Relationship between adipic acid concentration and the core symptoms of autism spectrum disorders.

Dicarboxylic acids are an important source of information about metabolism and potential physiopathological alterations in children with autism spectrum disorders (ASDs). We measured the concentration between dicarboxylic adipic and suberic acids in children with an ASD and typically-developing (TD) children and analyzed any relationships between the severity of the core symptoms of ASDs and other clinical features (drugs, supplements, drugs, or diet). The core symptoms of autism were evaluated using the DSM-IV criteria, and adipic acid and suberic acid were measured in urine samples. Overall, no increase in the concentration of adipic acid in children with ASDs compared to TD children, however when considering vitamin B supplementation in ASD there were significantly increased level of urinary adipic acid in children with an ASD not taking vitamin B supplementation compared to supplemented children or to TD children. No significant difference were observed in suberic acid. Interestingly, the increase in adipic acid concentration was significantly and indirectly correlated with the severity of the deficit in socialization and communication skills in children with an ASD. Therefore, therapeutic treatments aimed at decreasing adipic acid concentration might not be beneficial for treating the core symptoms of ASDs.

Increased homocysteine levels correlate with the communication deficit in children with autism spectrum disorder.

The clinical significance of high levels of homocysteine in autism spectrum disorder (ASD) is unknown. An experimental study was conducted in order to evaluate the concentration of homocysteine in children with ASD and typically developing children and to analyse any relationships with the severity of core symptoms of ASD and other clinical features (drugs, co-morbidities, gender, age, diet). Core symptoms of autism were evaluated by DSM-IV criteria. Homocysteine, glutathione, methionine, 3-nitrotyrosine were measured in urine. The increase in homocysteine concentration was significantly and directly correlated with the severity of the deficit in communication skills, but was unrelated to deficit in socialisation or repetitive/restricted behaviour. Urinary homocysteine concentration may be a possible biomarker for communication deficits in ASD and a potential diagnostic tool useful to evaluate new treatment options since no treatment for core symptoms of ASD are available.

Lead excretion in spanish children with autism spectrum disorder.

Among epigenetic factors leading to increased prevalence of juvenile neuropsychiatric disorders, including autism spectrum disorder, exposure to metals, such as lead (Pb) have led to conflicting results. The aim of the present study was to determine the levels of Pb in the urine of children with autism spectrum disorder (ASD) compared with typically developing children (TD) age- and sex-matched, and to analyze any association between core symptoms of ASD, special diets, supplements intake or prescription drugs and the concentration of Pb. The study was performed in a group of children with ASD (n = 35, average age 7.4 ± 0.5 years) and TD (n = 34, average age 7.7 ± 0.9 years). Measurement of lead in urine was performed by atomic absorption spectrometry; symptoms of ASD were analyzed by diagnostic and statistical manual of mental disorders (DMS-IV) using the questionnary ADI-R. Careful clinical evaluation was also undertaken and statistical analysis was done taking into account any possible confounding factor.

Repercusión de la incontinencia urinaria en la calidad de vida en mujeres mayores de 45 años en una población de Murcia / No disponible

La incontinencia urinaria es la pérdida involuntaria de orina, la cual causa un importante impacto social, psicológico, laboral, sexual y económico. Material y métodos: La muestra de estudio es de 50 mujeres seleccionadas con un muestreo aleatorio simple. Se emplean dos cuestionarios: el ICIQ-SF, para estudiarla prevalencia y el tipo de incontinencia, y el I-QOL, para investigar la afectación en la calidad de vida. El diseño de estudio es transversal y descriptivo. Resultados: Se obtiene un porcentaje de incontinencia del 32%: el 20% de esfuerzo, el 6% mixta y el 6% de urgencia. Aparece afectación en la calidad de vida de las incontinentes, siendo de peor calidad cuando el tipo es de urgencia; por otro lado se hallan relaciones significativas (P<0,05) entre la frecuencia de las pérdidas con: la repercusión psicosocial, los sentimientos de vergüenza en las relaciones sociales, problemas con el sueño y la depresión. Discusión: Nuestro trabajo encuentra similitudes con otros estudios en cuanto al tipo de incontinencia más predominante, como es la de urgencia, en la afectación de la evitación y limitación de la conducta, en la afectación del sueño y en la aparición de depresión en estas mujeres. Conclusiones: Aparece un porcentaje elevado de incontinencia, 3.2 mujeres de cada 10 la padecen, la incontinencia urinaria de esfuerzo es la predominante, afecta a la calidad de vida de las mujeres y cuando las pérdidas se originan con mayor frecuencia, se obtienen datos más negativos sobre la calidad de vida

The urinary incontinence is the involuntary leakage of HYPERLINK "http://en.wikipedia.org/wiki/Urine" urine which causes a huge social, psicological, working, sexual and economic impact. Equipment and methodology: The sample for the study was made up by 50 randomly selected women. Two questionnaires are used: the ICIQ-SF to study the prevalence and the type of incontinence and the I-QOL to investigate the affectation in the quality of life. The study is design is cross-sectional and descriptive. Results: The incontinence percentage was 32%: 20% from effort, 6% mixed and 6% from urgency. There is deterioration in the patient is quality of life, which gets worse when the incontinence type is urgency. On the other hand, there are significant connection (P<0.05) among the leakage frequency when: psychosocial consequences are involved, feelings of shamed affect the patient and when the subject suffers sleeping problems and depression. Discussion: This paper has some aspects in common with other studies; such as the most predominant incontinence type, which is urgency. As well as the influence and avoidance of the appearance of behavior change, sleeping disorders and depression on women suffering incontinence. Conclusion: There is a high percentage of incontinence: 3,2 women out of 10 suffer from this illness. Effort incontinence is the most predominant and it affects women’s quality of life. The more frequent the urine leakage is, the more negative the results from the quality of life are

Formación y detección de la violencia de género en la profesión sanitaria / Formação e detecção da violência de gênero na profissão de saúde / Formation and detection of gender violence in the healthcare profession

Objetivos: identificar a formação em violência de gênero (VG) dos profissionais de saúde e o conhecimento do protocolo de desempenho em VG tendo recebido formação com a descoberta de abuso. Métodos: estudo transversal, observacional e descritivo. A amostra foi de 119 profissionais de saúde de Múrcia (Espanha). Foram realizadas tabelas de contingência mediante a X2 de Pearson. Resultados: 82,9% dos profissionais desconhece a existência de protocolos para VG e 92,4% refere não ter recibo formação específica. 74,8%nunca detectaram casos de maus tratos em mulheres em sua prática profissional. O conhecimento dos protocolos de atuação e formação específica está significativamente relacionado (p<0,05) a detecção de VG. Conclusão: a formação, o conhecimento dos protocolos de atuação e uma maior sensibilização dos profissionais de saúde para o tema incrementariam o número de detecções de maus tratos, reduzindo problemas crônicos de saúde e gastos sanitários.

Aim: to identify the specific formation health professionals have on gende rviolence (GV) and knowledge about the actuation protocol on GV having received formation in mistreatment detection. Methods: transversal, observational and descriptive study. The sample size was 119 health professionals from Murcia (Spain). A statistical study of contingency tables was made, using the X2 of Pearson. Results: 82.9% of the professionals don’t know if there is a protocol of GV and 92.4% report never having received specific training. 74.8% have never detected a case of abuse in women during practice. Knowledge of the protocols and specific training is significantly related (p <0.05) with the detectionof GV. Conclusions: the specific formation, the knowledge of domestic violence protocols and a greater sensitization of health professionals would increase the number of detections of poorly treated women, reducing chronic health problems and health care spending.

Objetivos: identificar la formación en violencia de género (VG) de los profesionales sanitarios y el conocimiento del protocolo de actuación en VG, averiguar larelación entre conocimiento de los protocolos sobre VG y el haber recibido formación conla detección de maltrato. Métodos: estudio transversal, observacional y descriptivo. La muestra la componen 119 profesionales sanitarios de Murcia (España). Se han realizado tablas de contingencia mediante la X2 de Pearson. Resultados: el 82,9% no conoce siexiste un protocolo sobre VG y un 92,4% no ha recibido nunca formación específica. El74,8% no ha detectado un caso de malos tratos. Por tanto, el conocimiento de los protocolos de actuación y el haber recibido formación específica está significativamente relacionado (p<0,05) con la detección de malos tratos. Conclusión: la formación, el conocimiento de los protocolos y una mayor sensibilización en los profesionales sanitario sincrementarían el número de detecciones de maltrato, reduciendo problemas crónicos desalud y gasto sanitario.

Understanding bipolar disorder in late life: clinical and treatment correlates of a sample of elderly outpatients.

The aim of this study was to examine the demographic, clinical, and treatment correlates of bipolar disorder (BD) in outpatients 65 years or older and to compare patients with BD subtype I (BD-I) versus BD subtype II (BD-II) and patients with early onset (EO; <=50 years old) versus late onset (LO; >50 years old) of the illness. Sixty-nine consecutive outpatients with BD were included. Diagnosis was delayed for a mean of 14.1 years, significantly longer in patients with EO (18.6 years) than with LO (3.3 years). Mild to moderate depressive symptoms were detected in 29% of the patients. The patients were receiving a mean of 3 different psychotropic medications. Antidepressantswere more frequently prescribed to patients with BD-II than to patients with BD-I (75.80% vs. 48.60%) and to patients with EO (71.7%) than to LO (35.3%). Geriatric BD has similar clinical characteristics with those of younger ages, and these do not seem to greatly differ with subtype or age of onset.

Autism spectrum disorders associated to a deficiency of the enzymes of the mitochondrial respiratory chain.

Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders characterized by a combination of reciprocal social deficits, communication impairment, and rigid ritualistic interest and stereotypies. The etiology is generally multifactorial, including genetic, immunological and/or environmental factors. A group of ASD has been linked to mitochondrial dysfunction with subsequent deficiency in energy production. Patients with ASD and mitochondrial disease often show signs and symptoms uncommon to idiopathic ASD such as cardiac, pancreatic or liver dysfunction, cardiac, growth retardation, fatigability, but in some cases semiology is different. We show two clinical cases of ASD associated to a deficiency of the mitochondrial respiratory chain (complex I+III and IV) with different clinical presentations. In one case, signs and symptoms of mitochondrial disorder were mild and the second diagnosis was attained many years after that of ASD. These findings support the recent growing body of evidence that ASD can be associated with mitochondrial disorder. Children with ASD and abnormal neurologic or systemic findings should be evaluated for mitochondrial disorder.