Diffusive gradients in thin films for predicting methylmercury bioavailability in freshwaters after photodegradation.

Determination of the dissolved-bioavailable fraction of methylmercury (MeHg) and its degradation pathways in freshwaters deserve attention, to further our understanding of the potential risk and toxicity of MeHg. Since the photodegradation of MeHg is the most important known abiotic process able to demethylate MeHg, this study investigated the role of sunlight on MeHg bioavailability in freshwater environments. Experiments to calculate photodegradation rate constants of MeHg in different types of freshwater in combination with experiments to distinguish the labile fraction of MeHg after being exposed to sunlight were performed. The ability of diffusive gradients in thin films based on polyacrylamide (P-DGT) to assess DGT-labile MeHg during photodegradation was successfully tested. First order photodegradation rate constants (kpd) of bioavailable MeHg determined in five different types of waters with different amount of dissolved organic matter (DOM), were in the range 0.073-0.254 h(-1), confirming previous findings that once there is DOM in solution, which would favour the photodegradation process, the kpd is mainly affected by light attenuation. Simulated sunlight seems not to alter the lability of MeHg, although photodegradation processes may decrease the concentrations of MeHg, contributing to reduce the amount of bioavailable MeHg (i.e. MeHg uptake by DGT). However, the quality of DOM, rather than the quantity, plays an important role in the bioavailability of MeHg in freshwater.

Development of the DGT technique for Hg measurement in water: comparison of three different types of samplers in laboratory assays.

The Diffusive Gradients in Thin films (DGT) technique is an operationally defined method to determine the dissolved fraction of trace elements in water. The aim of this study was to develop this technique for the measurement of the bioavailable mercury species in natural waters. For that purpose, three types of DGT units (commercial, manufactured with agarose diffusive gel (DG) and manufactured with polyacrylamide DG) were tested under controlled conditions using an Hg(II) solution both with and without dissolved organic matter (DOM). An acid digestion method using aqua regia was optimised to efficiently digest the resin gel discs prior to analysis. A good performance was obtained for the three DGT types when deployed in a DOM-free mercury solution in the laboratory, and it was demonstrated that polyacrylamide gel can be used as diffusive layer for mercury sampling. However, when the DGT units were deployed in a mercury solution containing DOM, performance differences were observed. Furthermore, the mass of background mercury (blanks) varied among the different DGT types. In the light of the results, the devices manufactured with polyacrylamide DG seemed to be the best choice for dissolved mercury determination.

Síndrome de respuesta inflamatoria sistémica (SRIS) y cirugía cardiaca bajo circulación extracorpórea (Parte I) / Systemic inflammation reaction and extracorporeal circuit in cardiac surgery

La cirugía cardiaca bajo circulación extracorpórea (CEC) produce un síndrome de respuesta inflamatorio sistémico (SRIS) debido a una activación del sistema inmune desencadenado por el contacto de la sangre con superficies extrañas, el trauma quirúrgico, la lesión isquemia-reperfusión y la endotoxemia. Este SRIS produce un aumento de la morbimortalidad en los pacientes sometidos a estos procedimientos quirúrgicos. En esta primera parte, revisamos la activación de las células endoteliales, la cascada de la coagulación, y el sistema complemento (AU)

Cardiac surgery with extracorporeal circulation causes a systemic inflammatory response syndrome (SIRS) due to the activation of the immune system triggered by: the contact of the blood with foreign surfaces, the surgical trauma, the ischemiareperfusion lesion and the endotoxemia. This SIRS results in an increase in the morbidity-mortality in patients undergoing these surgical procedures. In this first part, the activation of the endothelial cells, the coagulation cascade and the complementary system are reviewed (AU)

El tiempo de psicosis no tratada como factor predictivo y pronóstico en el curso de los primeros episodios psicóticos / Duration of untreated psychosis as predictive and prognostic factor in the course of first episode psychosis

Introducción. El tiempo de psicosis no tratada ha estado en el punto de mira de numerosos artículos que intentan clarificar si podría resultar ser uno de los factores que condicionaría el pronóstico final de la enfermedad psicótica. Material y métodos. Presentamos un estudio realizado en 90 pacientes con un primer episodio psicótico que no habían tomado medicación previamente en el que se evaluaron los posibles factores pronósticos que influirían en la evolución de la enfermedad. A tal efecto se utilizó un protocolo que incluía las siguientes escalas: PANSS, escala de valoración global de estrés psicosocial (DSM IIIR), evaluación de actividad global (GAF-EEAG), impresión clínica global (ICG), escala de Montgomery-Asberg para la depresión, escala de manía de Young, escala de movimientos anormales, escala UKU para síntomas extrapiramidales y la escala de ajuste premórbido (Cannon-Spoor). El seguimiento se realizó durante 1 año con evaluaciones cada 3 meses. Resultados. Tras el análisis estadístico de los datos se concluyó que un tiempo de psicosis prolongado no se asociaba en nuestra muestra a una peor evolución de la enfermedad. Los únicos factores relacionados con dicho pronóstico resultaron ser el ajuste premórbido y el tipo de comienzo de la enfermedad. Así, pacientes con un mejor ajuste premórbido y un inicio de enfermedad agudo presentaban una mejor evolución. Conclusiones. Nuestro trabajo muestra una evidencia más en favor de la independencia del pronóstico final y el tiempo de psicosis sin tratar

Introduction. Recently, many studies have focused on the duration of untreated psychosis (DUP) in order to clarify if DUP could be one of the factors that would influence prognosis of psychotic disease. Material and methods. We present a one year follow - up study with 90 medication native, first episode psychotic patients. The likely prognosis factors that could influence in the outcome of the disease were measured. Therefore, we used a protocol including the following scales: PANSS, Psychosocial Stress Global Assessment scale (DSM IIIR), Global Assessment of Functioning scale (GAF-EEAG), Clinical Global Impression (CGI), Montgomery-Asberg scale for the depression, Young mania rating scale, abnormal involuntary movements scale, UKU scale for extrapyramidal symptoms and Premorbid Adjustment scale (Cannon-Spoor). Assessments were made every three months for 1 year. A statistical analysis of data was performed. Results. As a result, it was concluded that there was no relationship between a long duration untreated psychosis and a worse outcome of the illness in our sample. The only related factors with the prognosis were premorbid adjustment and the type of disease onset. Hence, the patients with a better premorbid adjustment and an acute onset of psychosis had a better outcome. Conclusion. Our study represents more evidence in favor of the independence of DUP and disease outcome

Controversias en torno al tiempo de psicosis no tratada como variable pronóstica independiente del curso evolutivo de las psicosis esquizofrénicas / Controversies about duration of untreated psychosis as independent prognostic variable of the evolutive course of schizophrenic psychoses

El objetivo del presente trabajo es detallar aquellos aspectos, a nuestro entender más relevantes, extraídos de la creciente literatura sobre el tiempo de psicosis no tratada (DUP), incidiendo sobre dos aspectos nucleares y objeto de una creciente controversia, como son: a) aquellas razones que a lo largo de la última década han llevado a catapultar el DUP a la primera plana de la investigación en el terreno de los primeros episodios psicóticos, y b) el papel último del DUP a la hora de vertebrar el diseño y las diferentes estrategias de actuación en los programas de intervención precoz sobre las psicosis. Se aportan datos correspondientes a la evaluación del DUP, como variable pronóstica independiente, en una muestra de 231 pacientes, con un diagnóstico de trastorno esquizofrénico y/o trastorno esquizofreniforme (criterios DSM-IV) y un seguimiento de 24 meses. La conclusión final es que el DUP funciona más como un marcador de riesgo que como una variable pronóstica independiente, determinante del curso evolutivo de las psicosis esquizofrénicas. En este sentido su papel dentro de los programas de intervención precoz en las psicosis debería revisarse

This study reviews recent literature on duration of untreated psychosis (DUP) and its most relevant characteristics and controversial issues, such as: a) why DUP has been pointed out as a main variable in first-episode psychosis research, and b) the role of DUP in designing intervention programs for the design and different action strategies in early intervention programs in psychoses. The authors also present data from a 2 year follow-up study of 231 patients with a diagnosis of schizophrenia and/or schizophreniform disorder (according to DSM-IV criteria). Results are included, analyzing DUP as prognostic factor for clinical outcome. Our conclusions suggest that DUP is a risk marker but not an independent prognostic factor determining follow-up in schizophrenic psychoses. Therefore, DUP's role in early intervention programs should be redefined

[Controversies about duration of untreated psychosis as independent prognostic variable of the evolutive course of schizophrenic psychoses]. / Controversias en torno al tiempo de psicosis no tratada como variable pronóstica independiente del curso evolutivo de las psicosis esquizofrénicas.

This study reviews recent literature on duration of untreated psychosis (DUP) and its most relevant characteristics and controversial issues, such as: a) why DUP has been pointed out as a main variable in first-episode psychosis research, and b) the role of DUP in designing intervention programs for the design and different action strategies in early intervention programs in psychoses. The authors also present data from a 2 year follow-up study of 231 patients with a diagnosis of schizophrenia and/or schizophreniform disorder (according to DSM-IV criteria). Results are included, analyzing DUP as prognostic factor for clinical outcome. Our conclusions suggest that DUP is a risk marker but not an independent prognostic factor determining follow-up in schizophrenic psychoses. Therefore, DUP's role in early intervention programs should be redefined.

Encefalomielitis aguda diseminada secundaria a vacuna antigripal / Acute disseminated encephalomyelitis secondary to influenza vaccination

No disponible

[Factorial variance of the SCL-90-R in a Spanish out-patient psychiatric sample]. / Variabilidad factorial del SCL-90-R en una muestra psiquiátrica ambulatoria.

OBJECTIVE: To test the consistency of the proposed structure for the SCL-90R. METHOD: 598 first appointments of a Mental Health Centre were evaluated. 352 of these patients completed the SCL-90-R during their first appointment and also 6 and 12 months later. The structure of this questionnaire from the first appointment as well as from follow-up observations is analysed separately in men and women by exploratory factor analysis. Moreover, confirmatory factor analysis have been applied in order to compare the relative adjustment with the data observed during the first appointment in the original model of Derogatis et al., as well as in 3 other factor models. RESULTS: Exploratory factor analysis rendered a different factor structure with all other contrasted models, that were rejected by confirmatory factor analysis as well, in men and women. Only a relative temporal stability in factor structure, different for men and women, was found. CONCLUSION: It seems that this tool may be rather more useful as a unitary measure for global distress. In addition, our results suggest that the factor structure of the SCL-90-R may vary in the same sample depending on the gender and also possibly varying throughout the time of observation. According to this, the benefit of the SCL-90-R for descriptive and monitoring studies throughout the time is questionable for this type of samples.

Variabilidad factorial del SCL-90-R en una muestra psiquiátrica ambulatoria / Factorial variance of the SCL-90-R in a Spanish out-patient psychiatric sample

Objetivos: Probar la consistencia de la estructura propuesta para el SCL-90-R.Método: Se estudian 598 primeras consultas de un CSM. De ellas, 352 respondieron al cuestionario SCL-90-R en la primera consulta y a los 6 y 12 meses de la misma. Se analiza la estructura del cuestionario en hombres y mujeres por separado mediante análisis factoriales exploratorios, tanto en la primera consulta como en los seguimientos. Además, se aplicaron análisis factoriales confirmatorios para comparar el ajuste relativo a los datos observados en la primera consulta, tanto en el modelo original de Derogatis et al, como en otros tres modelos factoriales de otros autores.Resultados: El modelo original de nueve escalas o factores y los demás modelos factoriales contrastados no son confirmados en los pacientes psiquiátricos ambulatorios, tanto hombres como mujeres, de nuestra muestra. Por otra parte, sólo se encontró una estabilidad temporal relativa, diferente para hombres y mujeres, en la estructura factorial.Conclusiones: Este instrumento podría resultar más útil como una medida unitaria de distrés global. Adicionalmente, nuestros resultados sugieren que la estructura factorial del SCL-90-R podría va riar en función del género y que también puede va riar a lo largo del tiempo en la misma muestra. Según esto, la utilidad del SCL-90-R en estudios descriptivos y de monitorización a través del tiempo en este tipo de muestras resulta discutible (AU)

Psychological and behavioural factors associated with relapse among heroin abusers treated in therapeutic communities.

The authors carried out a comparative study on two groups of heroin abusers treated in several therapeutic communities: One group consumed heroin on at least three occasions between the fifth and sixth months of treatment (n = 130), and the other continued without consuming heroin after 7 months of treatment (n = 130). The instruments used for data collection were a structured interview and urine analysis. The relapsed group includes older patients with more medical problems, lower educational and occupational level, and major chronicity in heroin consumption. The collection of retrospective data referring to the treatment period shows that relapsed patients more frequently consumed alcohol, hashish, cocaine, and amphetamines; suffered more heroin cravings; used fewer coping strategies to overcome the craving; and justified the craving or the heroin consumption in more situations than those who abstained. The last heroin craving during the treatment period arose in different temporal, social, and physical contexts in the two groups, and it was accompanied more frequently by inadequate responses in the relapsed group: psychophysiological alterations, depressed feelings, negative thoughts, and coping behaviours. The two groups are different in their attitudes toward heroin abstinence. The authors discuss the findings from a cognitive-behavioural perspective and come to the conclusion that various models need to be integrated.