Perfil de consumo de drogas en adolescentes. Factores protectores / Profile of drug use in adolescents. Protective factors

OBJETIVO: Determinar el patrón de consumo de tóxicos y analizar el papel de factores protectores personales y sociales sobre el consumo de alcohol. MATERIAL Y MÉTODOS: Se realizó un estudio descriptivo transversal en 5 institutos de educación secundaria de Cuenca capital (2015-2016). Se seleccionaron aleatoriamente los grupos (3.° y 4.° de ESO y 1.° y 2.° de bachillerato) y dieron su consentimiento 844 estudiantes. Se empleó un cuestionario autoadministrado con variables sociodemográficas, datos de consumo de sustancias y las escalas CD-RISC 10 para evaluar resiliencia y KIDSCREEN-52 para medir aspectos individuales y sociales asociados con la calidad de vida de los adolescentes. Se realizaron análisis descriptivos bivariados y multivariantes. RESULTADOS: Un 55,7% fueron chicas, la edad media fue de 16,36+/-1,05 años. El inicio se situó entre los 13-14 años, los porcentajes de consumo habitual fueron 70,9% para alcohol, 26,4% para tabaco y 14,2% para cannabis (cifras inferiores al consumo experimental). Se detectó policonsumo (35%). La regresión mostró que los no consumidores de alcohol presentaban mejores cifras de estado de ánimo, autopercepción, relación con los padres y entorno escolar. CONCLUSIONES: El inicio en el consumo de drogas es cada vez más temprano, especialmente en el cannabis. La disponibilidad y la baja percepción del riesgo hacen del alcohol la droga más extendida. Las acciones encaminadas a favorecer el bienestar emocional y el apoyo familiar proporcionan seguridad a los adolescentes y recursos para resistir las presiones del grupo

OBJECTIVE: To determine the patterns of drug use in an adolescent population and to analyse the role of personal and social protective factors in alcohol consumption. MATERIAL AND METHODS: A descriptive cross-sectional study was carried out in five secondary schools in the city of Cuenca (Spain) in the period 2015-2016. The groups were randomly selected (3rd - 4th GCSE and 1st - 2nd GCE), with a total of 844 students giving their consent. A self-administered questionnaire was used, which included sociodemographic variables, consumption data, CD-RISC 10 scale to evaluate resilience, and KIDSCREEN-52 questionnaire to measure individual and social aspects associated with health-related quality of life in adolescents. Descriptive bivariate and multivariate analyses were performed. RESULTS: Just over half (55.7%) of the pupils selected were girls, and the mean age was 16.3+/-1.01 years. The pupils began consumption when they became 13-14 years old. The percentages of habitual consumption were 70.9% for alcohol, 26.4% for tobacco, and 14.2% for cannabis. Multiple drug use was also found in 35%. The regression model for alcohol showed that non-consumers showed better values in emotional moods, self-perception, relationships with their parents, and their school environment. CONCLUSIONS: Adolescents start using drugs, especially cannabis, at an earlier age. Availability and the perception of low-risk make alcohol the most widespread drug. Actions aimed at fostering emotional well-being and family support provides security for adolescents, as well as the resources that help them overcome the pressures of the group

[Profile of drug use in adolescents. Protective factors]. / Perfil de consumo de drogas en adolescentes. Factores protectores.

OBJECTIVE: To determine the patterns of drug use in an adolescent population and to analyse the role of personal and social protective factors in alcohol consumption. MATERIAL AND METHODS: A descriptive cross-sectional study was carried out in five secondary schools in the city of Cuenca (Spain) in the period 2015-2016. The groups were randomly selected (3rd - 4th GCSE and 1st - 2nd GCE), with a total of 844 students giving their consent. A self-administered questionnaire was used, which included sociodemographic variables, consumption data, CD-RISC 10 scale to evaluate resilience, and KIDSCREEN-52 questionnaire to measure individual and social aspects associated with health-related quality of life in adolescents. Descriptive bivariate and multivariate analyses were performed. RESULTS: Just over half (55.7%) of the pupils selected were girls, and the mean age was 16.3±1.01 years. The pupils began consumption when they became 13-14 years old. The percentages of habitual consumption were 70.9% for alcohol, 26.4% for tobacco, and 14.2% for cannabis. Multiple drug use was also found in 35%. The regression model for alcohol showed that non-consumers showed better values in emotional moods, self-perception, relationships with their parents, and their school environment. CONCLUSIONS: Adolescents start using drugs, especially cannabis, at an earlier age. Availability and the perception of low-risk make alcohol the most widespread drug. Actions aimed at fostering emotional well-being and family support provides security for adolescents, as well as the resources that help them overcome the pressures of the group.

Age protects from harmful effects produced by chronic intermittent hypoxia.

Obstructive sleep apnoea (OSA) affects an estimated 3­7% of the adult population, the frequency doubling at ages >60­65 years. As it evolves, OSA becomes frequently associated with cardiovascular, metabolic and neuropsychiatric pathologies defining OSA syndrome (OSAS). Exposing experimental animals to chronic intermittent hypoxia (CIH) can be used as a model of the recurrent hypoxic and O2 desaturation patterns observed in OSA patients. CIH is an important OSA event triggering associated pathologies; CIH induces carotid body (CB)-driven exaggerated sympathetic tone and overproduction of reactive oxygen species, related to the pathogenic mechanisms of associated pathologies observed in OSAS. Aiming to discover why OSAS is clinically less conspicuous in aged patients, the present study compares CIH effects in young (3­4 months) and aged (22­24 months) rats. To define potential distinctive patterns of these pathogenic mechanisms, mean arterial blood pressure as the final CIH outcome was measured. In young rats, CIH augmented CB sensory responses to hypoxia, decreased hypoxic ventilation and augmented sympathetic activity (plasma catecholamine levels and renal artery content and synthesis rate). An increased brainstem integration of CB sensory input as a trigger of sympathetic activity is suggested. CIH also caused an oxidative status decreasing aconitase/fumarase ratio and superoxide dismutase activity. In aged animals, CIH minimally affected CB responses, ventilation and sympathetic-related parameters leaving redox status unaltered. In young animals, CIH caused hypertension and in aged animals, whose baseline blood pressure was augmented, CIH did not augment it further. Plausible mechanisms of the differences and potential significance of these findings for the diagnosis and therapy of OSAS are discussed.

Experimental Observations on the Biological Significance of Hydrogen Sulfide in Carotid Body Chemoreception.

The cascade of transduction of hypoxia and hypercapnia, the natural stimuli to chemoreceptor cells, is incompletely understood. A particular gap in that knowledge is the role played by second messengers, or in a most ample term, of modulators. A recently described modulator of chemoreceptor cell responses is the gaseous transmitter hydrogen sulfide, which has been proposed as a specific activator of the hypoxic responses in the carotid body, both at the level of the chemoreceptor cell response or at the level of the global output of the organ. Since sulfide behaves in this regard as cAMP, we explored the possibility that sulfide effects were mediated by the more classical messenger. Data indicate that exogenous and endogenous sulfide inhibits adenyl cyclase finding additionally that inhibition of adenylyl cyclase does not modify chemoreceptor cell responses elicited by sulfide. We have also observed that transient receptor potential cation channels A1 (TRPA1) are not regulated by sulfide in chemoreceptor cells.

The Carotid Body Does Not Mediate the Acute Ventilatory Effects of Leptin.

Leptin is a hormone produced mostly in adipose tissue and playing a key role in the control of feeding and energy expenditure aiming to maintain a balance between food intake and metabolic activity. In recent years, it has been described that leptin might also contributes to control ventilation as the administration of the hormone reverses the hypoxia and hypercapnia commonly encountered in ob/ob mice which show absence of the functional hormone. In addition, it has been shown that the carotid body (CB) of the rat expresses leptin as well as the functional leptin-B receptor. Therefore, the possibility exists that the ventilatory effects of leptin are mediated by the CB chemoreceptors. In the experiments described below we confirm the stimulatory effect of leptin on ventilation, finding additionally that the CB does not mediate the instant to instant control of ventilation.

Haemophilus parasuis subunit vaccines based on native proteins with affinity to porcine transferrin prevent the expression of proinflammatory chemokines and cytokines in pigs.

The expression of chemokines (CCL-2 and CXCL-8) and cytokines (IL-1 α , IL-1 ß , IL-6, TNF- α , and IL-10) was evaluated by RT-qPCR in colostrum-deprived pigs vaccinated and challenged with Haemophilus parasuis serovar 5. Two vaccines containing native proteins with affinity to porcine transferrin (NPAPTim and NPAPTit) were tested, along with two control groups: one inoculated with PBS instead of antigen (challenge group (CHG)), and another one nonimmunized and noninfected (blank group). The use of NPAPTim and NPAPTit resulted in complete protection against H. parasuis (no clinical signs and/or lesions), and both vaccines were capable of avoiding the expression of the proinflammatory molecules to levels similar to physiological values in blank group. However, overexpression of all proinflammatory molecules was observed in CHG group, mainly in the target infection tissues (brain, lungs, and spleen). High expression of CCL-2, CXCL-8, IL-1 α , IL-1 ß , and IL-6 can be considered one of the characteristics of H. parasuis infection by serovar 5.

New insights in cellular immune response in colostrum-deprived pigs after immunization with subunit and commercial vaccines against Glässer's disease.

Four groups of colostrum-deprived pigs were immunized with Porcilis Glässer® (PG) or with subunit vaccines developed by us (rTbpA, NPAPT(M) or NPAPT(Cp)) against Glässer's disease, and they were challenged with 3×10(8)CFU of Haemophilus parasuis. A strong reduction in CD3(+)γδTCR(+) cells was seen in non-immunized control and scarcely protected (rTbpA) groups, suggesting that these cells could represent a target of H. parasuis infection. A significant increase in CD172α(+)CD163(+) cells was detected in all groups but PG, while a reduction in SLAIIDR(+) molecules expression was observed after challenge in control animals. Significant increases in CD3ε(+)CD8α(+)CD8ß(+) and B cells were detected respectively in control and NPAPT groups, and in scarcely (rTbpA) and well-protected (NPAPT(M) and NPAPT(Cp)) groups. Finally, a greater response in CD4(+)CD8α(-) cells was observed in NPAPT(Cp) compared to NPAPT(M) and PG groups. These results state the potential of NPAPT antigen for developing effective vaccines against Glässer's disease.

Comparative efficacy of several disinfectants in suspension and carrier tests against Haemophilus parasuis serovars 1 and 5.

The comparative efficacy of 16 active compounds (including the most commonly used chemical groups) and 10 commercial formulations against Haemophilus parasuis serovars 1 and 5 was studied. These organisms were tested in suspension and carrier tests in the presence and absence of serum as representative of organic matter. Chloramine-T and half of the formulations from commercial sources (most of them including quaternary ammonium compounds) were effective in both in vitro tests, regardless of the presence or absence of organic load. All 26 disinfectants except for an iodophor (0.1% available iodine) resulted in at least 3-log(10) reduction in colony-forming units in suspension test, and most of them resulted in the maximal level of detection (>6-log(10) reduction). On the other hand, disinfectants were not as effective in carrier test as in suspension test, and the presence of serum considerably reduced the activities of most of the compounds tested, especially in carrier test. These results suggest the importance of selecting suitable disinfection for routine use on surfaces contaminated with H. parasuis, particularly when organic matter is present. Chloramine-T and formulations 2 and 7-10 are recommended for a complete inactivation of H. parasuis in swine herds.

Mechanisms of dexamethasone-mediated chemokine down-regulation in mild and severe acute pancreatitis.

This study aimed to investigate the role of therapeutic dexamethasone (Dex) treatment on the mechanisms underlying chemokine expression during mild and severe acute pancreatitis (AP) experimentally induced in rats. Regardless of the AP severity, Dex (1 mg/kg), administered 1 h after AP, reduced the acinar cell activation of extracellular signal-regulated kinase (ERK) and c-Jun-NH(2)-terminal kinase (JNK) but failed to reduce p38-mitogen-activated protein kinase (MAPK) in severe AP. In both AP models, Dex inhibited the activation of nuclear factor-kappaB (NF-kappaB) and signal transducers and activators of transcription (STAT) factors. All of this resulted in pancreatic down-regulation of the chemokines monocyte chemoattractant protein-1 (MCP-1) and cytokine-induced neutrophil chemoattractant (CINC). Lower plasma chemokine levels as well as decreased amylasemia, hematocrit and plasma interleukin-1beta (Il-1beta) levels were found either in mild or severe AP treated with Dex. Pancreatic neutrophil infiltration was attenuated by Dex in mild but not in severe AP. In conclusion, by targeting MAPKs, NF-kappaB and STAT3 pathways, Dex treatment down-regulated the chemokine expression in different cell sources during mild and severe AP, resulting in decreased severity of the disease.

The role of redox status on chemokine expression in acute pancreatitis.

This study focused on the involvement of oxidative stress in the mechanisms mediating chemokine production in different cell sources during mild and severe acute pancreatitis (AP) induced by bile-pancreatic duct obstruction (BPDO) and 3.5% NaTc, respectively. N-Acetylcysteine (NAC) was used as antioxidant treatment. Pancreatic glutathione depletion, acinar overexpression of monocyte chemoattractant protein-1 (MCP-1) and cytokine-induced neutrophil chemoattractant (CINC), and activation of p38MAPK, NF-kappaB and STAT3 were found in both AP models. NAC reduced the depletion of glutathione in BPDO- but not in NaTc-induced AP, in which oxidative stress overwhelmed the antioxidant capability of NAC. As a result, inhibition of the acinar chemokine expression and signalling pathways occurs in mild, but not in severe AP. However, MCP-1 and CINC expressions in whole pancreas and plasma chemokine levels were not reduced by NAC, even in BPDO-induced AP, suggesting that in addition to acini, other pancreatic cells produced chemokines by antioxidant resistant mechanisms. The high Il-6 plasma levels found during AP, both in NAC-treated and non-treated rats, pointed out cytokines as activating factors of chemokine expression in non-acinar cells. In conclusion, from early AP oxidant-mediated MAPK, NF-kappaB and STAT3 activation triggers the chemokine expression in acini but not in non-acinar cells.

Macroamilasemia y enfermedad celíaca / Macroamylasemia and celiac disease

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Megacolon tóxico como presentación de la enfermedad de Crohn / Toxic megacolon as presentation of Crohn disease

Presentamos un paciente joven, sin antecedentes de enfermedad inflamatoria intestinal (E.I.I.), que debutando como una Gastroenteritis aguda, evolucionó en los días siguientes hasta un megacolon tóxico. El paciente acudió a urgencias previamente por presentar náuseas, vómitos, fiebre alta y deposición líquida, explosiva y abundante sin productos patológicos. Fue tratado con dieta, reposición hidroelectrolítica por vía oral y antiadiarreicos de tipo opiáceo sin remisión clínica. Ingresó por añadirse rectorragia al cuadro descrito, evolucionando en los tres días siguientes hacia un megacolon tóxico que obligó a una cirugía urgente en la que se evidenciaron perforaciones en el colon. El diagnóstico anatomopatológico fue: enfermedad de Crohn. Aún en ausencia de antecedentes de E.I.I., se llegó al diagnóstico con los datos clínicos, analíticos y de la radiología simple de abdomen; siendo imposible confirmarlo mediante una colonoscopia, debido al riesgo de perforación. En estos casos, la cirugía precoz puede salvar la vida del paciente (AU)

[Toxic megacolon presenting as Crohn's disease]. / Megacolon tóxico como presentación de la enfermedad de Crohn.

We introduce a young patient, without history of inflammatory bowel disease (I.B.D.) who started with an acute gastroenteritis, which in the following days progressed to a toxic megacolon. The patient had come to hospital with nausea, vomiting, fever and liquid, explosive diarrhoea without pathologic products. There was no clinical remission with astringent diet, hydroelectrolitic reposition and antidiarrheic opiates. The patient was admitted in hospital when he had blood in the diarrhoea. This progressed to a toxic megacolon in three days and the patient had to be operated on urgently. The surgeons found perforations in the colon and the pathologists diagnosed Crohn disease. Even without previous E.B.D. history we reached the diagnosis from the clinical and analytical data and the plain abdominal radiology. It was impossible to confirm the diagnosis with a colonoscopy because of the high risk of perforation. In cases like this, early surgery may save the life of the patient.