Objective: To investigate oxidative stress markers and antioxidants in bipolar disorder (BD).Methods: Electronic MEDLINE/PubMed/Cochrane‐Library/Scopus/TripDatabase search until 06/30/2019 for studies comparing antioxidant or oxidative stress markers between BD and healthy controls (HCs). Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated for ≥3 studies.Results: Forty‐four studies (n = 3,767: BD = 1,979; HCs = 1,788) reported on oxidative stress markers malondialdehyde (MDA), thiobarbituric acid reactive substances (TBARS), and total nitrites; antioxidants glutathione (GSH), uric acid, and zinc; or antioxidantenhancing enzymes superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), and GSH‐transferase (GST). Compared with HCs, BD was associated with higher GST (P = .01), CAT (P = .02), nitrites (P < .0001), TBARS (P < .0001), MDA (P = .01), uric acid (P < .0001), and lower GSH (P = .006), without differences in SOD, GPX, and zinc. Compared to HCs, levels were higher in BD‐mania for TBARS (P < .0001) and uric acid (P < .0001); in BD‐depression for TBARS (P = .02); and BD‐euthymia for uric acid (P = .03). Uric acid levels were higher in BD‐mania vs BD‐depression (P = .002), but not vs BD euthymia. TBARS did not differ between BD‐mania and BD‐depression. Medication‐free BD‐mania patients had higher SOD (P = .02) and lower GPX (P < .0001) than HCs. After treatment, BD did not differ from HCs regarding SOD and GPX.Conclusions: Beyond a single biomarker of oxidative stress, the combination of several parameters appears to be more informative for BD in general and taking into account illness polarity. BD is associated with an imbalance in oxidative stress with some phase‐specificity for uric acid and TBARS and possible treatment benefits for SOD and GPX. Future studies should take into account confounding factors that can modify oxidative stress status and simultaneously measure oxidative stress markers and antioxidants including different blood sources.

Se realiza un estudio para conocer el tiempo que dedican los universitarios a las nuevas tecnologías diaria y semanalmente e identificar si su uso se convierte en un problema. La muestra se diferencia entre alumnos universitarios de primer y cuarto curso de la Facultad de Educación de Albacete, en España. Para realizar este estudio descriptivo se ha utilizado el Cuestionario sobre Uso Problemático de Nuevas Tecnologías (UPNT). Los resultados indican que los estudiantes dedican un tiempo elevado al uso del teléfono móvil y de internet y que un alto porcentaje de ellos tienen problemas por este motivo. Los estudiantes más jóvenes presentaron un uso mayor de internet frente a los estudiantes de curso más avanzado. En el uso del teléfono móvil no se aprecia estas diferencias. Como conclusión, se debe indicar que más de la mitad de la muestra dedica más de cinco horas al día al teléfono móvil y que el 79,6% de la misma manifiesta haber tenido problemas secundarios de comportamiento por su uso excesivo.

Background: Therapeutic drug monitoring of clozapine in children and adolescents has received insufficient attention. Calculation of concentration-to-dose (C/D) ratios from trough steady-state concentrations estimate drug clearance. Methods: A systematic electronic literature search was conducted in 3 article databases from inception until January 10, 2023, and articles reporting clozapine concentrations in children and adolescents were retrieved. The pharmacokinetic quality of the studies was assessed, and clozapine C/D ratios were calculated using the sample mean clozapine dose and concentration. Results: Of the 37 articles of potential interest, only 7 reported clozapine trough and steady-state concentrations. After excluding case reports and a study confounded by fluvoxamine, 4 studies on psychosis from Europe and the United States were included. The clozapine C/D ratios were similar to published adult values and ranged from 0.82 to 1.24 with a weighted mean of 1.08 ng/mL per mg/d. The weighted means were 334 mg/d for the dose and 380 ng/mL for the concentration. The stratified analysis of the weighted mean clozapine C/D ratios from 2 studies showed lower values in 52 male (1.05 ng/mL per mg/d) than in 46 female (1.46 ng/mL per mg/d) children and adolescents, with values similar to those reported for European adult nonsmokers. Two female adolescents had high clozapine C/D ratios (2.54 ng/mL per mg/d), an Asian American patient with borderline obesity and a patient with intellectual disability with low dosage (mean = 102 mg/d) and concentration (mean = 55 ng/mL). Conclusions: Reports on clozapine therapeutic drug monitoring in children and adolescents are limited in number and quality. Future studies should focus on basic pharmacokinetic issues, such as stratification by sex, smoking, and relevant comedications with inductive or inhibitory properties.

El Trabajo Cooperativo como Herramienta Formativa en los Estudiantes Universitarios