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1.
Mar Environ Res ; 152: 104791, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31640887

RESUMO

Harmful invader ctenophore Mnemiopsis leidyi's expansions in the Eurasian Seas, its spatio-temporal population dynamics depending on environmental conditions in recipient habitats have been synthesized. M. leidyi found suitable temperature, salinity and productivity conditions in the temperate and subtropical environments of the semi-enclosed seas, in the coastal areas of open basins and in closed water bodies, where it created autonomous populations. M. leidyi changes its phenology depending on seasonal temperature regime in different environments. We assessed ranges of sea surface temperature, sea surface salinity and sea surface chlorophyll values, sufficient for M. leidyi general occurrence and reproduction based on comprehensive long-term datasets, contributed by co-authors. This assessment revealed that there are at least two eco-types (Southern and Northern) in the recipient seas of Eurasia with features specific for their donor areas. The range of thresholds for M. leidyi establishment, occurrence and life cycle in both eco-types depends on variability of environmental parameters in their native habitats.


Assuntos
Ctenóforos , Espécies Introduzidas , Animais , Oceanos e Mares , Dinâmica Populacional , Reprodução , Salinidade
2.
Radiología (Madr., Ed. impr.) ; 60(2): 105-118, mar.-abr. 2018. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-174071

RESUMO

El dolor inguinal o de cadera es un motivo de consulta muy frecuente. Debido a las múltiples causas que pueden generarlo, y a que en muchas ocasiones comparten características clínicas y demográficas, las pruebas de imagen desempeñan un papel complementario en el diagnóstico etiológico. Se han descrito nuevas formas de atrapamiento extraarticular de la cadera como causa de dolor y limitación funcional, en especial en pacientes jóvenes activos. Incluyen el atrapamiento isquiofemoral, el choque subespinoso o de la espina iliaca anteroinferior, el atrapamiento del iliopsoas y el choque pélvico-trocantéreo. De forma general, se deben a un problema mecánico que conduce al contacto anormal o excesivo entre el fémur proximal y la pelvis ósea, o las partes blandas interpuestas. Realizamos una revisión actualizada de estas formas de atrapamiento extraarticular de la cadera, describiendo la fisiopatología, las manifestaciones clínicas, los hallazgos radiológicos más comunes y el tratamiento


Hip and groin pain is a common clinical problem. Multiple causes can generate hip or groin pain, often sharing clinical and demographic characteristics. Diagnostic imaging tests play an important role in the etiological diagnosis. New forms of extra-articular hip impingement have recently been recognized as a cause of hip pain and limited function especially in young active patients. These conditions include ischiofemoral impingement, anterior inferior iliac spine and subspine impingement, iliopsoas impingement and greater trochanteric-pelvic impingement. In general, they are caused by a mechanical conflict with an abnormal or excessive contact between the proximal femur and pelvis and/or soft tissue between them. In this manuscript we review the physiopathology, clinical presentation, the most common radiologic findings and treatment of these forms of extra-articular hip impingement


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Polimialgia Reumática/diagnóstico por imagem , Lesões do Quadril/diagnóstico por imagem , Dor/diagnóstico por imagem , Pelve/diagnóstico por imagem , Pelve/lesões , Lesões do Quadril/etiologia , Lesões do Quadril/fisiopatologia , Virilha/diagnóstico por imagem , Virilha/lesões , Manejo da Dor , Músculos Psoas/diagnóstico por imagem , Músculos Psoas/lesões , Diagnóstico Diferencial , Imageamento por Ressonância Magnética
3.
Mar Pollut Bull ; 129(2): 866-874, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29042106

RESUMO

We investigated at the single cell level during 16months (June 2012 to September 2013) the temporal distribution of picophytoplankton (picoeukaryotes, Synechococcus and Prochlorococcus) communities in two contrasted ecosystems: the Bay of Bizerte characterised by an oligotrophic regime typical of the Mediterranean Sea and the Bizerte Lagoon that exhibits a mesotrophic/eutrophic state. We aimed at depicting seasonal variations and quantifying the relationships between the environmental factors and the structure and abundance of picophytoplankton communities. Results showed that picophytoplankton groups were able to grow under a wide range of environmental conditions varying seasonally, although their abundances and contributions to the total chlorophyll biomass significantly varied and showed importance in the Bay of Bizerte. Synechococcus was the most abundant group reaching 225∗103cells·cm-3 in the Bay and 278∗103cells·cm-3 in the lagoon. This group was present all over the year in both ecosystems. Structural equation model results pointed out a different configuration regarding the picophytoplankton environmental drivers. The complexity of the configuration, i.e. number of significant links within the system, decreased under enhanced eutrophication conditions. The less exposure to anthropogenic stress, i.e. in the Bay of Bizerte, highlight a larger role of nutrient and hydrological conditions on the seasonal variations of picophytoplankton, whereas a negative effect of eutrophication on picophytoplankton communities was unveiled in the Bizerte Lagoon. We stress that such influence may be exacerbated under expected scenarios of Mediterranean warming conditions and nutrient release in coastal ecosystems.


Assuntos
Monitoramento Ambiental/métodos , Prochlorococcus/crescimento & desenvolvimento , Água do Mar/química , Synechococcus/crescimento & desenvolvimento , Poluentes Químicos da Água/análise , Biomassa , Clorofila/metabolismo , Ecossistema , Eutrofização , Mar Mediterrâneo , Dinâmica Populacional , Prochlorococcus/metabolismo , Salinidade , Estações do Ano , Synechococcus/metabolismo , Tunísia
4.
Radiologia (Engl Ed) ; 60(2): 105-118, 2018.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-29110905

RESUMO

Hip and groin pain is a common clinical problem. Multiple causes can generate hip or groin pain, often sharing clinical and demographic characteristics. Diagnostic imaging tests play an important role in the etiological diagnosis. New forms of extra-articular hip impingement have recently been recognized as a cause of hip pain and limited function especially in young active patients. These conditions include ischiofemoral impingement, anterior inferior iliac spine and subspine impingement, iliopsoas impingement and greater trochanteric-pelvic impingement. In general, they are caused by a mechanical conflict with an abnormal or excessive contact between the proximal femur and pelvis and/or soft tissue between them. In this manuscript we review the physiopathology, clinical presentation, the most common radiologic findings and treatment of these forms of extra-articular hip impingement.


Assuntos
Impacto Femoroacetabular , Impacto Femoroacetabular/diagnóstico por imagem , Impacto Femoroacetabular/etiologia , Humanos
7.
Radiología (Madr., Ed. impr.) ; 58(4): 246-256, jul.-ago. 2016. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-154183

RESUMO

La otosclerosis es una otodistrofia primaria del hueso temporal que produce una hipoacusia de transmisión progresiva. El diagnóstico es generalmente clínico, pero en ocasiones es necesaria la realización de una tomografía computarizada multidetector (TCMD), que es la técnica de imagen de elección. El objetivo de este artículo es realizar una actualización sistemática de la utilidad de las técnicas de imagen en el diagnóstico y la valoración posquirúrgica de la otosclerosis, fundamentalmente del papel de la TCMD, con el fin de disminuir el riesgo quirúrgico (AU)


Otosclerosis is a primary osteodystrophy of the temporal bone that causes progressive conductive hearing loss. The diagnosis is generally clinical, but multidetector CT (MDCT), the imaging technique of choice, is sometimes necessary. The objective of this article is to systematically review the usefulness of imaging techniques for the diagnosis and postsurgical assessment of otosclerosis, fundamentally the role of MDCT, to decrease the surgical risk (AU)


Assuntos
Humanos , Masculino , Feminino , Otosclerose , Diagnóstico por Imagem/instrumentação , Diagnóstico por Imagem/métodos , Tomografia Computadorizada Multidetectores/métodos , Tomografia Computadorizada Multidetectores , Cirurgia do Estribo/métodos , Cirurgia do Estribo , Diagnóstico Diferencial , Perda Auditiva Súbita/complicações , Perda Auditiva Súbita , Imageamento por Ressonância Magnética/métodos , Espectroscopia de Ressonância Magnética/métodos , Complicações Pós-Operatórias
8.
Radiologia ; 58(4): 246-56, 2016.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-27267384

RESUMO

Otosclerosis is a primary osteodystrophy of the temporal bone that causes progressive conductive hearing loss. The diagnosis is generally clinical, but multidetector CT (MDCT), the imaging technique of choice, is sometimes necessary. The objective of this article is to systematically review the usefulness of imaging techniques for the diagnosis and postsurgical assessment of otosclerosis, fundamentally the role of MDCT, to decrease the surgical risk.


Assuntos
Otosclerose/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Tomografia Computadorizada Multidetectores
9.
Lasers Med Sci ; 31(2): 383-92, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26754180

RESUMO

Low-level laser therapy (LLLT) has proved to have biostimulating effects on tissues over which they are applied, therefore accelerating the healing process. Most studies in implantology were focused on a reduction of the duration of osseointegration. There exist few articles analyzing the potential effects of these therapies on the osseointegration of titanium dental implants. The aim of this study was to assess the effect of LLLT on the interaction between the bone and the titanium dental implant and the methodological quality of the studies. We conducted an electronic search in PubMed, ISI Web, and Cochrane Library. From 37 references obtained, only 14 articles met the inclusion criteria. The analysis of the studies shows that most of the experiments were performed in animals, which have a high risk of bias from the methodological point of view. Only two studies were conducted in human bone under different conditions. Several protocols for the use of low-power laser and different types of laser for all studies analyzed were used. Although animal studies have shown a positive effect on osseointegration of titanium implants, it can be concluded that it is necessary to improve and define a unique protocol to offer a more conclusive result by meta-analysis.


Assuntos
Implantes Dentários , Terapia com Luz de Baixa Intensidade/métodos , Titânio , Animais , Odontologia Baseada em Evidências , Humanos
10.
Sanid. mil ; 70(4): 270-273, oct.-dic. 2014. ilus
Artigo em Espanhol | IBECS | ID: ibc-131777

RESUMO

Presentamos el caso de varón joven que ingresa en Unidad Cuidados Intensivos con dolor torácico como manifestación de insuficiencia aórtica masiva secundaria a endocarditis infecciosa sobre válvula aórtica bicúspide. El ecocardiograma transesofágico muestra además como complicación grave pseudoaneurisma en seno de Valsalva que comunica tanto con raíz aórtica como con ventrículo izquierdo


We present the case of a young man who is admitted in Intensive Care Unit with chest pain as manifestation of masive aortic regurgitation due to infective endocarditis in bicuspid aortic valve. The transesophageal echocardiography also shows, as severe complication, pseudoaneurysm of the sinus of Valsalva that communicates with both aortic root as left ventricle


Assuntos
Humanos , Masculino , Adulto Jovem , Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/diagnóstico , Lesões das Artérias Carótidas/diagnóstico , Endocardite/complicações , Estenose da Valva Aórtica/metabolismo , Estenose da Valva Aórtica , Estenose da Valva Aórtica/cirurgia , Lesões das Artérias Carótidas/complicações , Endocardite/prevenção & controle
11.
Enferm. glob ; 13(35): 384-397, jul. 2014. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-123981

RESUMO

El presente estudio intenta analizar para un grupo de mujeres embarazadas si existe una relación entre las características de personalidad, la percepción del dolor y la elección o no de analgesia durante el parto. Para ello se llevó a cabo un estudio de tipo longitudinal multicéntrico, de una cohorte prospectiva de 62 mujeres gestantes seleccionadas por muestreo consecutivo, que acuden a la consulta de bienestar fetal entre la semana 36-38 de embarazo en dos hospitales de la provincia de Jaén. Se emplearon cuestionarios estructurados para la valoración de las diferentes variables. Los resultados del análisis de regresión para el modelo de predicción de la intensidad del dolor a partir de las dimensiones de personalidad se realizó en función de que las mujeres hubieran usado o no medidas alternativas de alivio del dolor. De las dimensiones generales de personalidad únicamente hizo una aportación significativa la variable Afabilidad en el grupo sin medidas alternativas de alivio del dolor. De las subdimensiones de personalidad, tanto el Control Emocional como el Control de Impulsos hicieron una aportación significativa al modelo en el Grupo con medidas; y la Perseverancia, el Controlde Impulsos y la Apertura a la Cultura la hicieron en el Grupo sin medidas. Se encontró una relación inversa entre la edad y la intensidad total del dolor r = -0.301 (p=0.018).Además se encontraron diferencias significativas en la intensidad total del dolor y duración del alumbramiento en función de que las mujeres tuvieran o no medidas alternativas. Las otras dos variables analizadas, tipo de analgesia previa o epidural, no provocaron diferencias significativas en ninguna de las variables analizadas (AU)


The present study aims to analyze in a group of pregnant women if there is a relationship between personality characteristics, pain perception and the choice whether or not analgesia during labor. To do this we developed a multicenter longitudinal study , in a prospective cohort of 62 pregnant women selected by consecutive sampling, attending the fetal wellness visit between weeks 36-38 of pregnancy in two hospitals in the province of Jaén. Structured questionnaires were used to assess the different variables. The results of regression analysis for the prediction model of pain intensity from the dimensions of personality were carried out according to whether women had used or not alternative measures of pain relief. In the general dimensions of personality alone made a significant contribution Agreeableness variable in the group without alternative measures of pain relief. Sub-dimensions of personality, emotional control as both impulse control made a significant contribution to the model measures within the Group and Perseverance, Impulse Control and Openness to Culture in the group made it without measures. We found an inverse relationship between age and total pain intensity r = -0,301 (p = 0.018). In addition, significant differences in total pain intensity and duration of delivery, depending on whether or not women had alternative measures. The other two variables studied, type of previous or epidural/analgesia caused no significant differences in any of the variables analyzed (AU)


Assuntos
Humanos , Feminino , Gravidez , Analgesia Obstétrica , Anestesia Obstétrica , Preferência do Paciente/psicologia , Limiar da Dor , Estudos Prospectivos , Determinação da Personalidade , Dor do Parto/tratamento farmacológico , Manejo da Dor/métodos
12.
J Environ Radioact ; 131: 89-109, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24238917

RESUMO

Decisions on permitting, controlling and monitoring releases of radioactivity into the environment rely on a great variety of factors. Important among these is the prospective assessment of radionuclide behavior in the environment, including migration and accumulation among and within specific environmental media, and the resulting environmental and human health impacts. Models and techniques to undertake such assessments have been developed over several decades based on knowledge of the ecosystems involved, as well as monitoring of previous radionuclide releases to the environment, laboratory experiments and other related research. This paper presents developments in the assessment of radiation doses and related research for some of the key radionuclides identified as of potential significance in the context of releases to the biosphere from disposal facilities for solid radioactive waste. Since releases to the biosphere from disposal facilities involve transfers from the geosphere to the biosphere, an important aspect is the combined effects of surface hydrology, near-surface hydrogeology and chemical gradients on speciation and radionuclide mobility in the zone in which the geosphere and biosphere overlap (herein described as the geosphere-biosphere subsystem). In turn, these aspects of the environment can be modified as a result of environmental change over the thousands of years that have to be considered in radioactive waste disposal safety assessments. Building on the experience from improved understanding of the behavior of the key radionuclides, this paper proceeds to describe development of a generic methodology for representing the processes and environmental changes that are characteristic of the interface between the geosphere and the biosphere. The information that is provided and the methodology that is described are based on international collaborative work implemented through the BIOPROTA forum, www.bioprota.org.


Assuntos
Meio Ambiente , Resíduos Radioativos , Instalações de Eliminação de Resíduos , Fenômenos Geológicos , Radioisótopos
14.
J Fish Biol ; 81(5): 1501-13, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23020558

RESUMO

The relative roles of temperature and food availability on the seasonal and daily growth of whitefish Coregonus lavaretus larvae were investigated in the oligotrophic peri-alpine Lake Annecy, France. During the spring from 2004 to 2007, surface water temperature and density of potential zooplankton prey were monitored, and 2688 larvae were caught and measured. In addition, the daily growth of 130 larvae was estimated retrospectively by investigating the microstructure of their otoliths. Temperature played the predominant role in controlling both seasonal and daily growth of early larvae. In contrast, the abundance of Mesocyclops leuckarti and larval density was only slightly correlated to larval growth, suggesting no food limitation nor strong interindividual competition over the study period. Overall, these findings run counter to concerns about potential food limitation, but sound a warning about the potential impact of climate change on fish ecology and fisheries management.


Assuntos
Lagos , Salmonidae/crescimento & desenvolvimento , Temperatura , Animais , Copépodes/fisiologia , Cadeia Alimentar , Densidade Demográfica , Estações do Ano
15.
Radiología (Madr., Ed. impr.) ; 54(5): 410-423, sept.-oct. 2012. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-106743

RESUMO

La absorciometría con rayos X de doble energía (DXA o DEXA) es la técnica de elección para diagnosticar la osteoporosis y monitorizar la respuesta al tratamiento. Además, es útil para estudiar la composición corporal. En los últimos años han surgido nuevas aplicaciones como la morfometría vertebral, estudiando la columna en visión lateral, la integración de prótesis en ortopedia, o la lipodistrofia en los pacientes con infección por VIH, aunque su utilización en estos casos no está bien consolidada. En el estudio de la osteoporosis, densitometría es precisa y exacta. Para ello, es imprescindible optimizar cada etapa del proceso diagnóstico, cuidando la adquisición, el análisis de imágenes y la interpretación de los resultados. Por ello, para obtener la máxima utilidad para el clínico y el paciente, el radiólogo debe conocer la técnica, sus indicaciones y las dificultades. El objetivo de este artículo es revisar la DXA, haciendo hincapié en sus fundamentos, modalidades, metodología y aplicaciones clínicas (AU)


Dual-energy X-ray absorptiometry (DXA; DEXA) is the technique of choice to diagnose osteoporosis and to monitor the response to treatment. It is also useful for measuring body composition. In recent years, new applications have been developed, including vertebral morphometry through the study of the lateral spine, prosthesis integration in orthopedics, and lipodystrophy in HIV+ patients, although its use in these cases is not well established. DXA densitometry is accurate and precise. It is essential to optimize each step of the diagnostic process, taking care to ensure the best acquisition, image analysis, and interpretation of the results. Thus, to obtain the greatest utility from DXA, radiologists need to know the technique, its indications, and its pitfalls. This article reviews the fundamentals, modalities, methods, and clinical applications of DXA (AU)


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Absorciometria de Fóton/instrumentação , Absorciometria de Fóton/métodos , Densitometria/métodos , Osteoporose/complicações , Osteoporose/diagnóstico , Composição Corporal/efeitos da radiação , Densidade Óssea/efeitos da radiação , Absorciometria de Fóton/tendências , Absorciometria de Fóton , Tecnologia Radiológica/métodos , Tecnologia Radiológica/tendências
16.
Water Sci Technol ; 66(10): 2083-9, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22949237

RESUMO

The main aquifer of the Llobregat delta (Barcelona, Spain) has been affected by seawater intrusion since the 1960s. The Catalan Water Agency (ACA) has sponsored the construction of a positive hydraulic barrier in order to stop the progress of seawater intrusion advance due to the intensive aquifer development. The hydraulic barrier consists of 15 wells into which highly treated reclaimed water from the waste water treatment plant of the Baix Llobregat is injected. Water is subjected, prior to the distribution to the injection wells, to secondary and tertiary treatments, and later to ultrafiltration, UV disinfection without chlorination, and salinity reduction through reverse osmosis. A preliminary pilot phase of the project was started in late 2007, with highly positive results, and the second phase started in mid 2010. Hydrogeological and hydrochemical monitoring data indicate an efficient performance and aquifer improvement. The evaluation of such efficiency and operational costs has been analyzed and discussed.


Assuntos
Água Subterrânea , Reciclagem , Água do Mar , Eliminação de Resíduos Líquidos , Desinfecção , Monitoramento Ambiental/métodos , Reciclagem/economia , Espanha , Fatores de Tempo , Ultrafiltração , Raios Ultravioleta , Poluentes Químicos da Água , Poluição Química da Água , Purificação da Água
17.
Radiologia ; 54(5): 410-23, 2012.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-22285678

RESUMO

Dual-energy X-ray absorptiometry (DXA; DEXA) is the technique of choice to diagnose osteoporosis and to monitor the response to treatment. It is also useful for measuring body composition. In recent years, new applications have been developed, including vertebral morphometry through the study of the lateral spine, prosthesis integration in orthopedics, and lipodystrophy in HIV+ patients, although its use in these cases is not well established. DXA densitometry is accurate and precise. It is essential to optimize each step of the diagnostic process, taking care to ensure the best acquisition, image analysis, and interpretation of the results. Thus, to obtain the greatest utility from DXA, radiologists need to know the technique, its indications, and its pitfalls. This article reviews the fundamentals, modalities, methods, and clinical applications of DXA.


Assuntos
Absorciometria de Fóton , Osteoporose/diagnóstico por imagem , Absorciometria de Fóton/métodos , Humanos
18.
Rev. neurol. (Ed. impr.) ; 52(2): 95-100, 16 ene., 2011.
Artigo em Espanhol | IBECS | ID: ibc-86968

RESUMO

El tratamiento sintomático de la enfermedad de Alzheimer se realiza en la actualidad a través de una doble aproximación terapéutica: con los inhibidores de la acetilcolinesterasa, cuyo mecanismo de acción se basa en la inhibición selectiva de ésta, y con la memantina, que actúa bloqueando la activación tónica patológica de los receptores NMDA. Ambos fármacos han sido aprobados para el tratamiento de la enfermedad de Alzheimer y presentan un espectro de indicación terapéutica que es compartido en la fase moderada (MMSE: 10-20). Dado que ambas aproximaciones terapéuticas presentan mecanismos de acción complementarios y comparten indicación terapéutica en un espectro sintomático amplio de la enfermedad, el objetivo de este artículo es revisar la evidencia existente sobre la efi cacia de la terapia combinada para poder inferir su utilidad desde el inicio del tratamiento (AU)


The symptomatic treatment of Alzheimer’s disease is currently carried out using a twofold therapeutic approach involving acetylcholinesterase inhibitors, whose mechanism of action is based on the selective inhibition of this enzyme, and memantine, which acts by blocking the pathological tonic activation of NMDA receptors. Both drugs have been approved for the treatment of Alzheimer’s disease and present a therapeutic indication spectrum that is shared in the moderate phase (MMSE: 10-20). Since both therapeutic approaches off er the same complementary mechanisms of action and share the same therapeutic indication over a wide symptomatic disease spectrum, the aim of this article is to review the existing evidence on the eff ectiveness of combined therapy so as to be able to discern its usefulness from the moment treatment begins (AU)


Assuntos
Humanos , Doença de Alzheimer/tratamento farmacológico , Memantina/farmacocinética , Inibidores da Colinesterase/uso terapêutico , Demência/tratamento farmacológico , Quimioterapia Combinada , Atividades Cotidianas , Qualidade de Vida
19.
An. psiquiatr ; 24(6): 267-279, nov.-dic. 2008. tab
Artigo em Es | IBECS | ID: ibc-70415

RESUMO

Revisamos el trastorno bipolar (TB) infantil y juvenil:diagnóstico, epidemiología, etiología (factores genéticosy ambientales), comorbilidades, curso, suicidio, tratamiento,prevención e investigación futura en el TBpediátrico. El TB de inicio infantil y de la primera adolescenciapuede ser una forma más severa del trastornoque el de inicio en el final de la adolescencia o en laadultez, los subtipos del TB infanto-juvenil puedenentenderse como fenotipos en un continuo o espectrobipolar. Su prevalencia puede estar subestimada. El cursodel trastorno es grave con alto consumo de recursosmédicos y educativos, severo deterioro psicosocial yuna estrecha relación con el fenotipo adulto más grave.A pesar de su carga genética, los factores ambientalesinfluyen decisivamente en la gravedad de la psicopatologíay el curso. El tratamiento combinado con fármacos,psicoeducación y psicoterapia mejora el pronóstico.Se requieren criterios más específicos para los niñosque recojan mejor su fenomenología


We review bipolar disorder (BD) in childhood and adolescence: diagnostic, epidemiology, aetiology(genetic and environmental factors), comorbidities,course, suicide, treatment, outcome and future researchabout pediatric BD. Bipolar disorder with childhood orfirst adolescent onset could be a more severe form ofdisorder than adult or late-adolescence onset BD and wefound that the subtypes of the childhood and adolescentBD could be phenotypes on a continuum or bipolarspectrum. The prevalence may be underestimated. Thecourse of BD is severe with high use of medical andeducational resources and severe psychosocial impairmentand it is also related with the most severe adultphenotype. In spite of its genetic load, the environmentalfactors influence decisively in the severity of thepsychopathology and the course. Combined treatmentwith pharmacotherapy, psychoeducational and psychotherapyapproach improves the outcome. More specificdiagnostic criteria are needed for the children thatbetter fulfill this phenomenology


Assuntos
Humanos , Masculino , Feminino , Adolescente , Pré-Escolar , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/prevenção & controle , Transtorno Bipolar/psicologia , Tentativa de Suicídio/prevenção & controle , Tentativa de Suicídio/psicologia , Neurobiologia/métodos , Comorbidade , Carência Psicossocial , Apoio Social , Neurobiologia/estatística & dados numéricos , Neurobiologia/tendências
20.
Rev. psiquiatr. infanto-juv ; 24(2/4): 200-212, abr.-dic. 2007. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-87257

RESUMO

Objetivo: Se examina el perfil de personalidad asociado a diferentes diagnósticos clínicos en una muestra de pacientes ambulatorios del Centro de Salud Mental Infanto-Juvenil. Material y métodos: 77 adolescentes entre 13 y 17 años fueron evaluados con el MMPI-A. Hemos realizado un análisis retrospectivo de las historias clínicas para obtener los datos sociodemográficos y clínicos (edad, sexo, cronicidad y diagnóstico CIE-10 y CFTMIA). Mostramos el perfil global y por diagnóstico, los estadísticos descriptivos y comparamos las medias para los diferentes diagnósticos (test de Kruskal- Wallis, Median test, Kolmogorov- Smirnov y test de Mann Whitney) y edades (correlaciones divariadas de Pearson, test de Kruskal- Wallis y test de Mann Whitney). Resultados: El total de la muestra presenta elevaciones moderadas en las escalas de depresión y desviación psicopática. Se asocian diferentes perfiles a cada diagnóstico edad. Los trastornos psicóticos y los trastornos mixtos de la conducta y las emociones muestran un perfil más psicopatológico en las escalas clínicas y mayor deterioro psicosocial reflejado en las escalas de contenido. Los adolescentes más mayores (edades de 16 y 17) tienen puntuaciones más altas que los adolescentes jóvenes (13 a 15 años) en depresión e introversión. Discusión: Los estudios revisados sugieren que hay un sustancial grado de asociación entre el inicio de los trastornos del eje I y la psicopatología del eje II en el final de la adolescencia y el inicio de la primera adultez. Comentamos nuestros resultados y discutimos la asociación entre trastornos mentales en la infancia y adolescencia y alteraciones de la personalidad. Conclusiones: Identificar y tratar con éxito los trastornos en la infancia puede ayudar a reducir el riesgo de desarrollar un trastorno de personalidad adulto. Se necesita más investigación para desarrollar recomendaciones de evaluación y tratamiento para las manifestaciones tempranas de las alteraciones de la personalidad (AU)


Objective: We examined the personality profile associated to diferents diagnoses in a sample of outpatients of the Mental Health Center for Children and adolescents. Method: 77 adolescents with ages from 13 to 17 were assessed with the MMPI-A. We made a prospective analysis of each clinical report to obtain sociodemographic and clinical data (age, gender, cronicity, diagnostic with CIE- 10 and CFTMA).We show the profiles of both the total sample and of each diagnostic cathegory using descriptive statistics and compared means for the diffe- 201 rent diagnoses (using Kruskal- Wallis test, Median test, Mann-Whitney test and Kolmogorov- Smirnov test) and for ages (using Pearson bivariate correlations, Kruskal- Wallis test and Mann- Whitney test). Results: All the sample show moderate elevations in Depression and Psychopatic deviation. Differents profiles are associated to each diagnosis and age: psychotic and mixed disorders of conduct and emotions show more severe psychopathology profile in clinical scales and more psychosocial impairment reflected in content scales. Older adolescents (age 16 and 17) have more elevated and significative scores than younger adolescents (age 13 to 15) in depression and introversion. Discussion: Studies revised suggest a substantial degree of association between early onset axis I disorders and axis II psychopathology in late adolescence and young adults. We comment our results and discuss the association between mental disorders in childhood and adolescence and personality disfunction. Conclusions: Identification and successful treatment of childhood disorders and severe early impairment, may help to reduce the risk of subsequent development of an adult personality disorder. More research is needed to develop assessment and treatment recommendations addressing the early manifestations of personality disturbance (AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Comportamento do Adolescente/psicologia , Determinação da Personalidade , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , MMPI , Transtornos da Personalidade/epidemiologia , Transtornos do Neurodesenvolvimento/epidemiologia
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