Impact of ADHD symptoms on family functioning, family burden and parents’ quality of life in a hospital area in Spain

Background and objectives: The aim of this study was to evaluate whether ADHD symptom severity and ADHD subtype are associated with family functioning, family burden and quality of life, in a sample of parents of children diagnosed with ADHD.MethodsSeventy-four parents of children diagnosed with ADHD were recruited at an Outpatient Child & Adolescent Mental Health Clinic in Madrid (Spain) and afterwards completed four electronical self-administered scales to determine their perceived family functioning, family burden and quality of life, as well as the severity and subtype of ADHD symptoms in their children.ResultsSeverity of children’s ADHD symptoms negatively affected parents’ quality of life, family functioning and family burden. Higher scores in inattention and combined subtypes were correlated with lower results in those domains. In adjusted correlations, the SWAN hyperactivity/impulsivity subscale significantly correlated with the four scales.ConclusionsThese results suggest that severity of the ADHD symptoms has a negative impact on parent’s quality of life and family functioning in inattention and combined subtypes. Family therapy and other interventions targeted towards improving family relationships and caregivers’ wellbeing should be considered when managing ADHD in the clinical practice. Electronic measurement tools are a promising method of evaluation in mental health research. (AU)

Nivel de evidencia científica en la revista Rehabilitación / Level of scientific evidence in the Rehabilitacion journal

Introducción. El objetivo de este estudio es evaluar el nivel de evidencia científica producido en la revista Rehabilitación entre los años 1998 y 2003. Material y métodos. Revisión de los artículos publicados en la revista Rehabilitación, en el período entre enero de 1998 y diciembre de 2003. Se han utilizado las guías de lectura crítica de Sackett para evaluar la validez interna y la clasificación de niveles de evidencia del Centro de Medicina Basada en la Evidencia (MBE) de la Universidad de Oxford. Resultados. Los temas más frecuentes son Traumatología y Ortopedia, que junto con Neurología suponen hasta un 50 %. Un 4,6 % de los artículos tienen como tema principal la MBE. Presentaron un nivel de evidencia 4 ó 5, equivalente a estudios descriptivos u opinión de expertos el 92,9 % de los artículos sobre terapia, el 62,9 % sobre pruebas diagnósticas, el 60 % sobre etiología y factores de riesgo y el 57,1 % sobre pronóstico. Se encontraron únicamente 3 ensayos clínicos aleatorizados, todos ellos sobre distintos tipos de terapia (ortesis, ultrasonidos y ejercicio). Conclusión. Los resultados de la revisión muestran que la mayoría de la producción científica en la revista Rehabilitación presenta un bajo nivel de evidencia destacando la escasez de ensayos clínicos aleatorizados. Sin embargo hemos de resaltar una favorable evolución para alcanzar un mayor nivel científico, en cuanto a la metodología y técnicas estadísticas empleadas en los últimos años. También se valora como positiva la progresiva sustitución de las revisiones narrativas clásicas para dar paso a revisiones sistemáticas

Introduction. The objective of this study is to evaluate the level of scientific evidence produced in the journal Rehabilitación between the years 1998 and 2003. Material and methods. Review of the articles published in the journal Rehabilitación, in the period between January 1998 and December 2003. Sackett's guide to critical reading was used to evaluate the internal validity and classification of the evidence levels of the Evidence Based Medicine Site (EBM) of the University of Oxford. Results. The most frequent subjects are Traumatology and Orthopedia, which together with Neurology, account for 50 %. The main subject of 4.6 % of the articles is EBM. A total of 92.9 % of the articles on therapy, 62.9 % on diagnostic tests, 60 % on etiology and risk factors and 57.1 % on prognosis have a 4 or 5 level of evidence, equivalent to descriptive studies or expert's opinion. Only 3 randomized clinical trials were found, all of them on different types of therapy (orthesis, ultrasound and exercise). Conclusion. The results of the review show that most of the scientific production in the Rehabilitación journal has a low level of evidence, the scarcity of randomized clinical trials standing out. However, we have to stress a favourable evolution to reach a major scientific level in regards to methodology and statistical techniques used in the last years. The progressive substitution of the classical narrative reviews to obtain systematic reviews is also evaluated as positive

Respirar sin problemas. El yoga, una técnica eficaz para los enfermos con asma / Breathing without difficulty... yoga as an effective technique for asthma patients

No disponible

[Omeprazole in the prophylaxis of Mendelson syndrome in elective surgery]. / Omeprazol en la profilaxis del síndrome de Mendelson en cirugía electiva.

AIMS: To study the efficacy of different doses of omeprazole and the influence of premedication in the prophylaxis of the acid aspiration syndrome. METHODS: A double blind prospective study was carried out ASA I-III on 103 patients (mean age 51.08 yr) undergoing either general, gynecological or orthopedic surgery, allocated into 4 groups. Group NP: 24 non premedicated patients; group P: 29 patients premedicated with 1 mg of lorazepam the previous night and 50 mg of meperidine 1 hour before surgery and haloperidol or dipotassic chlorazepate according to age; group 020: 25 patients premedicated with the same drugs and doses as in group P plus 20 mg or oral omeprazole the night prior to surgery; group 040: 25 patients premedicated as in group P 40 mg of oral omeprazol the night prior to surgery. Following induction of anesthesia a nasogastric tube was placed and gastric juice withdrawn to determine the pH; were excluded patients with an aspiration volume of less than 8 ml. RESULTS: No significant differences were found in regard to pH among the non premedicated and premedicated groups, however a change between the latter two groups having received omeprazole was observed. The results of the pH were significantly higher in the group treated with 40 mg of omeprazole (mean 4.87 +/- SD 2.35) with respect to the group treated with 20 mg of omeprazole (mean 3.78 SD +/- 2.35). In the group treated with 40 mg of omeprazole, the incidence of pH < 1.5 was 4% vs 24% of cases in the group treated with 20 mg of omeprazole. CONCLUSIONS: Premedication with 40 mg of oral omeprazol the night prior to surgery increases pH up to safe values for the prophylaxis of the acid aspiration syndrome.