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Delgado-Gomez D.,Charles III University of Madrid | Penuelas-Calvo I.,Hospital Universitario Fundacion Jimenez Diaz | Maso-Besga A.E.,Goal Systems Co | Vallejo-Onate S.,Hospital Universitario Fundacion Jimenez Diaz | And 11 more authors.
Journal of Medical Internet Research | Year: 2017

Background: One of the major challenges in mental medical care is finding out new instruments for an accurate and objective evaluation of the attention deficit hyperactivity disorder (ADHD). Early ADHD identification, severity assessment, and prompt treatment are essential to avoid the negative effects associated with this mental condition. Objective: The aim of our study was to develop a novel ADHD assessment instrument based on Microsoft Kinect, which identifies ADHD cardinal symptoms in order to provide a more accurate evaluation. Methods: A group of 30 children, aged 8-12 years (10.3 [SD 1.4]; male 70% [21/30]), who were referred to the Child and Adolescent Psychiatry Unit of the Department of Psychiatry at Fundación Jiménez Díaz Hospital (Madrid, Spain), were included in this study. Children were required to meet the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria of ADHD diagnosis. One of the parents or guardians of the children filled the Spanish version of the Strengths and Weaknesses of ADHD Symptoms and Normal Behavior (SWAN) rating scale used in clinical practice. Each child conducted a Kinect-based continuous performance test (CPT) in which the reaction time (RT), the commission errors, and the time required to complete the reaction (CT) were calculated. The correlations of the 3 predictors, obtained using Kinect methodology, with respect to the scores of the SWAN scale were calculated. Results: The RT achieved a correlation of -.11, -.29, and -.37 with respect to the inattention, hyperactivity, and impulsivity factors of the SWAN scale. The correlations of the commission error with respect to these 3 factors were -.03, .01, and .24, respectively. Conclusions: Our findings show a relation between the Microsoft Kinect-based version of the CPT and ADHD symptomatology assessed through parental report. Results point out the importance of future research on the development of objective measures for the diagnosis of ADHD among children and adolescents.


Berrouiguet S.,Brest Medical University Hospital | Berrouiguet S.,Telecom Bretagne | Brandt S.A.,Mount Sinai School of Medicine | Alvarez-Garcia R.,Rey Juan Carlos University | And 7 more authors.
PLoS ONE | Year: 2016

Purpose The emergence of electronic prescribing devices with clinical decision support systems (CDSS) is able to significantly improve management pharmacological treatments. We developed a web application available on smartphones in order to help clinicians monitor prescription and further propose CDSS. Method A web application (www.MEmind.net) was developed to assess patients and collect data regarding gender, age, diagnosis and treatment. We analyzed antipsychotic prescriptions in 4345 patients attended in five Psychiatric Community Mental Health Centers from June 2014 to October 2014. The web-application reported average daily dose prescribed for antipsychotics, prescribed daily dose (PDD), and the PDD to defined daily dose (DDD) ratio. Results The MEmind web-application reported that antipsychotics were used in 1116 patients out of the total sample, mostly in 486 (44%) patients with schizophrenia related disorders but also in other diagnoses. Second generation antipsychotics (quetiapine, aripiprazole and long-acting paliperidone) were preferably employed. Low doses were more frequently used than high doses. Long acting paliperidone and ziprasidone however, were the only two antipsychotics used at excessive dosing. Antipsychotic polypharmacy was used in 287 (26%) patients with classic depot drugs, clotiapine, amisulpride and clozapine. Conclusions In this study we describe the first step of the development of a web application that is able to make polypharmacy, high dose usage and off label usage of antipsychotics visible to clinicians. Current development of the MEmind web application may help to improve prescription security via momentary feedback of prescription and clinical decision support system. © 2016 van Essen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


PubMed | IIS Jimenez Diaz Foundation, University of Granada, University of Seville and CIBER ISCIII
Type: | Journal: Data in brief | Year: 2017

This article contains information related to the research article entitled Biomarkers associated with disease severity in allergic and nonallergic asthma (S. Baos, D. Calzada, L. Cremades, J. Sastre, J. Quiralte, F. Florido, C. Lahoz, B. Crdaba, In press). Specifically, the clinical criteria stablished for selecting the study population (


PubMed | IIS Jimenez Diaz Foundation, University of Granada, University of Seville and CIBER ISCIII
Type: | Journal: Molecular immunology | Year: 2016

Asthma is a complex, chronic respiratory disease with a wide clinical spectrum. Use of high-throughput technologies has generated a great deal of data that require validation. In this work the objective was to validate molecular biomarkers related to asthmatic disease types in peripheral blood samples and define their relationship with disease severity. With this purpose, ninety-four previously described genes were analyzed by qRT-PCR in 30 healthy control (HC) subjects, 30 patients with nonallergic asthma (NA), 30 with allergic asthma (AA), and 14 patients with allergy (rhinitis) but without asthma (AR). RNA was extracted from peripheral blood mononuclear cells (PBMCs) using the TRIzol method. After data normalization, principal component analysis (PCA) was performed, and multiple approaches were used to test for differential gene expression. Relevance was defined by RQ (relative quantification) and corrected P value (<0.05). Protein levels of IL-8 and MSR1 were determined by ELISA and Western blot, respectively. PCA showed 4 gene expression clusters that correlated with the 4 clinical phenotypes. Analysis of differential gene expression between clinical groups and HCs revealed 26 statistically relevant genes in NA and 69 in AA. Protein interaction analysis revealed IL-8 to be a central protein. Average levels of IL-8 were higher in the asthma patients sera (NA: 452.28357.72, AA: 327.46377pg/ml) than in HCs (286.09179.10), but without reaching statistical significance. Nine genes, especially MSR1, were strongly associated with severe NA. In conclusion, several molecular biomarkers of asthma have been defined, some of which could be useful for the diagnosis or prognosis of disease severity.


Blasco-Fontecilla H.,Puerta Of Hierro Hospital | Delgado-Gomez D.,Charles III University of Madrid | Ruiz-Hernandez D.,CUNEF University | Aguado D.,Autonomous University of Madrid | And 4 more authors.
Journal of Psychiatric Research | Year: 2012

Objectives: A major interest in the assessment of suicide risk is to develop an accurate instrument, which could be easily adopted by clinicians. This article aims at identifying the most discriminative items from a collection of scales usually employed in the assessment of suicidal behavior. Methods: The answers to the Barrat Impulsiveness Scale, International Personality Disorder Evaluation Screening Questionnaire, Brown-Goodwin Lifetime History of Aggression, and Holmes & Rahe Social Readjustment Rating Scale provided by a group of 687 subjects (249 suicide attempters, 81 non-suicidal psychiatric inpatients, and 357 healthy controls) were used by the Lars-en algorithm to select the most discriminative items. Results: We achieved an average accuracy of 86.4%, a specificity of 89.6%, and a sensitivity of 80.8% in classifying suicide attempters using 27 out of the 154 items from the original scales. Conclusions: The 27 items reported here should be considered a preliminary step in the development of a new scale evaluating suicidal risk in settings where time is scarce. © 2012 Elsevier Ltd.


Delgado-Gomez D.,Charles III University of Madrid | Baca-Garcia E.,IIS Jimenez Diaz Foundation | Baca-Garcia E.,Columbia University | Aguado D.,Autonomous University of Madrid | And 4 more authors.
Journal of Affective Disorders | Year: 2016

Background Several Computerized Adaptive Tests (CATs) have been proposed to facilitate assessments in mental health. These tests are built in a standard way, disregarding useful and usually available information not included in the assessment scales that could increase the precision and utility of CATs, such as the history of suicide attempts. Methods Using the items of a previously developed scale for suicidal risk, we compared the performance of a standard CAT and a decision tree in a support decision system to identify suicidal behavior. We included the history of past suicide attempts as a class for the separation of patients in the decision tree. Results The decision tree needed an average of four items to achieve a similar accuracy than a standard CAT with nine items. The accuracy of the decision tree, obtained after 25 cross-validations, was 81.4%. A shortened test adapted for the separation of suicidal and non-suicidal patients was developed. Conclusion CATs can be very useful tools for the assessment of suicidal risk. However, standard CATs do not use all the information that is available. A decision tree can improve the precision of the assessment since they are constructed using a priori information. © 2016 Elsevier B.V.


Gonzalez N.,Autonomous University of Madrid | Martin-Duce A.,University of Alcalá | Martinez-Arrieta F.,Autonomous University of Madrid | Moreno-Villegas Z.,Autonomous University of Madrid | And 2 more authors.
International Journal of Molecular Medicine | Year: 2015

Bombesin receptor subtype-3 (BRS-3) is an orphan G-protein-coupled receptor (GPCR) member of the bombesin receptor family. Several studies have suggested an association between obesity, alterations in glucose metabolism, diabetes and the BRS-3 receptor. In this study, we focused on patients simultaneously diagnosed with obesity and type 2 diabetes (OB/T2D). The analysis of BRS-3 expression in the skeletal muscle of these patients revealed a marked decrease in the expression of BRS-3 at the mRNA (23.6±1.3-fold downregulation, p<0.0001) and protein level (49±7% decrease, p<0.05) compared to the normal patients (no obesity and diabetes). Moreover, in cultured primary myocytes from patients with OB/T2D, the synthetic BRS-3 agonist, [D-Try6,β-Ala11,Phe13,Nle14]bombesin6-14, significantly increased the phosphorylation levels of mitogen-activated protein kinase (MAPK), p90RSK1, protein kinase B (PKB) and p70s6K. Specifically, the ligand at 10-11 M induced the maximal phosphorylation of MAPKs (p42, 159±15% of the control; p44, 166±11% of the control; p<0.0001) and p90RSK1 (148±2% of the control, p<0.0001). The basal phosphorylation levels of all kinases were reduced (p<0.05) in the patients with OB/T2D compared to the normal patients. Furthermore, the BRS-3 agonist stimulated glucose transport, which was already detected at 10-12 M (133±9% of the control), reached maximal levels at 10-11 M (160±9%, p<0.0001) and was maintained at up to 10-8 M (overall mean, 153±7%; p<0.007). This effect was less promiment than that attained with 10-8 M insulin (202±9%, p=0.009). The effect of the agonist on glycogen synthase a activity achieved the maximum effect at 10-11 M (165±16% of the control; p<0.0001), which did not differ from that observed with higher concentrations of the agonist. These results suggest that muscle cells isolated from patients with OB/T2D have extremely high sensitivity to the synthetic ligand, and the effects are particularly observed on MAPK and p90RSK1 phosphorylation, as well as glucose uptake. Moreover, our data indicate that BRS-3 may prove to be useful as a potential therapeutic target for the treatment of patients with OB/T2D.


PubMed | Autonomous University of Madrid, IIS Jimenez Diaz Foundation and University of Alcalá
Type: Journal Article | Journal: International journal of molecular medicine | Year: 2015

Bombesin receptor subtype-3 (BRS-3) is an orphan G-protein-coupled receptor (GPCR) member of the bombesin receptor family. Several studies have suggested an association between obesity, alterations in glucose metabolism, diabetes and the BRS-3 receptor. In this study, we focused on patients simultaneously diagnosed with obesity and type 2 diabetes (OB/T2D). The analysis of BRS-3 expression in the skeletal muscle of these patients revealed a marked decrease in the expression of BRS-3 at the mRNA (23.6 1.3-fold downregulation, p<0.0001) and protein level (49 7% decrease, p<0.05) compared to the normal patients (no obesity and diabetes). Moreover, in cultured primary myocytes from patients with OB/T2D, the synthetic BRS-3 agonist, [D-Try6,-Ala11,Phe13,Nle14]bombesin6-14, significantly increased the phosphorylation levels of mitogen-activated protein kinase (MAPK), p90RSK1, protein kinase B (PKB) and p70s6K. Specifically, the ligand at 10-11 M induced the maximal phosphorylation of MAPKs (p42, 159 15% of the control; p44, 166 11% of the control; p<0.0001) and p90RSK1 (148 2% of the control, p<0.0001). The basal phosphorylation levels of all kinases were reduced (p<0.05) in the patients with OB/T2D compared to the normal patients. Furthermore, the BRS-3 agonist stimulated glucose transport, which was already detected at 10-12 M (133 9% of the control), reached maximal levels at 10-11 M (160 9%, p<0.0001) and was maintained at up to 10-8 M (overall mean, 153 7%; p < 0.007). This effect was less promiment than that attained with 10-8 M insulin (202 9%, p = 0.009). The effect of the agonist on glycogen synthase a activity achieved the maximum effect at 10-11 M (165 16% of the control; p<0.0001), which did not differ from that observed with higher concentrations of the agonist. These results suggest that muscle cells isolated from patients with OB/T2D have extremely high sensitivity to the synthetic ligand, and the effects are particularly observed on MAPK and p90RSK1 phosphorylation, as well as glucose uptake. Moreover, our data indicate that BRS-3 may prove to be useful as a potential therapeutic target for the treatment of patients with OB/T2D.


Parra Uribe I.,Autonomous University of Barcelona | Blasco-Fontecilla H.,Iis Puerta Of Hierro University Hospital | Garcia-Pares G.,Autonomous University of Barcelona | Giro Batalla M.,Autonomous University of Barcelona | And 6 more authors.
Journal of Affective Disorders | Year: 2013

Background: Suicide attempters and suicide completers are two overlapping but distinct suicide populations. This study aims to present a more accurate characterization by comparing populations of suicide attempters and completers from the same geographical area. Methods: Samples and procedure: All cases of attempted suicide treated at the emergency room of the Corporacio Sanitària i Universitaria Tauli Pare de Sabadell in 2008 (n=312) were compared with all completed suicides recorded in the same geographical area from 2008 to 2011 (n=86). Hospital and primary care records were reviewed for sociodemographic and clinical variables. Statistical analysis: Chi- square, ANOVA, and Mann-Whitney U tests were used to identify characteristics related to suicide completion. Results: Compared to suicide attempters, suicide completers were more likely to be male (73.3%vs. 37.8%; p < 0.001), pensioners (73.7%vs. 23.4%; p < 0.001), and people living alone (31.8%vs. 11.4%; p = 0.006). Suicide completers more frequently presented somatic problems (71.7 vs. 15.7; p < 0.001), Major Depressive Disorder (54.7%vs. 27.9%; p < 0.001), and made use of more lethal methods (74.1 vs. 1.9; p < 0.001). Suicide completers were more likely to have been followed by a primary care provider (50.0%vs. 16.0%; p < 0.001). 92.3%of the suicides committed were completed during the first or second attempt. Limitations: Suicide completers were not evaluated using the psychological autopsy method. Conclusions: Despite presenting a profile of greater social and clinical severity, suicide completers are less likely to be followed by Mental Health Services than suicide attempters. Current prevention programs should be tailored to the specific profile of suicide completers. © 2013 Elsevier B.V. All rights reserved.


To search for new therapies aimed at ameliorating the neurologic symptoms and epilepsy developing in patients with Lafora disease.Lafora disease is caused by loss-of-function mutations in either the EPM2A or EPM2B genes. Epm2aSodium selenate ameliorates some of the motor and memory deficits and the sensitivity observed with pentylenetetrazol (PTZ) treatments in Epm2bSodium selenate could be beneficial for ameliorating some symptoms that present in patients with Lafora disease.

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