > 0,89 para la version abreviada de 20 items). Los resultados confirman las hipotesis sobre su validez: la escala de problemas en la ejecucion se relaciona con la capacidad para resolver tests que presumiblemente valoran funciones ejecutivas de origen prefrontal (validez convergente), mientras que las escalas de problemas en el control emocional y problemas en la conducta social no se relacionan con dichas capacidades cognitivas (validez discriminante). Conclusiones. El ISP es una prueba clinicamente util, psicometricamente valida y aplicable en multiples poblaciones clinicas.

Loss of the tumor suppressor spinophilin (PPP1R9B) increases the cancer stem cell population in breast tumors.

The spinophilin (Spn, PPP1R9B) gene is located at 17q21.33, a region frequently associated with microsatellite instability and loss of heterozygosity, especially in breast tumors. Spn is a regulatory subunit of phosphatase1a (PP1), which targets the catalytic subunit to distinct subcellular locations. Spn downregulation reduces PPP1CA activity against the retinoblastoma protein, pRb, thereby maintaining higher levels of phosphorylated pRb. This effect contributes to an increase in the tumorigenic properties of cells in certain contexts. Here, we explored the mechanism of how Spn downregulation contributes to the malignant phenotype and poor prognosis in breast tumors and found an increase in the stemness phenotype. Analysis of human breast tumors showed that Spn mRNA and protein are reduced or lost in 15% of carcinomas, correlating with a worse prognosis, a more aggressive tumor phenotype and triple-negative tumors, whereas luminal tumors showed high Spn levels. Downregulation of Spn by shRNA increased the stemness properties along with the expression of stem-related genes (Sox2, KLF4, Nanog and OCT4), whereas ectopic overexpression of Spn cDNA reduced these properties. Breast tumor stem cells appeared to have low levels of Spn mRNA, and Spn loss correlated with increased stem-like cell appearance in breast tumors as indicated by an increase in CD44+/CD24- cells. A reduction of the levels of PPP1CA mimicked the cancer stem-like cell phenotype of Spn downregulation, suggesting that the mechanism of Spn involves PP1a. These increased cancer stem cell-like properties with reduced Spn might account for the malignant phenotype observed in Spn-loss tumors and may contribute to a worse patient prognosis.

[Visuoperceptual processing in Parkinson's disease: from the retina to the frontal cortex]. / Proceso visuoperceptivo en la enfermedad de Parkinson: de la retina a la corteza frontal.

INTRODUCTION: The growing interest in the cognitive impairment shown by patients with Parkinson's disease has led to a wealth of research in this line over recent years. In this paper we review the visuospatial alterations in these patients, which are usually linked to other disorders such as those affecting planning, sequencing, attention or mnemonic processes. DEVELOPMENT: We report the most relevant findings, which suggest that the existence of these visuospatial disorders shown by patients with Parkinson's disease are not always secondary to other frontal-type cognitive impairments, as has been claimed in recent years. Instead, they may be due to disorders in other anterior points of the perceptive process (as a result of dopaminergic deficits in basal-thalamic-cortical circuits). Thus, visuoperceptual disorders are classified according to their location in the brain: from the retina to the lateral geniculate nucleus, the visual cortex and the extrastriate cortex and, finally, the frontal and prefrontal cortex. CONCLUSIONS: We propose this classification of the disorders according to their location to aid in achieving an objective selection of the sample and of the neuropsychological tests used in studies. In this regard, we consider that there should be a higher degree of agreement among researchers when it comes to designing research projects that deal with visuospatial disorders in patients with Parkinson's disease.

[Superior vesical fissure]. / Fisura vesical superior.

Although vesical extrophy is a well-known anomaly, the variants of vesical extrophy are exceptional. We present the case of a newborn child, who upon exploration, revealed a defect of closure in the infra-umbilical abdominal wall through which vesical mucous membrane protruded. A probe introduced into the urethra appeared externally at the place of the infraumbilical defect. Following the diagnosis of superior vesical fissure, resection of the protruding vesical mucous membrane and closure were carried out. The authors reviewed the bibliography published in order to study the different kinds of variants of vesical extrophy and the associated congenital anomalies. Although these children are usually continent, a urodynamic study and a VCU are recommended in order to discard the existence of a post closure-uretheral-vesical reflux of the umbilical defect.

Prefrontal symptomatology in People with Amyotrophic lateral Sclerosis: Clinical Utility and Psychometric Properties of Prefrontal Symptoms Inventory (PSI)

The Amyotrophic Lateral Sclerosis (ALS) is a multisystemic disorder. It is considered a neuromuscular disease but also involves cognitive (executive functions, social cognition, attention, memory and language), emotional or behavior changes in over 50% of the reported cases and to of frontotemporal diagnosis lobar degeneration of behavioral variant in up to 15% of the cases. For this reason, the presence of cognitive and motivational problems was analysed in a Spanish sample of ALS patients through the prefrontal symptoms inventory (PSI) to determine applicability in this disease STI. A sample of 31 patients with a potential ALS or definitive diagnostic criteria according to El Escorial was used. Obtained results ISP were compared with a sample of 31 healthy people in the same proportions of gender, age and education level. Obtained results showed a not significant difference between the two populations in the motivational factor problems, related to the depression symptomatology frequently associated with ALS. A significant positive correlation between age at diagnosis and the scale of the motivational problems was observed, with a not significant trend related to problems in the executive control and in social the behavior control and with the age at diagnosis, in the same sense with age at diagnosis. Therefore, it can be concluded that, despite the results obtained, emotional and behavioral deficits in ALS patients and symptoms related to frontotemporal dementia (among others, anosognosia or lack of consciousness symptoms) could have interfered in patient perception about their symptomatology

[Neurocognitive screening in substance addicts: the Montreal Cognitive Assessment]. / Cribado neurocognitivo en adictos a sustancias: la evaluacion cognitiva de Montreal.

INTRODUCTION: The detection of neurocognitive disorders in addicts would allow subjects with functional impairment to be assigned to cognitive rehabilitation programmes. The Montreal Cognitive Assessment (MoCA) is a screening test that can be a valuable aid with this kind of patient. AIMS: To use the MoCA with a sample of subjects with addictions who are receiving treatment and to compare the results with the criteria proposed for the general population, mild cognitive impairment and early dementias. It also intends to examine the concurrent validity with global execution tests and the relationship with socio-demographic variables and others related to addiction. PATIENTS AND METHODS: The MoCA and the Allen Cognitive Level Screen-5 (ACLS-5) test were administered to a sample of 79 patients with addiction who were beginning treatment in a specific centre. RESULTS: Only 29.1% of the participants presented normal performance in terms of the criteria proposed by the authors. The others achieved scores below the cut-off point, many of them displaying an alarmingly low score, even when compared with criteria for mild cognitive impairment and early dementias. The MoCA showed concurrent validity with the ACLS-5 and correlation with academic level, but not with variables related to addiction. CONCLUSIONS: The MoCA is a test that is quick and simple to administer and correct. It allows the detection of subjects with extremely low cognitive performance that require neuropsychological and occupational interventions for cognitive rehabilitation, which increases treatment compliance and the benefits to be gained from other interventions with important cognitive demands, such as relapse prevention psychotherapy.

[Prevalence of attention-deficit hyperactivity disorder in substance addiction: from screening to diagnosis]. / Prevalencia del trastorno por deficit de atencion/hiperactividad en adictos a sustancias: del cribado al diagnostico.

INTRODUCTION: There is a rich body of literature on the coexistence of diagnostic criteria for attention deficit hyperactivity disorder (ADHD) and substance abuse/dependence. Prevalence, however, varies considerably from one work to another. AIMS: To apply an algorithm that takes into account all the criteria needed to reach an adequate diagnosis and to explore the conditions associated with false positives. PATIENTS AND METHODS: The diagnostic algorithm was applied using several tests in the different phases, i.e. the Attention Deficit Hyperactivity Disorder Self-Report Scale was used for screening, the Wender-Utah Rating Scale and the Parents' Rating Scale were administered for the retrospective diagnosis, and the self-administered Spanish version of the frontal behaviour scale and the perceived stress scale were used to study false positives. Symptoms of other axis I disorders were also explored and a battery of classic neuropsychological tests was administered. All this was carried out with a sample of 696 subjects whose treatment began in a care centre for drug addicts. RESULTS: The final prevalence was found to be 6.89%. The symptoms of the false positives in the screening test prior to consumption were similar to those of the true negatives, but in that moment those symptoms were similar to those of the true positives, with whom no differences were found in the neuropsychological performance. Generalised anxiety disorder was the one that showed the highest relation with false positives. CONCLUSIONS: The diagnostic category of ADHD is usually utilised indiscriminately to classify subjects with early-onset neurological disorders and those who present similar manifestations following the phase of active addiction to substances. There is a need for a neurological and neuropsychological study that goes beyond the mere symptoms so as to be able to carry out a suitable characterisation and treatment of a set of similar symptomatic manifestations, but with a very wide range of developmental and aetiopathogenic components.

[Cognitive remediation in addictions treatment]. / Rehabilitacion cognitiva en el tratamiento de las adicciones.

More recent theories of addiction suggest that neurocognitive mechanisms, such as attentional processing, cognitive control, and reward processing play a key role in the development or maintenance of addiction. Ultimately, the addiction (with or without substances) is based on the alteration of brain decision-making processes. The neurosciences, particularly those responsible for behavior modification, must take into account the neurobiological processes underlying the observable behavior. Treatments of addiction usually do not take into account these findings, which may be at the base of the low retention rates and high dropout rates of addicted patients. Considered as an alteration of brain functioning, addiction could be addressed successfully through cognitive rehabilitation treatments used in other clinical pathologies such as brain damage or schizophrenia. Although there are few studies, it is suggest that intervention to improve patients' cognitive functioning can improve the efficiency of well-established cognitive-behavioral therapies, such as relapse prevention. This paper reviews the available evidence on cognitive rehabilitation in treating addiction as well as in other pathologies, in order to formulate interventions that may be included in comprehensive rehabilitation programs for people with addictive disorders.

[Frontal symptoms in substance abusers under treatment using the Spanish version of the Frontal System Behaviour Scale]. / Sintomatología frontal en adictos a sustancias en tratamiento mediante la versión española de la escala de comportamiento frontal.

INTRODUCTION AND AIMS: There are different studies that suggest a relationship between frontal symptoms and substance addiction. The Frontal System Behavior Scale is a questionnaire used to consider the manifestations of three frontal syndromes: executive dysfunction, apathy and lack of inhibition. SUBJECTS AND METHODS: The Spanish version of the Frontal System Behavior Scale (FrSBe-Sp) is administered to 215 addicted individuals starting treatment and to 267 nonclinical participants. The FrSBe-Sp is a self-administered questionnaire of 46 items that evaluate the three syndromes afore- mentioned, in an estimation of baseline (before substance use) and in a present estimation (after substance consumption). RESULTS: The questionnaire shows suitable psychometric properties and convergent validity with another similar questionnaire (DEX-Sp). Statistically significant differences appear between the scores of the addicted individuals compared with the group control at the baseline, as well as, specially, the present time. CONCLUSIONS: The results point out the fact that possibly the alterations of frontal character were previous. Maybe they acted as some kind of risk factors at the beginning of substance use. Also, they have significantly increased during the phase of active substance use. The FrSBe-Sp seems to be a good instrument to explore, both synchronically and diachronically, symptoms of frontal type related to addictive behaviors. New hypotheses of special relevance for treatment of addictive behaviors are suggested.

[Analysis of adverse drug reactions detected in a primary health care center]. / Análisis de las reacciones adversas detectadas en un centro de atención primaria.

OBJECTIVE: To determine the incidence and epidemiological characteristics of adverse drug reactions (ADR) and to assess their relevance in primary health care. DESIGN: An open prospective descriptive study. PATIENTS: All patients cared for in one primary health care centre during 2 months. MEASUREMENTS AND MAIN RESULTS: 73 ADR were detected during the period of study (two of which corresponded to pediatric patients) with an incidence of 1.35% in adult general medicine and 0.36% in pediatric medicine. 67% of the patients were female, and all adult patients were distributed into three age groups (15-44, 45-64 and > or = 65 years of age). The frequency of ADR was similar in all three age groups. The ADR were most present in the GI tract, central nervous system, general symptoms and skin. Among the most frequently pharmacological groups implicated in the ADR were cardiovascular drugs, antibiotics and drugs for the central nervous system. Only in 12 cases the ADR was considered as clinically relevant, according with the criteria of the participating physicians; in 6 cases they were evaluated as avoidable. CONCLUSIONS: The ADR are not a relevant clinical problem, nor are they frequent in the outpatients primary health care. In most cases there are slight and self-limiting, which appeared in a limited number of patients. However clinically relevant and important ADRs appeared in 0.1-0.3% of the consultations, which, in practice, represent one to two serious ADRs per month and physician.