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Biomedical subjects

R Gandía

Publications and source records attributed to R Gandía.

3 recordsLinked to original sources

[Attention deficit hyperactivity disorder therapy update: extended-release methylphenidate].

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is a very common condition in neuropaediatric practice and the most widely used medication is methylphenidate (MPT). We discuss the comorbid disorders, diagnosis, aetiopathology and neurochemical bases, and we also stress the importance of pharmacological action on the dopaminergic and noradrenergic pathways, and the problems and benefits of the different formulations of MPT. AIMS: Since extended-release MPT by means of the OROS technique has only recently been commercialised in Spain, we conducted a comparative analysis of immediate-release MPT and extended-release MPT in a series of 93 patients in order to determine which of them is preferable, to evaluate the reasons why this is so, and to analyse the shortcomings and advantages of the two drugs. PATIENTS AND METHODS: We present a study of 93 patients between 6 and 18 years old. Once an initial treatment had been established, changing over to extended-release MPT was proposed. We analysed compliance, effectiveness, safety, the preferences of the family and the degree of control over afternoon symptoms with the new treatment. RESULTS AND CONCLUSIONS: Most of the patients began treatment with immediate-release MPT or other medication. Changing to extended-release MPT brought about greater satisfaction with the control of afternoon symptoms and an improvement in the degree of compliance with respect to the initial treatment with immediate-release MPT or other drugs.

Attention Deficit Disorder with Hyperactivity↗

Continuous heart rate variability monitoring through complex demodulation implemented with the fast Fourier transform and its inverse.

UNLABELLED: A new method for the analysis of 24-hour heart rate variability (HRV) using complex demodulation (CDM) implemented with the fast Fourier transform (FFT) and its inverse is described. In a control group with palpitations and dizzy spells (n = 30, 47.2 +/- 16.7 years) the relationship between HRV parameters and subject age was investigated. CDM was used to obtain the amplitude and frequency of the low frequency (LF) and high frequency (HF) oscillations for 8 diurnal hours and 4 nocturnal hours. Differences between the two periods were seen in the LF/HF ratio (2.2 +/- 0.6 vs 1.5 +/- 0.6; P < 0.0001), HF amplitudes (12 +/- 6 vs 17 +/- 7 normalized units, P < 0.05), and in the mean frequency of the LF oscillations (0.078 +/- 0.008 vs 0.073 +/- 0.007 Hz, P < 0.01). During the daytime, age was inversely correlated to HF amplitude (r = -0.60), directly correlated to HF mean central frequency (r = 0.40), inversely correlated to LF amplitude (r = -0.55), and likewise inversely correlated to LF mean central frequency (r = -0.74, P < 0.001). At night, age was only inversely correlated to HF amplitude and to LF mean central frequency. CONCLUSIONS: Continuous HRV monitoring through CDM implemented with the FFT and its inverse differentiates the periods of diurnal activity and nocturnal rest as an expression of two different activity states of the autonomic nervous system. It allows nonstationary analysis, and separately provides mean and instantaneous oscillation amplitude and frequency. Subject age is not equally related to mean amplitude and frequency of a given oscillation.

Adolescent↗

[Treatment and prevention of cerebral hemorrhage in newborns].

INTRODUCTION: The risk factors leading to the occurrence of intracranial hemorrhages in premature newborn babies are well known. However, in full-term babies this has not been so systematically studied. Although the incidence is lower it is not rare and they are more varied in the form of presentation than in premature babies. Thus, as well as the classical intraperiventricular hemorrhages, subarachnoid and intraparenchymatous hemorrhages also occur relatively often, particularly the subarachnoid kind. The aetiopathogenesis of the hemorrhages is different, so preventive measures are also different, based particularly on avoidance of perinatal asphyxia and traumatic manoevres during labour. DEVELOPMENT: A study by our Department, in which risk factors associated with 17 newborn babies of over 35 weeks gestation who had a history of intracranial hemorrhage in the early neonatal period showed that over half the cases (58%) had a history of acute foetal distress. A quarter had congenital cardiopathy (detected at birth) and the same number had a respiratory distress syndrome due to various causes, particularly pneumothorax and infections. Regarding treatment of the acute phase, it is essential to maintain cerebral perfusion and monitor both arterial hypertension and hypotension, control the intracranial pressure (avoiding increases) and avoid fluctuations of cerebral blood flow. CONCLUSION: Follow-up by means of serial echographs makes early detection of dilatation and hydrocephaly possible and permits suitable suitable treatment rapidly and with immediate monitoring of its efficacy.

Cerebral Hemorrhage↗