Trastorno disfórico premenstrual / Premenstrual dysphoric disorder

El trastorno disfórico premenstrual (TDP) es una entidad clínica con características propias y bases biológicas conocidas, aunque no definitivas. Se diferencia del síndrome premenstrual (SPM) y constituye para muchos, el extremo más severo de él, con síntomas de la esfera depresiva, ansiosa y cambios en la conducta que alteran la vida de relación. Los tratamientos efectivos en SPM no lo han sido para el TDP. Deben considerarse las medidas generales y sintomáticas. Entre aquellas que evidencien estacionalidad, la exposición diaria a la luz natural matinal o a la luz blanca artificial son medidas accesorias a considerar. El uso de ISRS, preferentemente intermitente, es el tratamiento de primera línea. Si los síntomas físicos persisten luego de tres ciclos de iniciado tratamiento, es conveniente asociar fármacos que alivien esos síntomas. En pacientes donde fracasan los esquemas anteriores, se plantea el uso continuado de ISRS, cambiar de ISRS, potenciar su acción con privación de sueño o luminoterapia como medidas necesarias antes de llegar a usar los agonistas GnRH, tanto por la sintomatología colateral que provocan como por el breve lapso en que se pueden usar. Este último tipo de fármacos pueden, teóricamente, ser usados para confirmar el cuadro, en casos de difícil diagnóstico. Hoy en día se considera el TDP es un cuadro crónico, que si no es tratado, aumenta el riesgo de trastorno depresivo mayor, depresión post parto así como de otros cuadros del ôespectro serotoninérgicoõ y cuya recaída es altamente probable si se suspende la terapéutica.

The inclusion of premenstrual dysphoric disorder (PMDD) in DSM IV recognizes the fact that some women have extremely distressing, emotional and behavioural symptoms premenstrually. PMDD can be differentiated from premenstrual syndrome (PMS), which presents with milder physical symptoms and more minor mood changes. The DSM IV diagnostic criteria stipulate a minimum of 5 symptoms, one of which must be a mood symptom (feeling sad, feeling tense, marked lability, irritability). These symptoms must regularly occur during the last week of the luteal phase, and the symptoms disappear completely shortly after the onset of menstruation. In addition, these symptoms must cause a significant impairment in lifestyle and relationships. Disorder is confirmed by prospective daily ratings during at least 2 consecutive symptomatic cycles. PMDD can be differentiated from premenstrual magnification of physical or psychological symptoms of a concurrent psychiatric or medical disorder. As many as 75% of women with regular menstrual cycle experience some symptoms of PMS, according to epidemiologic surveys. PMDD is much less common; it affects 2% to 9% of women in this group. The etiology of PMDD is unknown, but the current consensus is that normal ovarian function (rather than hormone imbalance) is the cyclical trigger for PMDD-related biochemical events within the central nervous system. The serotonergic system in a close reciprocal relation with the gonodal hormones and has been identified as the most plausible target for interventions. Almost all treatments used for 50 years are not of real utility. Hormonal therapies, such as gonadotropin-releasing (GnRH) agonists, estradiol, and danazol, are occasionally taken to ameliorate PMDD symptoms, but the side-effect profile of these therapies makes them less desirable for the treatment option, with excelent efficacy and minimal side effects, specially in intermitent use (premenstrual only).

Water deficit as a driver of the mutualistic relationship between the fungus Trichoderma harzianum and two wheat genotypes.

The aim of this study was to assess the occurrence of mutualistic interactions between the fungus Trichoderma harzianum and two wheat genotypes, Triticum aestivum cv. Talhuén and T. turgidum subsp. durum cv. Alifén, and the extent to which water deficit affected these interactions. Two wheat genotypes were cultivated in the presence or absence of T. harzianum and in the presence or absence of water deficit. T. harzianum was in turn cultivated in the presence or absence of wheat plants and in the presence or absence of water deficit. To evaluate the plant-fungus interactions, the root volume, dry biomass, and fecundity of wheat were determined, as was the population growth rate of the fungus. Trichoderma harzianum exerted a positive effect only on plants subjected to water deficit. The population growth rate of T. harzianum was negative in the absence of wheat plants and reached its highest level in the presence of plants under conditions of water deficit. These results confirm the occurrence of a mutualistic interaction between wheat and T. harzianum and show that it is asymmetric and context dependent.

Enfermedad bipolar en la mujer en edad fértil / Bipolar disease in women during fertile age

Durante la adolescencia, la mujer se hace particularmente vulnerable a los trastornos del ánimo, estimándose que un 20 por ciento de las mujeres entre 15 y 24 anos desarrollan un episodio depresivo mayor, el doble de lo observado en el sexo masculino. Las enfermedades del ánimo de inicio temprano en la vida, se asocian con un curso más severo y ominoso; estando las mujeres más expuestas a presentar enfermedades médicas como trastornos tiroideos y obesidad, abuso de sustancias, trastornos de ansiedad y de la alimentación, entre las patologías psiquiátricas. Particularmente la enfermedad bipolar por su curso tórpido, físico, recurrente e imprevisible, precisa de una intervención precoz y sostenida a lo largo del tiempo, que tenga como objetivo próximo alcanzar y mantener la eutimia y lograr que cuando la joven tome la decisión de embarazarse pueda hacerlo con el menor riesgo posible de recidiva. Se presenta una revisión de los fármacos mas utilizados como parte del arsenal terapéutico de la enfermedad bipolar, con diversas consideraciones relacionadas al embarazo, parto y lactancia...

Estimación del riesgo a caries dental en escolares a través de evaluaciones clínicas, microbiológicas y radiológicas / Dental caries risk estimation in schoolchildren, trougth clinical, microbiological and radiological evaluation

The purpose of this epidemiological study was to find correlation among dental caries and S. mutans in schoolchildren from a Protection Center. Quantitative and semiquantitative methods were employed to determine salivary concentration of mutans streptococci. The results showed that 44 percent of children had 1-3 dental caries, while 23 percent had 4-7. A direct relationship was found with the concentration of mutans streptococci in saliva. Both methods employed showed that the caries risk level, can be stabilized approximately in 5 x 105 UFCf S. mutans/mL saliva. Biochemical and serological characterisation of the isolated streptococci mutans group revealed that 95 percent was of biotype I, serotype c (c, e, f) belonged to S. mutans specie, and of 5 percent was S. sobrinus biotype IV, serotype (d, g, h). A direct correlation between decalcified areas and the quantity of salivary S. mutans was also found. Based in these results, a prediction about people in risk of develop dental caries, can be made, and so adequate prevention programs, can be established