Biomedical subjects

S Hernández-Muela

Publications and source records attributed to S Hernández-Muela.

4 recordsLinked to original sources

PubMed2005

[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↗

PubMed2005

[The contribution of the cerebellum to cognitive processes].

INTRODUCTION: Apart from its functions involving control over movement, the cerebellum is also related to learning motor sequences and, according to the experimental and clinical evidence we will examine, to cognitive and learning processes that do not exclusively involve motor activity. DEVELOPMENT: The cerebrocerebellar connections act as a vehicle for the afferent information from the sensory-motor cortex, prefrontal cortex, the frontal regions responsible for (expressive) language, parietal cortex, superior colliculus and superior temporal cortex, returning efferences to similar areas that are responsible for attention, visuospatial perception, memory and the regulation of executive and emotional functions. It plays a role in the preparation and anticipation of motor responses, according to sequences experienced previously depending on the information received from the surroundings, thus anticipating the physiological state for carrying out perceptual motor or cognitive tasks. A number of experimental neuroimaging studies, as well as the discovery of a new cell in the neuronal population of the cerebellum, relate the cerebellum to cognitive processing. CONCLUSIONS: Clinical observation of patients with cerebellar lesion or dysfunction, which are related to a deficit in the cognitive functions, suggests a model with which to understand these mechanisms. Long-lasting depression is considered to be the learning mechanism in the cerebellum and is intimately related to the mechanisms involved in neuronal plasticity and in memory.

Cerebellum↗

PubMed2003

[Adopted children: risk factors and neuropsychological problems].

In recent years there has been a striking increase in the number of transnational adoptions in our country, which follows the trend already observed in other developed European countries. Major contributing factors to this phenomenon have been the improvements in socioeconomic conditions in our country, the drop in the birth rate, with the corresponding decrease in the number of children available for adoption, and the disappearance of orphanages. This growing demand can be met by developing countries, in which the birth rate is still high and there are only limited chances of being able to maintain offspring. The children that are adopted come mainly from countries in Central and South America, Eastern Europe and Asia. Pathologies that can be expected in adopted children include general paediatric conditions, especially infections (which are often autochthonous ailments in their own country) and malnutrition, as well as neuropsychological and developmental disorders, such as psychomotor retardation, conduct and behavioural disorders, which sometimes stem from conflicts arising in the process of adaptation, communication problems, which occasionally reflect an autistic like disorder, and the problems deriving from the circumstances that condition the donation of the child for adoption (perinatal pathology, maternal drug addiction and withdrawal symptoms, maternal psychopathology.). The pathology, history and prognosis of the adopted child depend on several different factors that act in an accumulative fashion. The country of origin plays a decisive role in the type of pathology, according to the level of the health care system that exists there, the existence of adoption programmes that are regulated by law, etc. The child's age at adoption marks the difference in the optimisation of their development, if they have early access to a stable family unit. Having stayed in institutions and the length of time spent there is a risk factor for presenting a neuropsychological pathology. On many occasions the scarce information available about the child's medical history makes it more difficult to anticipate the appearance of certain problems. The existence of social risk factors in the biological families is a conditioning factor in increased morbidity. We describe a short series of adopted patients who were attended in our Neuropaediatric clinic, and we analyse the above mentioned conditioning variables and the most frequent pathologies.

Adolescent↗

PubMedDate not supplied

[Attention deficit hyperactivity disorder and epilepsy].

INTRODUCTION: Attention deficit hyperactivity disorder (ADHD) is currently one of the morbid clinical pictures in childhood and adolescence that is most frequently diagnosed in the Neuropaediatric clinic. DEVELOPMENT: ADHD is sometimes associated to other important neurological problems, such as behavioural disorders, tics or headaches, and may occasionally be related to epilepsy, although in this particular case the epileptic syndromes often involve disorders affecting behaviour and attention. Due to the frequent association of these disorders (epilepsy and ADHD) it is wise to perform an electroencephalographic study in patients who visit because of symptoms of disattention. Likewise, the neuropsychological assessment of epileptic children must not be neglected. We analyse the therapeutic options regarding the use of stimulants when both disorders coexist and we endorse the association of antiepileptic and psychostimulant drugs when necessary.

Adolescent↗