Validity and reliability of the kiddie schedule for affective disorders and schizophrenia present and lifetime version DSM-5 (K-SADS-PL-5) Spanish version.

BACKGROUND: There are various language adaptations of the Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL). In order to comply with the changes in DSM classification, the Spanish edition of the interview was in need of update and evaluation. METHODS: K-SADS-PL was adapted to correspond to DSM-5 categories. All clinicians received training, and a 90% agreement was reached. Patients and their parents or guardians were interviewed and videotaped, and the videos were exchanged between raters. Factor analysis was performed and inter-rater reliability was calculated only in the case of diagnoses in which there were more than five patients. RESULTS: A total of 74 subjects were included. The Factor Analysis yielded six factors (Depressive, Stress Hyperarousal, Disruptive Behavioral, Irritable Explosive, Obsessive Repetitive and Encopresis), representing 72% of the variance. Kappa values for inter-rater agreement were larger than 0.7 for over half of the disorders. CONCLUSIONS: The factor structure of diagnoses, made with the instrument was found to correspond to the DSM-5 disorder organization. The instrument showed good construct validity and inter-rater reliability, which makes it a useful tool for clinical research studies in children and adolescents.

Construct validity and parent-child agreement of the six new or modified disorders included in the Spanish version of the Kiddie Schedule for Affective Disorders and Schizophrenia present and Lifetime Version DSM-5 (K-SADS-PL-5).

Changes to the Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM-5) incorporate the inclusion or modification of six disorders: Autism Spectrum Disorder, Social Anxiety Disorder, Intermittent Explosive Disorder, Disruptive Mood Dysregulation Disorder, Avoidant/Restrictive Food Intake Disorder and Binge Eating Disorder. The objectives of this study were to assess the construct validity and parent-child agreement of these six disorders in the Spanish language Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL-5) in a clinical population of children and adolescents from Latin America. The Spanish version of the K-SADS-PL was modified to integrate changes made to the DSM-5. Clinicians received training in the K-SADS-PL-5 and 90% agreement between raters was obtained. A total of 80 patients were recruited in four different countries in Latin America. All items from each of the six disorders were included in a factor analysis. Parent-child agreement was calculated for every item of the six disorders, including the effect of sex and age. The factor analysis revealed 6 factors separately grouping the items defining each of the new or modified disorders, with Eigenvalues greater than 2. Very good parent-child agreements (r>0.8) were found for the large majority of the items (93%), even when considering the sex or age of the patient. This independent grouping of disorders suggests that the manner in which the disorders were included into the K-SADS-PL-5 reflects robustly the DSM-5 constructs and displayed a significant inter-informant reliability. These findings support the use of K-SADS-PL-5 as a clinical and research tool to evaluate these new or modified diagnoses.

Yield Losses in Transgenic Cry1Ab and Non-Bt Corn as Assessed Using a Crop-Life-Table Approach.

In this study, we constructed crop life tables for Bacillus thuringiensis Berliner (Bt) Cry1Ab and non-Bt corn hybrids, in which yield-loss factors and abundance of predaceous arthropods were recorded during 2 yr at two locations. Corn kernel/grain was the yield component that had the heaviest losses and that determined the overall yield loss in the corn hybrids across years and locations. Yield losses in both corn hybrids were primarily caused by kernel-destroying insects. Helicoverpa zea (Boddie) and Spodoptera frugiperda (Smith) (Lepidoptera: Noctuidae) were the key loss factors at one location, while at the other, the key loss factor was the silk fly larvae, Euxesta spp. (Diptera: Ulidiidae). Although the realized yield of corn grains was not different (P > 0.05) between Cry1Ab and non-Bt corn hybrids, the Bt corn hybrid reduced (P < 0.05) the damage by H. zea and S. frugiperda in three of the four field trials, particularly at the location where Lepidoptera were the key loss factors. As expected, no reduction in the abundance of predaceous arthropods was observed in Cry1Ab corn fields. Various species of natural enemies were recorded, particularly the earwig Doru luteipes (Scudder) (Dermaptera: Forficulidae), which was the most abundant and frequent predaceous insect. These results indicate that integration of pest management practices should be pursued to effectively minimize losses by kernel-destroying insects during corn reproductive stages when growing non-Bt or certain low-dose Bt corn cultivars for fall armyworm and corn earworm, such as those producing Cry1Ab or other Cry toxins.

Patterns of Systemic Hypertension among Adults with Perinatally Acquired HIV.

Patients with perinatally acquired HIV may be at risk for the development of age-related non-AIDS diseases. The primary aim of this study was to describe patterns of systemic hypertension among a cohort of adults (≥18 years) with perinatally acquired HIV. A retrospective cohort study was conducted among adults (≥18 years) with perinatally acquired HIV infection. Primary outcomes included documentation of systemic hypertension as well as several additional non-AIDS-associated illnesses. Systemic hypertension incidence rates and rate ratios (RRs) were calculated among groups aged ≥18 and <18 years at the time of hypertension diagnosis. The overall prevalence of hypertension in the cohort (N = 109) was 26.6%, and the incidence rate of hypertension was significantly higher among those aged ≥18 years compared to those who are aged <18 years at the time of diagnosis (RR: 10.0, CI: 7.29-13.71). By multivariable analysis, only coexisting renal disease was associated with an increased risk of hypertension diagnosis.

Proximal End Root Morphology Characteristics in Antemortem Anagen Head Hairs.

The proximal end morphology of antemortem anagen head hair was compared with the characteristics documented to occur in postmortem hairs. Antemortem anagen and telogen head hairs (N = 967) were recovered following exposure to seven environments. Root morphology characteristics consistent with those reported in postmortem hairs were observed in 66 (14%) hairs exposed to a water, normal saline, outdoor soil, or indoor shower environment. Thirty-three anagen hairs (7%) exhibited a root band at the proximal end. The mean distance from the root tip to the onset of the root band ranged from 0.23 to 0.7 mm, depending on the environment. The mean distance from the root tip to the onset of the root band was 0.46 mm, with a mean band length of 0.44 mm. The results illustrate the need to better characterize postmortem banding through quantitative measurements, including the range for root tip to band distance and the overall band length.

Isolation and characteristics of sulfentrazone-degrading bacteria.

This study aimed to isolate and characterize bacteria able to use sulfentrazone in the commercial formulation as their sole carbon source. The isolation of the potential sulfentrazone-degrading bacteria was made from soil samples with a recent history of herbicide application and from isolates identified through rDNA sequencing. Subsequently, we assessed the growth of the isolates and their sulfentrazone degradation ability using high-performance liquid chromatography. Twenty-six potential sulfentrazone-degrading bacterial isolates were obtained in pure culture. Through analysis of the rDNA sequences, the predominance of bacterial species of the genus Pseudomonas was found. The isolates presented a differentiated ability of sulfentrazone degradation. The presence of herbicide in the culture medium reduced the log phase of four isolates. Pseudomonas putida, Pseudomonas lutea, Pseudomonas plecoglossicida and three isolates of Pseudomonas sp. showed higher sulfentrazone degradation capacity, which varied from 4 to 15%. This is the first report of the Pseudomonas genre capable of sulfentrazone degradation. The isolates obtained present potential use in bioremediation programs for soil contaminated with sulfentrazone.

Validez del Trastorno por Déficit de Atención con Hiperactividad como un trastorno del neurodesarrollo / Validity of Attention Deficit Hyperactivity Disorder as a Neurodevelopmental Disorde

ADHD was included in the DSM-5 as part of neurodevelopmental disorders (NDD), which also include autism spectrum disorders, intellectual disability, among others. This review makes an analysis of the validity of the diagnosis of ADHD and its inclusion within the NDD from the perspective of the diagnostic validity criteria of Robins, Guze and Feighner: 1. Clinical description, 2. Demarcation with other disorders, 3. Genetic studies, 4. Neuropsychological imaging and laboratory studies, 5. Follow up studies and 6. Response to treatment. It analyzes in a rational way the scientific evidence for each of these six areas of diagnostic validity for ADHD and the dimension of NDD.Key words: attention deficit hyperactivity neurodevelopmental disorders.

El TDAH fue incluido dentro del DSM-5 como parte de los trastornos del neurodesarrollo (TND), donde además se encuentran los trastornos del espectro autista, la discapacidad intelectual, entre otros. Esta revisión realiza un análisis de la validez del diagnóstico del TDAH y de su inclusión dentro de los TND bajo la perspectiva de la validez diagnóstica de los criterios de Robins, Guze y Feighner: 1. Descripción clínica, 2. Delimitación con otros trastornos, 3. Estudios genéticos, 4. Estudios neuropsicológicos, de imagen y de laboratorio, 5. Estudios de seguimiento y 6. Respuesta al tratamiento. Se analiza de forma razonada la evidencia científica para cada una de estas seis áreas de validez diagnóstica para el TDAH y la dimensión de los TND. Palabras clave: déficit atención hiperactividad trastornos neurodesarrollo.

The cerebellum and addiction: insights gained from neuroimaging research.

Although cerebellar alterations have been consistently noted in the addiction literature, the pathophysiology of this link remains unclear. The cerebellum is commonly classified as a motor structure, but human functional neuroimaging along with clinical observations in cerebellar stroke patients and anatomical tract tracing in non-human primates suggests its involvement in cognitive and affective processing. A comprehensive literature search on the role of the cerebellum in addiction was performed. This review article (1) considers the potential role of the cerebellum in addiction; (2) summarizes the cerebellar structural alterations linked to addiction; (3) presents the functional neuroimaging evidence linking the cerebellum with addiction; and (4) proposes a model for addiction that underscores the role of the cerebellum. The data implicate the cerebellum as an intermediary between motor and reward, motivation and cognitive control systems, as all are relevant etiologic factors in addiction. Furthermore, consideration of these findings could contribute to deeper and more sophisticated insights into normal reward and motivational function. The goal of this review is to spread awareness of cerebellar involvement in addictive processes, and to suggest a preliminary model for its potential role.

Anti-inflammatory and antinociceptive activities of LQFM002 - A 4-nerolidylcatechol derivative.

AIMS: The current study describes the synthesis and pharmacological evaluation of (E)-N-(3,7-dimethylocta-2,6-dienyl)-1,3-dimethyl-1H-pyrazol-5-amine (LQFM002), a compound originally designed through a molecular simplification strategy from 4-nerolidylcatechol. LQFM002 was evaluated for preservation of the PLA(2) enzyme inhibitory effects of the lead compound, 4-nerolidylcatechol, using in vitro and in vivo models. MAIN METHODS: Rota-rod, open field and pentobarbital-induced sleeping tests were used to evaluate the effects of LQFM002 on the central nervous system. A gel plate assay of PLA(2) activity, carrageenan-induced pleurisy and TNF-α levels was used to assay anti-inflammatory activity. Antinociceptive activities of LQFM002 were evaluated with acetic acid-induced writhing, formalin and hot-plate tests, while involvement of the opioid pathway in the LQFM002 antinociceptive effect was investigated with naloxone pre-treatment. KEY FINDINGS: LQFM002 inhibited PLA(2) activity, cell migration into the pleural cavity, and capillary permeability (Evan's blue concentration) and reduced TNF-α levels in pleural exudates. LQFM002 also reduced acetic acid-induced writhing and the licking time in both phases of the formalin test and increased latency in the hot-plate test. Pre-treatment with 8.25 µmol/kg naloxone (3mg/kg) reversed the analgesic effects of LQFM002 in the early phase of the formalin test. SIGNIFICANCE: LQFM002 showed anti-inflammatory activity, which possibly involved reduction of leukocyte migration and TNF-α levels. LQFM002 also demonstrated inhibition of PLA(2) activity in vitro. LQFM002 had an antinociceptive effect that involved the opioidergic system.

Surgically induced neuropathic pain: understanding the perioperative process.

Nerve damage takes place during surgery. As a consequence, significant numbers (10%-40%) of patients experience chronic neuropathic pain termed surgically induced neuropathic pain (SNPP). The initiating surgery and nerve damage set off a cascade of events that includes both pain and an inflammatory response, resulting in "peripheral and central sensitization," with the latter resulting from repeated barrages of neural activity from nociceptors. In affected patients, these initial events produce chemical, structural, and functional changes in the peripheral and central nervous systems (CNS). The maladaptive changes in damaged nerves lead to peripheral manifestations of the neuropathic state-allodynia, sensory loss, shooting pains, etc, that can manifest long after the effects of the surgical injury have resolved. The CNS manifestations that occur are termed "centralization of pain" and affect sensory, emotional, and other (eg, cognitive) systems as well as contributing to some of the manifestations of the chronic pain syndrome (eg, depression). Currently there are no objective measures of nociception and pain in the perioperative period. As such, intermittent or continuous pain may take place during and after surgery. New technologies including direct measures of specific brain function of nociception and new insights into preoperative evaluation of patients including genetic predisposition, appear to provide initial opportunities for decreasing the burden of SNPP, until treatments with high efficacy and low adverse effects that either prevent or treat pain are discovered.

BOLD responses in somatosensory cortices better reflect heat sensation than pain.

The discovery of cortical networks that participate in pain processing has led to the common generalization that blood oxygen level-dependent (BOLD) responses in these areas indicate the processing of pain. Physical stimuli have fundamental properties that elicit sensations distinguishable from pain, such as heat. We hypothesized that pain intensity coding may reflect the intensity coding of heat sensation during the presentation of thermal stimuli during fMRI. Six 3T fMRI heat scans were collected for 16 healthy subjects, corresponding to perceptual levels of "low innocuous heat," "moderate innocuous heat," "high innocuous heat," "low painful heat," "moderate painful heat," and "high painful heat" delivered by a contact thermode to the face. Subjects rated pain and heat intensity separately after each scan. A general linear model analysis detected different patterns of brain activation for the different phases of the biphasic response to heat. During high painful heat, the early phase was associated with significant anterior insula and anterior cingulate cortex activation. Persistent responses were detected in the right dorsolateral prefrontal cortex and inferior parietal lobule. Only the late phase showed significant correlations with perceptual ratings. Significant heat intensity correlated activation was identified in contralateral primary and secondary somatosensory cortices, motor cortex, and superior temporal lobe. These areas were significantly more related to heat ratings than pain. These results indicate that heat intensity is encoded by the somatosensory cortices, and that pain evaluation may either arise from multimodal evaluative processes, or is a distributed process.

Kinetics of the inflammatory response in subcutaneous cysticercosis induced in mice by Taenia crassiceps.

The larval stage of Taenia crassiceps has been used to study human cysticercosis as these larvae have antigenic similarity to the cysticerci of Taenia solium. The aim of this study was to evaluate the histopathological and immunological changes that followed the inoculation of T. crassiceps cysticerci into the subcutaneous tissue of C57BL/6 mice. Microscopically, granulomas formed of neutrophils and macrophages developed at the sites of inoculation. The serum concentration of the cytokine interferon (IFN)-γ increased throughout the course of infection, while the serum concentration of interleukin-4 increased during the period of transition from the initial phase (7-30 days postinoculation [dpi]) to the late phase (60-90 dpi) of infection. Destruction of the parasite therefore appears to be associated with an increase in IFN-γ, suggesting that a type 1 immune response is important in the control of the parasite.

Diuretic activity and acute oral toxicity of Palicourea coriacea (Cham.) K Schum.

AIM OF THE STUDY: Palicourea coriacea (Cham.) K Schum, is an endemic plant used in the Midwestern Region of Brazil, popularly known as "douradinha do campo" and "congonha do campo". This plant has been used in traditional medicine for several ailments, especially to treat kidney diseases. Since no formal studies on the biological activities and medicinal properties of the ethanolic extract of Palicourea coriacea (PCEE) have been carried out previously, the present study represents the first research into the efficacy of this plant as a diuretic agent employing laboratory rats as test animals. MATERIALS AND METHODS: For diuretic activity evaluation we assayed three doses of PCEE (20, 40 and 80mg/kg) and measurement of the urinary volume and electrolytes (Na(+), K(+)) concentration were taken. The acute oral toxicity of PCEE was investigated according to OECD Guideline 423. RESULTS: The oral administration of a single dose of PCEE significantly increased the urinary volume in 24h. Additionally, the treatment with PCEE increased, in a dose-dependent manner, the excretion of both, Na(+) and K(+). No sign of toxicity was observed in the animals. CONCLUSIONS: The present study confirmed the ethnopharmacological use of Palicourea coriacea as a diuretic agent in the experimental condition tested here. Additionally, this work supports the importance of the preservation of local knowledge as well as the conservation of Brazilian biodiversity.

Comparison of evoked vs. spontaneous tics in a patient with trigeminal neuralgia (tic doloureux).

A 53-year old woman with tic doloureaux, affecting her right maxillary division of the trigeminal nerve (V2), could elicit shooting pains by slightly tapping her teeth when off medication. The pains, which she normally rated as > 6/10 on a visual analog scale (VAS), were electric shock-like in nature. She had no other spontaneous or ongoing background pain affecting the region. Based on her ability to elicit these tics, functional magnetic resonance imaging (fMRI) was performed while she produced brief shocks every 2 minutes on cue (evoked pain) over a 20 min period. In addition, she had 1-2 spontaneous shocks manifested between these evoked pains over the course of functional image acquisition. Increased fMRI activation for both evoked and spontaneous tics was observed throughout cortical and subcortical structures commonly observed in experimental pain studies with healthy subjects; including the primary somatosensory cortex, insula, anterior cingulate, and thalamus. Spontaneous tics produced more decrease in signals in a number of regions including the posterior cingulate cortex and amygdala, suggesting that regions known to be involved in expectation/anticipation may have been activated for the evoked, but not spontaneous, tics. In this patient there were large increases in activation observed in the frontal regions, including the anterior cingulate cortex and the basal ganglia. Spontaneous tics showed increased activation in classic aversion circuitry that may contribute to increased levels of anxiety. We believe that this is the first report of functional imaging of brain changes in tic-doloureaux.

Neuroimaging revolutionizes therapeutic approaches to chronic pain.

An understanding of how the brain changes in chronic pain or responds to pharmacological or other therapeutic interventions has been significantly changed as a result of developments in neuroimaging of the CNS. These developments have occurred in 3 domains : (1) Anatomical Imaging which has demonstrated changes in brain volume in chronic pain; (2) Functional Imaging (fMRI) that has demonstrated an altered state in the brain in chronic pain conditions including back pain, neuropathic pain, and complex regional pain syndromes. In addition the response of the brain to drugs has provided new insights into how these may modify normal and abnormal circuits (phMRI or pharmacological MRI); (3) Chemical Imaging (Magnetic Resonance Spectroscopy or MRS) has helped our understanding of measures of chemical changes in chronic pain. Taken together these three domains have already changed the way in which we think of pain - it should now be considered an altered brain state in which there may be altered functional connections or systems and a state that has components of degenerative aspects of the CNS.

Breaking down the barriers: fMRI applications in pain, analgesia and analgesics.

This review summarizes functional magnetic resonance imaging (fMRI) findings that have informed our current understanding of pain, analgesia and related phenomena, and discusses the potential role of fMRI in improved therapeutic approaches to pain. It is divided into 3 main sections: (1) fMRI studies of acute and chronic pain. Physiological studies of pain have found numerous regions of the brain to be involved in the interpretation of the 'pain experience'; studies in chronic pain conditions have identified a significant CNS component; and fMRI studies of surrogate models of chronic pain are also being used to further this understanding. (2) fMRI studies of endogenous pain processing including placebo, empathy, attention or cognitive modulation of pain. (3) The use of fMRI to evaluate the effects of analgesics on brain function in acute and chronic pain. fMRI has already provided novel insights into the neurobiology of pain. These insights should significantly advance therapeutic approaches to chronic pain.

[Occurrence of encephalic and cardiac cysticercosis (Cysticercus cellulosae) in necropsy]. / Ocorrência de cisticercose (Cysticercus cellulosae) encefálica e cardíaca em necropsias.

OBJECTIVE: To review the incidence and pathologic findings of cysticercosis diagnosed at autopsies, with emphasis on the most common organs affected. METHODS: Reports of 1.596 autopsies performed between 1974 and 1997 at a school hospital in Uberaba, MG, Brazil were studied. The following data were obtained: age, sex, ethnic group, body mass index, and the site of the cysticercosis. RESULTS: The study found diagnosis of cysticercosis in 53 autopsies (3.3%). The average age of patients with cysticercosis was 50 (range: 15 to 86 years); 62.3% were male, and 64.1% Caucasian. The most affected organs were: brain (79.2%), heart (22.6%), skeletal muscle (11.3%), and other organs (5.7%). No statistical differences were found comparing age, gender, ethnic group, and body mass index of the affected and the non-affected patients. In two cases of neurocysticercosis the lesions were located in the ventromedial nucleus of the hypothalamus. CONCLUSION: Both the overall incidence of cysticercosis and the incidence of cardiac cysticercosis were greater in the study than in other autopsy series from the same geographic areas. In two cases there was an association between hypothalamic cysticercosis and obesity

[Nursing process used for diabetes. Evaluation of the rate of return of treated patients]. / Proceso de enfermeria aplicado al diabetico. Evaluacion de retorno de la clientela asistida.

The authors described an exploration study about nursing care which has been developed as out-patient treatment at the Diabetes Department of the University-Ceara in Brazil. The main goal of the study was to assess patients' return to subsequent visits. The data were collected from September 1989 to October 1989. The results reached showed the importance of visits for nursing care.

Tuberculosis vertebral en el adulto / Adult spinal tuberculosis

Se hizo una revisión sobre pacientes afectados por tuberculosis vertebral de febrero de 1987 a mayo de 1991, tratados en el Hospital de traumatología y Ortopedia "Lomas Verdes". De un total de 38 pacientes, se incluyó en la presente serie a 30, de uno y otro sexo y con edad mayor de 15 años. A 17 enfermos se les administró el tratamiento clásico con hidrazida del ácido isonicotínico (HAIN) y etambutol durante 18 meses, además de estreptomicina solamente los primeros dos meses. El llamado tratamiento corto, se aplicó durante un periodo de seis meses con pirazinamida, rifampicina y estambutol en ocho casos. Finalmente, el tratamiento para las recaídas consistió en un programa de HAIN y rifampicina durante 12 meses y se aplicó en otros cinco pacientes. Si los pacientes no trníasn destrucción ósea masiva, daño neurológico, ni fomación de abscesos o fístulas, se les aplicó tratamiento ortopédico conservador, que consistió en un corsé o reposo en cama durante un periodo de tres a cuatro meses. Este método se aplicó en 13 enfermos. En cambio, si existían las lesiones señaladas, se aplicó tratamiento quirúrgico que consistió en desbridamiento, descompresión y artrodesis anterior con injerto óseo autólogo de ilíaco. Este tratamiento quirúrgico primario se realizó en los restantes 17 enfermos, de los cuales 12 tenían paraplejía. Se requirió cirugía adicional en 12 de aquellos 17 enfermos, por destrucción masiva e inestabilidad espinal, que consistió en simple artrodesis posterior de dos y artrodesis con instrumentación de Luque en 10. Hubo mejoría del daño neurológico sólo en siete de los 12 pacientes. Por otra parte, hubo dos que presentaron daño neural después de la cirugía. El resultado global fue bueno en 23 casos (76 por ciento), regular en cinco y malo en dos. A mayor duración de la enfermedad la capacidad de recuperación de los enfermos fue menor.