Search

Resumen La estadificacion clinica es una herramienta diagnostica utilizada en otras especialidades de la medicina que surge de la combinacion de un enfoque categorial y dimensional. En las ultimas 2 decadas, se ha planteado su aplicacion en el campo de la psiquiatria, fundamentalmente como herramienta de ayuda diagnostica, de orientacion terapeutica y pronostica. En este trabajo se revisan los modelos de estadificacion clinica que han sido propuestos hasta la fecha para el trastorno bipolar, la depresion y la esquizofrenia. Se realizo una busqueda bibliografica en las bases de datos PubMed y Medline. Se seleccionaron con base en los criterios de inclusion y exclusion un total de 15 estudios. Se describen y comparan las caracteristicas de cada uno de los modelos agrupados segun el tipo de trastorno para el que fueron propuestos (trastorno bipolar: 4; depresion: 5; esquizofrenia: 6). Como conclusion, identificamos la necesidad de validar empiricamente dichos modelos para asi demostrar que son una herramienta util en la practica clinica habitual.

Background: COVID-19 is the pandemic most affected since the 1918 influenza In order to control its effects, the governments of different countries, including Spain, adopted exceptional measures such as lockdown and the suspension of non-essential economic activity Studies carried out in China, where the population was also confined, have found an increase in the prevalence of post-traumatic stress symptom among the most affected regions compared to other less affected [1] Aim: To describe the presence of post-traumatic symptom among a large sample from the general population in the different regions of Spain after two weeks from the declaration of the state of alarm in Spain Methods The data was obtained through an online questionnaire two weeks after the declaration of the state of alarm in Spain (performed between 19 and 26 March, 2020) addressed to general population over eighteen years old [2] It was spread using an online “snowball” method Assessment sociodemographic, clinical variables and psychometric scales Post-traumatic stress symptoms were measured by the Stressful Impact Scale (EIE), which consists of 15 items, divided into two subscales related to symtoms of intrusion and avoidance The SPSS v24 0 program was used in the statistical analysis Results: The sample consists of 21,153 individuals [30 3% men] with an average age of 39 75 ± 14 04 (18 to 100 years) A) Intrusive response: regions with the highest prevalence of intrusive response are Castilla La Mancha (31 2%), Andalusia (30 7%) and Extremadura (26 2%);regions with the lowest prevalence of intrusive response are Aragon (18 9%), Navarra (16 0%) and La Rioja (21 4%) B)Avoidance response: regions with the highest prevalence of avoidance response are Andalusia (55 7%), Extremadura (53 7%) and Castilla La Mancha (51 3%);regions with the lowest prevalence of avoidance response are Galicia (39%), Aragon (37 6%) and Navarra (32 7%) In Madrid, the prevalence of avoidant and intrusive symptoms was 43 1% and 26 0%, respectively Conclussions: Avoidance symptoms were more frequent than intrusion symptoms in all regions Andalusia, Extremadura and Castilla La Mancha are the regions with the highest prevalence of post-traumatic stress symptoms, both intrusive and avoidant In addition, Aragon and Navarra presented low post-traumatic symptoms prevalence The situation in the Community of Madrid is particularly garish Despite being the region most affected by the COVID-19 pandemic in Spain, the prevalence of post-traumatic stress symptoms, both intrusive and avoidant, is close to average The representativeness of the regions in the sample is a limitation of our study However, the Madrid region is well represented in terms of the percentage share of the total sample The results obtained do not seem consistent with the epidemiological situation of these regions at that time It neither are according to the findings of other studies, so it would be necessary to investigate the existence of other factors that contribute to explaining these results No conflict of interest

Glutamate is the major excitatory neurotransmitter in the central nervous system, and it is linked with the amino acid glutamine through a metabolic relationship of enzymatic compound interconversion and transportation, also known as the glutamate-glutamine cycle.A growing body of evidence suggests involvement of the glutamatergic neurotransmitter system in suicidal behaviours. The initial evidence comes from the pathophysiology of neuropsychiatric disorders, as disruptions in glutamate neurotransmission have been found underlying pathology in multiple suicide-related psychiatric conditions such as major depressive disorder, schizophrenia, post-traumatic stress disorder, and bipolar disorder.Existing data from experimental animal models and human in vivo studies also demonstrate that glutamate plays a key role in suicide-related personality traits including aggression and impulsive aggression.Further studies on glutamate system dysfunction underlying suicidal behaviours have focused on the different steps of the glutamate-glutamine cycle: an inflammation-mediated reduction of glutamine synthetase activity has been found in depressed suicide attempters, phosphate-activated glutaminase genes are reduced in suicide completers, and gene expression abnormalities in NMDA receptors have also been discovered in suicide victims.Evidence of a role of the glutamate-glutamine cycle in suicidal behaviours unveils new targets for anti-suicide interventions. Lithium's mechanism to reduce the risk of suicide in people with mood disorders may be related to its ability to increase glutamine synthetase, whereas novel NMDA antagonists such as ketamine [or its S(+) enantiomer esketamine] have already demonstrated positive results in reducing suicidal ideation.

Given the lack of information on the psychological impact of COVID-19 on people aged ≥60, we aimed to describe their psychological responses to this pandemic and lockdown situation and compare them with those under 60 years of age.Secondary analysis of a larger online cross-sectional study designed to determine the psychological impact of the COVID-19 pandemic and lockdown across Spain. We analyzed a total of 1690 respondents aged ≥60 years and compared them with 13,363 respondents under 60 years of age. We employed the Depression, Anxiety, and Stress Scale and the Impact of Event Scale to evaluate psychological responses.In all, 52.6% of women and 34.3% of men were found to be probable cases of any emotional distress (Contrary to our hypothesis and despite the high percentage of emotional distress we found in older adults, especially women, they are actually at lower risk of developing depressive and stress consequences from COVID-19 and lockdown than those under 60 years of age. That said, we believe our results highlight the need for expert guidance in this age group, especially older women living alone.

Until now, no follow-up studies had simultaneously evaluated executive functions, other non-executive functions related cognitive func-tions, and impulsivity in a large enough sample of moderate to severe alcohol use disorder (AUD) patients. The main objective of the present study was to compare neuropsychological performance and its relation to alcohol use in patients with AUD and healthy controls, and to determine the evolution of cognitive impairment and alcohol use over time. For this purpose, a 6-month follow-up study was designed to compare a sample of 100 outpatients with AUD (DSM-5 criteria) with 100 matched healthy controls. The patient group was recruited from three different health centres in Spain located in Orense, Gijon and Barcelona. The assessment consisted of a systematic battery of cognitive tests to evaluate the following functions: attention, anterograde memory, processing speed, verbal fluency, executive function, and implicit attitude toward alcoholic beverages. We also compared clinical variables associated with alcohol use, such as alcohol craving and impulsivity. After 6 months, anterograde memory, working memory, and resistance to interference improved remarkably in AUD patients, although not enough to match the normal population. With regard to clinical variables, there was a small but significant cognitive improve-ment related to a reduction in alcohol use and impulsivity. Executive dysfunction and other non-executive functions related cognitive func-tions impairment can be considered prognostic factors in outpatients with moderate to severe AUD.

High prevalence of smoking in people with severe mental disorders (SMD) contributes to their medical morbidity and reduced life expectancy. Despite the evidence of gender differences in smoking cessation, few studies have tested those differences among people with SMD. This is a non-randomized, open-label, prospective, 9-month follow-up multicentre trial to examine gender differences in the efficacy, safety and tolerability of a Multi-Component Smoking Cessation Support Programme (McSCSP). The results showed that there were no significant differences in short- (males 44.9% vs females 57.7%, chi-square = 1.112, p = 0.292) or long-term efficacy (week 24: males 40.8%, females 42.3%, chi-square = 0.016, p = 0.901; week 36: males 36.7%, females 38.5%, chi-square = 0.022, p = 0.883) between gender, neither controlled by diagnosis or treatment. Regarding safety and tolerability, there was significant increase in abdominal perimeter in males [from 105.98 (SD 13.28) to 108.52 (SD 14.01), t = -3.436, p = 0.002)], but not in females. However, there were no significant gender differences in adverse events (constipation, abnormal/vivid dreams, nausea/vomiting or skin rash/redness around patch site). In conclusion, we have demonstrated that is effective and safe to help either male or female patients with stabilized SMD to quit smoking. However, it might be a tendency in females to respond better to varenicline treatment in the short term. Future research with larger samples is required to more clearly determine whether or not the there are differences, in addition to their reliability and robustness.

Despite the proven association between smoking and high rates of medical morbidity and reduced life expectancy in people with severe mental disorders (SMD), their smoking rates do not decline as they do in the general population. We carried out a non-randomized, open-label, prospective, 9-month follow-up multicentre trial to investigate the clinical efficacy, safety and tolerability of a 12-week smoking cessation programme for patients with SMD in the community under real-world clinical conditions. Eighty-two adult outpatients with schizophrenic/bipolar disorder smoking ≥15 cigarettes/day were assigned by shared decision between doctors and patients to transdermal nicotine patches (TNP) [36(46.2%)] or varenicline [39(50%)]. Short-term efficacy: The 12-week 7-day smoking cessation (self-reported cigarettes/day=0 and breath carbon monoxide levels≤9ppm) prevalence was 49.3%, without statistically significant differences between medications (TNP 50.0% vs varenicline 48.6%, chi-square=0.015, p=1.000). Long-term efficacy: At weeks 24 and 36, 41.3 and 37.3% of patients were abstinent, with no statistically significant differences between treatments. Safety and Tolerability: no patients made suicide attempts/required hospitalization. There was no worsening on the psychometric scales. Patients significantly increased weight [TNP 1.1(2.8) vs varenicline 2.5(3.3), p=0.063], without significant changes in vital signs/laboratory results, except significant decreases in alkaline phosphatase and low-density lipoprotein-cholesterol levels in the varenicline group. Patients under varenicline more frequently presented nausea/vomiting (p

Symptomatology of schizophrenia is heterogeneous, there is not any pathognomonic symptom. Moreover, the diagnosis is difficult, since it is based on subjective information, instead of markers. The purpose of this study is to provide a review of the current status of blood-based biomarkers of psychopathological dimensions of schizophrenia. Inflammatory, hormonal or metabolic dysfunctions have been identified in patients with schizophrenia and it has attempted to establish biomarkers responsible for these dysfunctions. The identification of these biomarkers could contribute to the diagnosis and treatment of schizophrenia.

Symptomatology of schizophrenia is heterogeneous, there is not any pathognomonic symptom. Moreover, the diagnosis is difficult, since it is based on subjective information, instead of markers. The purpose of this study is to provide a review of the current status of blood-based biomarkers of psychopathological dimensions of schizophrenia. Inflammatory, hormonal or metabolic dysfunctions have been identified in patients with schizophrenia and it has attempted to establish biomarkers responsible for these dysfunctions. The identification of these biomarkers could contribute to the diagnosis and treatment of schizophrenia.

Aims: Smoking cessation in subjects with a severe mental illness (SMI) is a challenging but attainable goal. Furthermore, the identification of variables involved in the quitting process is a highly relevant factor in clinical practice. This study aimed to analyze the influence of smokers’ motivation in smoking reduction and cessation and select the most suitable way of measuring motivation. Methods: This is a secondary analysis of a 9-month, multicenter trial examining a Multicomponent Smoking Cessation Program in 82 adult outpatients with SMI. At the end of the preparation stage, the smokers’ motivational level was evaluated with the University of Rhode Island Change Assessment Scale. This allowed us to rate subjects using a continuous measure (“Readiness to Change,” RTC) and group them in “Stages of Change” (SOC). Regression analyses were carried out to identify predictors of the efficacy outcomes: a reduction in at least 50% of the cigarettes smoked per day (CPD), a reduction in the expired carbon monoxide (CO), and complete abstinence from smoking. Results: We studied differences in measurements of motivational levels independently (RTC and SOC) for patients who had a reduction in at least 50% of the CPD and for patients who achieved complete abstinence from smoking. However, these differences did not reach statistical significance during the follow-up study with a logistic mixed-effects model. In a linear mixed-effects model, the reduction of expired CO was significantly associated with RTC, at the end of the active treatment phase and during follow-up (β: –1.51; SD 0.82; p < 0.01). Conclusion: The motivation level achieved in the preparation phase predicted the reduction of expired CO over a given period when calculated by a continuous measure (RTC).

Clinical staging is a diagnostic tool used in other medical specialties, which has resulted from the combination of a categorical and dimensional approach. In the last 2decades, the usefulness of its application in the field of psychiatry has been suggested, mainly as a tool for diagnostic help, and therapeutic and prognostic orientation. In this paper we review the clinical staging models that have been proposed to date for bipolar disorder, depression and schizophrenia. A literature search was performed in PubMed and Medline databases. A total of 15 studies were selected according to inclusion and exclusion criteria. Models were grouped according to the type of disorder for which staging was proposed (bipolar disorder: 4, depression: 5, schizophrenia: 6), and their characteristics were described. As a conclusion, we identify the need to empirically validate these models to demonstrate that staging is a useful tool for clinical practice.

Introduction The study of administrative prevalence from cumulative psychiatric case registers allows the mental health state of the studied region and the functioning of its Health Services to be estimated. Methods Data were extracted from the Asturias Cumulative Psychiatric Case Register (RACPAS) between January 1st 1998 and December 3rd 2010. Characteristics of the population of the catchment area were studied, and their relationship with the administrative prevalence was analysed. Results The mean population in the studied period was 1,078,406 inhabitants. The Fritz index and the Youth and replacement indices of the active population decreased throughout the period. There was no significant increase in the prevalence of organic mental disorders, psychosis, mood disorders, and substance use in males, or behavioural disorders associated with somatic factors and physiological dysfunctions in females. There were significant gender differences in the prevalence of all disorders, except for personality disorders and organic mental disorders. Population ageing had a significant influence on the increase in the prevalence of most mental disorders in both males and females. Conclusions A slight general increase in the administrative prevalence of mental disorders is observed during the studied period, and it was influenced by population ageing.

Resumen Introduccion El estudio de la prevalencia administrativa a partir de los Registros Acumulativos de Casos Psiquiatricos permite tener una estimacion de la salud mental de la poblacion de una zona y del funcionamiento de sus servicios sanitarios. Metodos Analisis de los datos del Registro Acumulativo de Casos Psiquiatricos de Asturias (RACPAS) entre el 1-1-1998 y el 3-12-2010. Estudio de las caracteristicas de la poblacion de referencia y analisis de la asociacion de los indices sociodemograficos con la prevalencia de la enfermedad mental. Resultados La poblacion media en los anos estudiados fue de 1.078.406 con disminucion de los indices de juventud, de Fritz y de reemplazo de la poblacion activa. Se observo un leve incremento de la prevalencia de la mayoria de los trastornos mentales registrados en el RACPAS. No se observo un incremento significativo en la prevalencia de los trastornos mentales organicos, psicosis, trastornos del humor, consumo de sustancias no alcoholicas en los hombres ni en los trastornos del comportamiento asociados a disfunciones fisiologicas y a factores somaticos en las mujeres. Hubo diferencias significativas entre los sexos en la prevalencia de todos los trastornos excepto en los trastornos de la personalidad y los trastornos organicos cerebrales. El envejecimiento poblacional tuvo una influencia significativa en el incremento de la prevalencia de la mayoria de los trastornos mentales tanto en hombres como en mujeres. Conclusiones Durante el periodo estudiado se observo un leve incremento general de la prevalencia administrativa influida por el envejecimiento poblacional.

Purpose TP53 mutations have been described in chronic lymphocytic leukemia (CLL) and have been associated with poor prognosis in retrospective studies. We aimed to address the frequency and prognostic value of TP53 abnormalities in patients with CLL in the context of a prospective randomized trial. Patients and Methods We analyzed 529 CLL samples from the LRF CLL4 (Leukaemia Research Foundation Chronic Lymphocytic Leukemia 4) trial (chlorambucil v fludarabine with or without cyclophosphamide) at the time of random assignment for mutations in the TP53 gene. TP53 mutation status was correlated with response and survival data. Results Mutations of TP53 were found in 40 patients (7.6%), including 25 (76%) of 33 with 17p deletion and 13 (3%) of 487 without that deletion. There was no significant correlation between TP53 mutations and age, stage, IGHV gene mutations, CD38 and ZAP-70 expression, or any other chromosomal abnormality other than 17p deletion, in which concordance was high (96%). TP53 mutations were significantly associated with poorer overall response rates (27% v 83%; P < .001) and shorter progression-free survival (PFS) and overall survival (OS; 5-year PFS: 5% v 17%; 5-year OS: 20% v 59%; P < .001 for both). Multivariate analysis that included baseline clinical variables, treatment, and known adverse genetic factors confirmed that TP53 mutations have added prognostic value. Conclusion TP53 mutations are associated with impaired response and shorter survival in patients with CLL. Analysis of TP53 mutations should be performed in patients with CLL who have progressive disease before starting first-line treatment, and those with mutations should be selected for novel experimental therapies.

This is an open-access article distributed under the terms of the Creative Commons Attribution License.-- et al., Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare subtype of leukemia/lymphoma, whose diagnosis can be difficult to achieve due to its clinical and biological heterogeneity, as well as its overlapping features with other hematologic malignancies. In this study we investigated whether the association between the maturational stage of tumor cells and the clinico-biological and prognostic features of the disease, based on the analysis of 46 BPDCN cases classified into three maturation-associated subgroups on immunophenotypic grounds. Our results show that blasts from cases with an immature plasmacytoid dendritic cell (pDC) phenotype exhibit an uncommon CD56- phenotype, coexisting with CD34+ non-pDC tumor cells, typically in the absence of extramedullary (e.g. skin) disease at presentation. Conversely, patients with a more mature blast cell phenotype more frequently displayed skin/extramedullary involvement and spread into secondary lymphoid tissues. Despite the dismal outcome, acute lymphoblastic leukemia-type therapy (with central nervous system prophylaxis) and/or allogeneic stem cell transplantation appeared to be the only effective therapies. Overall, our findings indicate that the maturational profile of pDC blasts in BPDCN is highly heterogeneous and translates into a wide clinical spectrum -from acute leukemia to mature lymphoma-like behavior-, which may also lead to variable diagnosis and treatment., This work was supported by grants RD06/0020/0035 and RD12/0036/0048 from RETICS (Instituto de Salud Carlos III, Ministerio de Economía y Competitividad, Madrid, Spain and Fondos FEDER) and grant EDU/878/2004 from Junta de Castilla y León and Fondo Social Europeo.

7 páginas, 4 tablas, 4 figuras, Environmental factors influencing growth during the first stages of an animal's life cycle are determinative. External factors have often been implicated in the determination of rates of development of teleost larvae; however, the first stages of development of cephalopods remain poorly studied. In view of the fact that previous studies had shown that temperature is an important factor affecting cephalopod growth, particularly at high food concentrations, in this study the effect of temperature under conditions of non-satiation were investigated. A food-stress experiment was carried out for 75 days on 80 juvenile cuttlefish (Sepia elliptica) reared under two temperatures (25 and 30°C) and two food rations of glass shrimps Acetes sibogae australis at high and low proportions (2:1, respectively). We examined the effect of temperature and feeding regime on the growth of the whole animal, cuttlebone, and muscle tissue. Mantle-muscle blocks were 15% larger at 30°C than at 25°C, with the greatest difference in the middle mantle region (21% more at 30°C), whereas cuttlebone and somatic growth varied when the combination that included either the higher temperature or the higher food ration was used. Thus, at 30°C under the low feeding regime, final dorsal mantle length (DML) and cuttlebone growth index (CGI) were higher; however, at 25°C, final DML, CGI, and survivorship increased under the higher feeding regime. It was concluded that food scarcity may exaggerate the effect of small temperature differences. The results are discussed in the light of previous findings on the growth of other cuttlefish species, cephalopods, and teleosts., This work was supported by a Merit Research Grant from James Cook University

Obstructive sleep apnea (OSA) is a disorder characterized by repeated episodes of complete (apneas) or partial (hypopneas) cessations of breathing while sleeping. While continuous positive airway pressure (CPAP) treatment is commonly chosen to treat OSA, various conservative behavioral therapies are also used, particularly in patients unable to tolerate or benefit from CPAP or who have mild OSA. The principal purpose of these behavioral measures is to reduce risk factors which may underlie or exacerbate the disorder (e.g., weight reduction, smoking cessation, reduction/elimination of alcohol consumption, change in sleeping posture and sleep hygiene). Numerous studies have been conducted to evaluate the efficacy and/or effectiveness of CPAP in treating a wide range of OSA symptomatology. The present study consists of an exhaustive bibliographic search in Medline, PsycINFO, and Cochrane Review (1994-2007) databases and selection of works which have evaluated the efficacy and/or effectiveness of CPAP vis-a-vis daytime sleepiness, depression and cognitive functioning in OSA patients. The selected studies include randomized clinical trials in which CPAP was compared with more conservative measures, sham CPAP and oral placebos. The most important studies which evaluate the efficacy of behavioral treatments for OSA are also reviewed and the most remarkable results are presented. Various conclusions derived from the studies are discussed.

Bigeye (Thunnus obesus) is a large, pelagic, and migratory species of tuna that inhabits tropical and temperate marine waters worldwide. Previous studies based on mitochondrial RFLP data have shown that bigeye tunas from the Atlantic Ocean are the most interesting from a genetic point of view. Two highly divergent mitochondrial haplotype clades (I and II) coexist in the Atlantic Ocean. One is almost exclusive of the Atlantic Ocean whereas the other is also found in the Indo-Pacific Ocean. Bigeye tuna from the Atlantic Ocean is currently managed as a single stock, although this assumption remains untested at the genetic level. Therefore, genetic diversity was determined at the mitochondrial control region to test the null hypothesis of no population structure in bigeye tuna from the Atlantic Ocean. A total of 331 specimens were sampled from four locations in the Atlantic Ocean (Canada, Azores, Canary Islands, and Gulf of Guinea), and one in the Indian and Pacific Oceans, respectively. The reconstructed neighbor-joining phylogeny conWrmed the presence of Clades I and II throughout the Atlantic Ocean. No apparent latitudinal gradient of the proportions of both clades in the diVerent collection sites was observed. Hierarchical AMOVA tests and pairwise ST comparisons involving Atlantic Ocean Clades I and II were consistent with a single stock of bigeye tuna in the Atlantic Ocean. Population genetic analyses considering phylogroups independently supported gene flow within Clade II throughout the Atlantic Ocean, and within Clade I between Atlantic and Indo-Pacific Oceans. The latter result suggests present uni-directional gene flow from the Indo-Pacific into the Atlantic Ocean. Moreover, mismatch analyses dated divergence of Clades I and II during the Pleistocene, as previously proposed. In addition, migration rates were estimated using coalescent methods, and showed a net migration from Atlantic Ocean feeding grounds towards the Gulf of Guinea, the best-known spawning ground of Atlantic bigeye tuna., This work received partial financial support from the BETYP-ICCAT and from a project of the MEC to R.Z. (REN2001-1514/GLO).

12 páginas, 3 figuras, 5 tablas.-- The original publication is available at www.springerlink.com, Squids of the genus Illex are representative of the family Ommastrephidae and account for 65% of the world’s cephalopod captures. Illex is formed by four taxa distributed throughout the Atlantic Ocean (I. argentinus, I. coindetii, I. illecebrosus and I. oxygonius), whose identification and phylogenetic relationships based on morphological characters remain controversial. Thirty-seven enzyme-coding loci were analysed in 230 individuals from seven populations of Illex and ten specimens of Todaropsis eblanae, which were used as the outgroup. Two to four enzyme loci (ALPDH*, IDHP- 1*, MEP* and SOD*) were diagnostic among Illex species depending on the species-pair comparison. Individuals morphologically identified as I. oxygonius were also found genetically distinct, which proves the taxonomic validity of this species. No significant intraspecific genetic heterogeneity was detected within Illex argentinus, I. coindetii and I. illecebrosus (Mean GST= 0.011, 0.003, 0.017, respectively). I. illecebrosus and I. oxygonius were shown as sister species with a close relationship to I. argentinus, whereas I. coindetii formed a different lineage., This research was supported by the projects 64102C028 (Universidade de Vigo, Spain) and REN2000-1193 MAR (Ministerio de Ciencia y Tecnología, Spain) to A.S. Portions of this paper fulfilled Ph.D. requirements for P.M., who received a scholarship from University of Vigo.

13 páginas, 9 tablas, 4 figuras.-- The original publication is available at www.springerlink.com, Shortfinned squid species of the genus Illex support commercial fisheries throughout the Atlantic Ocean and Mediterranean Sea. Previous identification of interspecific and intraspecific populations by morphological and size-at-maturity studies have not provided conclusive results. We analysed morphometric body and beak variables (24 characters) in three species of the genus (I. coindetii, I. illecebrosus and I. argentinus), using a geographic and seasonal series of 33 populations for 1,500 specimens of I. coindetii, I. illecebrosus and I. argentinus. Residuals of the regression between each morphometric body and beak variable and mantle length were used as input in a stepwise discriminant analysis. Species discrimination by body and hectocotylus characters required at least eight variables and resulted in high correct-classification percentages for I. coindetii and I. argentinus (75% and 90%, respectively), whereas the best identification resulted from beak characters (83% correctly classified). Size of the suckerless basal arm, sucker-bearing length and beak lateral wall discriminated best among I. coindetii from northern Iberia, northwest Iberia (year-1996) and Ireland in the Atlantic and western Mediterranean versus middle and eastern Mediterranean samples. Canadian shelf and American samples were discriminated from Canadian slope I. illecebrosus. Winter/shelf and winter/ slope samples of I. argentinus seemed to form a single biological group separated from Falkland Island, 46 S/ autumn spawners and 46 S/1996 specimens along the Patagonian Shelf. No significant sexual or maturity polymorphism was obtained. Discriminant analysis optimised population diagnosis on a morphometric basis of interest in fisheries strategies.

Anxiety disorders and substance use disorders are highly comorbid (between 18% and 37%), and such comorbidity complicates treatment and worsens prognosis (including higher suicide risk). There are not many research works on the specific pharmacologic treatment of dual comorbid anxiety disorders. Most authors recommend a simultaneous approach of both, anxiety and substance use, disorders. Research data on pharmacotherapy suggest that psychotropics used in the treatment of anxiety disorders are also effective in dual diagnosis. SSRIs are considered first-line therapy in the treatment of dual anxiety while benzodiacepines should be avoided. New generation antiepileptic have shown efficacy in case series and open label studies in the latest years, thus being a promising treatment option for dual comorbid anxiety disorders, specially pregabalin in generalized anxiety disorder.

We have utilised aCGH (Breakthrough Breast Cancer Research Centre 5.8K array) and mutational analysis of the TP53 gene (exons 4–10) on 74 cases of CLL to define the extent of deletion at 17p, TP53 mutational status, additional genomic changes, and how this affects clinical outcome. 17p- cases were selected by FISH (n=37, Vysis LSI P53 probe) and 37 cases were selected as being representative of the survival curve of CLL patients without 17p-. FISH identified 22 cases with TP53- in ≥ 50% of cells, 4 cases with TP53- 20–50% and 11 cases with TP53- ≤ 20%. aCGH can detect abnormalities present in >50% of cells and all of the TP53- cases greater than 50% by FISH were detected with deletion ranging between 6-20Mb in length, the majority encompassing the entire p-arm. In addition aCGH detected deletion of 17p in 5/15 cases with TP53- 20% have a poor clinical outcome (median survival 11 months, median progression free survival 3 months), the majority of these (85%) also have a mutation of TP53 whereas in cases with ≤ 20% 17p- only 10% were mutated. The 17p- group was characterised by additional recurrent deletions involving 18p, 20p and 22q, which tended to occur as single additional events. Understanding the order in which these events occur is important, 18p- was found in 6 cases, 2 of which had Recurrent abnormalities were also found on other chromosomes, but did not differ between the two groups. These included regions with previously identified abnormalities; trisomy 12 (n=11), loss of 6q14.1–24.3 (n=11), loss of 11q12.1–25 (n=17) and loss of 13q12.1–21.1 (n=6) as well as detection of novel abnormalities; gain of 4p16.3–16.1 (n=23), gain of 11p15.5–15.3 (n=22), gain of 22q11.21–13.33 (n=22) and deletions on chromosome 9 (n=9). These results show that deletion of TP53 and mutation of the other allele are critical adverse prognostic factors. We have also defined a genetic background (18p-, 20p- and 22q-) on which these changes arise.

Esta revision pretende evaluar las evidencias empiricas existentes en relacion a las secuelas psicologicas persistentes asociadas al uso recreativo de MDMA. Numerosos casos clinicos sugieren que el uso regular de MDMA puede asociarse con trastornos psiquiatricos cronicos (psicosis, crisis de panico, despersonalizacion, depresion, flashbacks) que persisten tras el cese del consumo. Es dificil determinar si el consumo de MDMA es el responsable directo de estos cuadros o es una asociacion casual. Estudios comparativos entre usuarios regulares de MDMA y controles sugieren que la MDMA puede generar alteracion selectiva de la memoria episodica, memoria de trabajo, y de la atencion. Evidencias preclinicas apoyan dichos hallazgos: deplecion serotoninergica en usuarios importantes de MDMA, relacion dosis-respuesta entre consumo de MDMA y gravedad del deterioro cognitivo. Hay que ser cautos al establecer relaciones de causalidad entre consumo de MDMA y trastornos mentales, usando datos procedentes de estudios transversales, ya que el uso de MDMA se asocia a patron de policonsumo y, ademas, el comienzo del trastorno mental podria en muchas ocasiones preceder al uso de la sustancia.

La MDMA (extasis), es sin duda, la droga que mayor popularidad ha alcanzado durante la ultima decada. A pesar de haber sido sintetizada en 1912, no es hasta finales de los anos 70 cuando comienza a ser utilizada por diversos grupos poblacionales en Estados Unidos (estudiantes, yuppies, gays y new agers). En el ano 1985 es incluida en la Lista I de la Comprehensive Substances Act americana y en el ano 1986, la OMS la incluye en la Lista I del Convenio sobre Psicotropicos. Su posterior gran expansion a escala mundial se ha asociado a determinadas subculturas musicales y de ocio. En Espana, su difusion ha pasado por cinco fases diferentes: fase previa (1978-1986), fase inicial (1987-1989), fase de popularizacion (1990-1991), fase de vulgarizacion y consumo masivo (1992-1996) y fase de rutina y agotamiento del ciclo o fase de estabilizacion (1997-). Durante los ultimos anos existe cada vez mayor interes por parte de organismos internacionales y nacionales en la puesta en marcha de acciones conjuntas dirigidas a conocer la verdadera magnitud epidemiologica del fenomeno, sus consecuencias sobre la salud y en la puesta en marcha de acciones dirigidas a aminorar los potenciales danos asociados a su consumo.

Objetivos: Describir la prevalencia de consumo de MDMA y el perfil toxicologico y psicologico en una muestra de estudiantes de secundaria. Sujetos y Metodo: Durante el curso academico 1998-99 se evaluo una muestra compuesta por 2.862 jovenes de ambos sexos [edad media (SD): 15.87 (1.48); 50.6% hombres], estudiantes de secundaria de Oviedo (Asturias). Evaluacion: Cuestionario de la OMS de consumo de alcohol y drogas, cuestionario de personalidad de Eysenck version adultos (EPQ-A) y, la escala de busqueda de sensaciones de Zuckerman (EBS). Resultados: Las prevalencias vida, ultimo ano y ultimo mes, de consumo de MDMA fueron 3.8%, 2.7% y 1.6%, ocupando la MDMA la 7a posicion entre las drogas ilegales consumidas alguna vez. Los hombres mostraron mayores prevalencias de consumo, vida, ultimo ano y ultimo mes, que las mujeres (p< .05). Comparados con los estudiantes que nunca han consumido MDMA (pero que pueden haber consumido otras drogas ilegales), los usuarios de MDMA refieren una historia mas extensa de uso de drogas. La MDMA es, tras la heroina, la droga asociada a un mayor indice de policonsumo. Los jovenes que han usado MDMA alguna vez obtuvieron puntuaciones mas elevadas en la subescala de psicoticismo del EPQ-A y refirieron niveles mas elevados de busqueda de sensaciones. Conclusiones: Los consumidores de MDMA son policonsumidores de otras sustancias legales e ilegales. Aquellos que consumen MDMA tienen un perfil psicologico diferente, caracterizado por elevados niveles de busqueda de sensaciones y psicoticismo.