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array:23 [ "pii" => "S0025775310007487" "issn" => "00257753" "doi" => "10.1016/j.medcli.2010.06.011" "estado" => "S300" "fechaPublicacion" => "2011-02-12" "aid" => "1510" "copyright" => "Elsevier España, S.L.. All rights reserved" "copyrightAnyo" => "2010" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Med Clin. 2011;136:103-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2240 "formatos" => array:3 [ "EPUB" => 10 "HTML" => 1872 "PDF" => 358 ] ] "itemSiguiente" => array:18 [ "pii" => "S002577531000881X" "issn" => "00257753" "doi" => "10.1016/j.medcli.2010.09.005" "estado" => "S300" "fechaPublicacion" => "2011-02-12" "aid" => "1550" "copyright" => "Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Med Clin. 2011;136:106-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 8320 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 7915 "PDF" => 399 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Editorial</span>" "titulo" => "Isquemia crítica de miembros inferiores: una enfermedad cada vez más prevalente" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "106" "paginaFinal" => "108" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Critical lower limb ischemia: an increasingly prevalent disease" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Raúl Lara-Hernández, Pascual Lozano-Vilardell" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Raúl" "apellidos" => "Lara-Hernández" ] 1 => array:2 [ "nombre" => "Pascual" "apellidos" => "Lozano-Vilardell" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S002577531000881X?idApp=UINPBA00004N" "url" => "/00257753/0000013600000003/v1_201304301937/S002577531000881X/v1_201304301937/es/main.assets" ] "itemAnterior" => array:17 [ "pii" => "S0025775310008365" "issn" => "00257753" "doi" => "10.1016/j.medcli.2010.03.039" "estado" => "S300" "fechaPublicacion" => "2011-02-12" "aid" => "1525" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Med Clin. 2011;136:97-102" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 12626 "formatos" => array:3 [ "EPUB" => 19 "HTML" => 12251 "PDF" => 356 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Mortalidad atribuible al consumo de tabaco en España en 2006" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "97" "paginaFinal" => "102" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Smoking-attributable deaths in Spain, 2006" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1125 "Ancho" => 3375 "Tamanyo" => 217802 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Evolución temporal del porcentaje de muertes atribuibles al tabaquismo sobre el total de muertes ocurridas en España, por sexo, 1979-2006.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "José R. Banegas, Lucía Díez-Gañán, Beatriz Bañuelos-Marco, Jesús González-Enríquez, Fernando Villar-Álvarez, José M. Martín-Moreno, Rodrigo Córdoba-García, Alfonso Pérez-Trullén, Carlos Jiménez-Ruiz" "autores" => array:9 [ 0 => array:2 [ "nombre" => "José R." "apellidos" => "Banegas" ] 1 => array:2 [ "nombre" => "Lucía" "apellidos" => "Díez-Gañán" ] 2 => array:2 [ "nombre" => "Beatriz" "apellidos" => "Bañuelos-Marco" ] 3 => array:2 [ "nombre" => "Jesús" "apellidos" => "González-Enríquez" ] 4 => array:2 [ "nombre" => "Fernando" "apellidos" => "Villar-Álvarez" ] 5 => array:2 [ "nombre" => "José M." "apellidos" => "Martín-Moreno" ] 6 => array:2 [ "nombre" => "Rodrigo" "apellidos" => "Córdoba-García" ] 7 => array:2 [ "nombre" => "Alfonso" "apellidos" => "Pérez-Trullén" ] 8 => array:2 [ "nombre" => "Carlos" "apellidos" => "Jiménez-Ruiz" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775310008365?idApp=UINPBA00004N" "url" => "/00257753/0000013600000003/v1_201304301937/S0025775310008365/v1_201304301937/es/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original breve</span>" "titulo" => "Dream changes following initiation of efavirenz treatment" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "103" "paginaFinal" => "105" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "María Velasco, Juan Antonio Pareja, Juan Emilio Losa, José Francisco Valverde, Alfredo Espinosa, Carlos Gujarro" "autores" => array:6 [ 0 => array:4 [ "nombre" => "María" "apellidos" => "Velasco" "email" => array:1 [ 0 => "mvelasco@fhalcorcon.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Juan Antonio" "apellidos" => "Pareja" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Juan Emilio" "apellidos" => "Losa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "José Francisco" "apellidos" => "Valverde" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "Alfredo" "apellidos" => "Espinosa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "Carlos" "apellidos" => "Gujarro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Infectious Diseases Section, Internal Medicine, Hospital Universitario Fundación Alcorcón, España" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Neurology Unit, Hospital Universitario Fundación Alcorcón, España" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Microbiology Unit, Hospital Universitario Fundación Alcorcón, España" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cambios en la ensoñación tras el inicio de tratamiento con efavirenz" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Efavirenz is a potent antiretroviral drug for HIV infection but neuropsychological toxicity is reported in around 20 to 50% of patients.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> One of the most common effects reported is sleeping disturbances including nightmares and vivid dreams. There have been quantitative studies reported on the influence of efavirenz on sleep architecture.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2–4</span></a> In most studies, a questionnaire performed after the night of the study was used to assess dream changes.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a> Retrospective self-reports significantly underestimate current nightmare and bad dream frequency when compared to other methods.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Qualitative studies focusing on the possible impact of efavirenz on dream content are lacking. We endeavoured to assess the possible influence of efavirenz treatment on the length of dreams, the thematic of the oniric scenes and the emotional content of dreams.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Patients and method</span><p id="par0010" class="elsevierStylePara elsevierViewall">This was a pilot study. Ten HIV patients currently on follow-up in our clinic who consecutively started efavirenz treatment were studied before and after starting efavirenz treatment; thus, they were their own controls, a previously used design.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Inclusion criteria were to be older than 18 years, to start efavirenz treatment for any reason and to signed informed consent form. Exclusion criteria were patients with previously known psychiatric disorders or psychiatric treatment, any neurological disorder that could influence dreaming and sleep alterations. The Ethical Hospital Institutional Committee Board approved the study.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Clinical and epidemiological variables were taken into account. All the patients fulfilled a structured questionnaire designed by one of the authors (JAP) as a general assessment of sleep disorders symptoms.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> A nocturnal polysomnogram (PSG) study was performed before starting efavirenz and within two weeks after treatment. A blood sample was obtained just before the second polysomnographic study to assess efavirenz plasma levels.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The PSG was performed recording electroencephalogram, electrocardiogram and continuous finger pulse oxymetry. Sleep stages were scored visually according to standard criteria. Standard methods of PSG recording and scoring were used and we used validated techniques previously used to evaluate dreaming.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">We intended to study dream content of both the first and last REM sleep periods: The REM sleep period occurring after 5:00 am was considered the last REM period. We studied REM sleep because during such a sleep stage dreams are more frequently reported and remembered, and dream content is more vivid and emotional, whereas dreaming arising from other sleep stages tend to be formed by short, fragmented oniric scenes. Otherwise, nightmares are acknowledged as a REM sleep processes.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In each study subjects were awakened by calling their names 5-10<span class="elsevierStyleHsp" style=""></span>minutes after the beginning of the first and last REM sleep periods. Once fully awake, subjects were asked: “Were you dreaming?”. If so, “could you please tell me what actually were you dreaming before I woke you up?” Once the patient spontaneously related the content of the dream, we asked again twice: “Do you remember anything else?”. All the questions and responses were audio taped for later analysis. After each awakening subjects were allowed to fall sleep again.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Reports, when present, were written and later analyzed by the investigators, who were unaware if the PSG was performed before or after the efavirenz treatment. To evaluate the measure of the length of the dream we counted the number of words and the number of thematic units. A new thematic unit was considered if the setting, the activity or the main character of the dream changed.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Emotional content of the dream were classified into four categories: violent/highly anxious, moderately anxious, pleasant and neutral. Dreams were considered violent/highly anxious whenever there was verbal or physical violence in the dream or when the subject reported an awful, stressful or highly emotional situation. When subjects upon awakening were not able to remember any details of the dream in spite of thinking that they had dreamt, we considered no dream recall and number of words was scored as null.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">We compared the dream changes before and after efavirenz in each subject. For statistical analysis we used the Wilcoxon Signed Ranks Test to compare type of emotional content, Z-test (proportions) for overall emotional content, T Test for repeated measures for number of thematic units and words, Chi-squared or Fischer as appropriate for recall rate.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0045" class="elsevierStylePara elsevierViewall">Eighteen PSG were performed in ten patients; 10 underwent the first PSG and 8 the second PSG. Reasons for withdrawal during the 2° PSG were an onset of severe diarrhoea and hospital admission in one patient and laboral reasons in the other (he started a night work). The results were essentially identical when the 2 patients with incomplete follow-up were excluded from the analysis.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Eight patients were male and two female. Mean age was 38.6 (10.9) years. Mean time from HIV diagnosis to antiretroviral treatment was 2.4 (4.3) years. Only 2 patients had received previous HAART without efavirenz, and their mean time on HAART before efavirenz use was 1.04 (2.2) years (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Mean CD4 cells at baseline was 247. 1 (SD 167.1) c/mL, and viral load 5.0 (SD 1.6) lg10 cp/mL. No patients were taking neuropsychiatric drugs and no one had previous sleeping abnormalities. Mean time on efavirenz treatment at the 2° PSG was 10.4 (5.4) days. Plasma levels of efavirenz extracted just before the PSG study were within therapeutic range in all the patients (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">After efavirenz treatment, several symptoms were self-reported by the patients: 4 of them reported anxiety, 2 impaired concentration, 1 diurnal somnolence and 1 insomnia. Sleeping disturbances were self reported in 3 patients. No patient had depressive symptoms. Patient number 7 suffered a self limited acute confusional syndrome one day after starting efavirenz treatment. Efavirenz was not stopped and the patient fully recovered in the following 48<span class="elsevierStyleHsp" style=""></span>hours.</p><p id="par0060" class="elsevierStylePara elsevierViewall">PSG were essentially normal in all the subjects, apart from the two provoked interruptions to ask patients for their dreams. Nine patients recalled at least one dream in the baseline study when awakened in REM sleep. One patient reported dreaming only the first night and six patients reported dreaming both nights. No patient reported dreams only the second night. There were 16 dream reports in baseline night (ten patients) and 6 in second night (eight patients). Dreams were recalled in 16 out of 19 (84%) awakenings in the patients without treatment, and in 6 out of 14 awakenings (43%) in the patients with efavirenz treatment (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.024) (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). Some patients recalled just one dream: 2 in the first night and 4 patients in the second night.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">There were no differences in the mean number of words per dream before and after efavirenz treatment (61.9 <span class="elsevierStyleItalic">versus</span> 47.5, p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.115) but the number of thematic units was higher before efavirenz than after (16 <span class="elsevierStyleItalic">versus</span> 8, p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.442). Emotional content is described in detail in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>. The proportion of dreams with no neutral emotional content (either pleasant or unpleasant) was higher after efavirenz treatment: 37.5% in the first night and 66.7% in the second night.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">In this study, surprisingly, we have not found relevant abnormalities in dream patterns in patients taking efavirenz. It is conceivable that the higher proportion of emotional dreams after efavirenz treatment underlies the perception of the effects of efavirenz on dream quality. The artificial awakening in the laboratory of the present study has undercovered a substantial number of “neutral” dreams that may have been unnoticed in other studies.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Neuropsychiatric side effects of efavirenz may be related to its plasma levels.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> In our series, levels of efavirenz were within the therapeutical range in all patients, showing that the drug was present at the moment of the PSG study. Besides that, none of our patients had prior neuropsychiatric abnormalities, which may explain the absence of major dreams changes.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">An obvious limitation of our work is the small size and the possibility of a result by chance. This series may be underpowered to detect significant changes in dream pattern. Other reports on sleep abnormalities after efavirenz treatment evaluated by PSG have explored 10 or 18 patients, a number very similar to our study.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> The withdrawal adds a difficult to the correct interpretation of the data. However, repeated analysis without withdrawals showed similar results.</p><p id="par0085" class="elsevierStylePara elsevierViewall">In conclusion, in spite of the common belief that efavirenz increases dream production, dream recall and length of dreams were lower after efavirenz treatment. The perception of a higher dream production may be due to the lower percentage of dreams with neutral emotional content. Our data suggest that dream changes after efavirenz treatment are more complex than usually considered. Further research may shed light in the complex effects of efavirenz in dreams.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflict of interest</span><p id="par0090" class="elsevierStylePara elsevierViewall">The authors declare that they do not have competing interests.</p><p id="par0095" class="elsevierStylePara elsevierViewall">The study was supported by Bristol-Myers Squibb. BMS had no role in the design, analysis, or interpretation of the study.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:2 [ "identificador" => "xres106153" "titulo" => array:5 [ 0 => "Abstract" 1 => "Background and objective" 2 => "Patients and method" 3 => "Results" 4 => "Conclusions" ] ] 1 => array:2 [ "identificador" => "xpalclavsec93539" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres106152" "titulo" => array:5 [ 0 => "Resumen" 1 => "Fundamento y objetivo" 2 => "Pacientes y método" 3 => "Resultados" 4 => "Conclusiones" ] ] 3 => array:2 [ "identificador" => "xpalclavsec93540" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients and method" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interest" ] 9 => array:2 [ "identificador" => "xack36019" "titulo" => "Acknowledgements" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-01-21" "fechaAceptado" => "2010-06-17" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec93539" "palabras" => array:4 [ 0 => "Dreams" 1 => "Efavirenz" 2 => "HIV infection" 3 => "Adverse effects" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec93540" "palabras" => array:4 [ 0 => "Sueños" 1 => "Efavirenz" 2 => "Infección por VIH" 3 => "Efectos adversos" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background and objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The objective was to evaluate abnormalities in the quality of dreams after the use of efavirenz.</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Ten HIV patients without neuropsychiatric diseases underwent a polisomnography (PSG) study before and after efavirenz treatment, [after 10.4 (SD 5.4) days]. Patients were awoke after REM phases to record their dreams. All patients had therapeutic efavirenz plasma levels.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Dreams were recalled in 84% before efavirenz and 43% after efavirenz (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.024). There were no differences in the mean number of words per dream before and after efavirenz treatment (61.9 versus 47.5, p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.115). The proportion of dreams with no neutral emotional content (either pleasant or unpleasant) was 37.5% in the first night and 66.7% in the second night (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.046).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">There were a higher proportion of dreams with no neutral emotional content after efavirenz treatment in this group of patients. However, no longer dreams and no more dreams with negative emotional content were noted. Dream recall was lower after efavirenz treatment.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Fundamento y objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El objetivo del presente trabajo fue evaluar las alteraciones en la calidad de la ensoñación tras el inicio de efavirenz.</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Se realizó una polisomnografía (PSG) a diez pacientes sin antecedentes neurosiquiátricos antes y después del tratamiento con efavirenz (10,4 [DS 5.4] días después), y se despertó a los pacientes en fase REM para grabar la ensoñación. Todos los pacientes tenían niveles plasmáticos terapéuticos de efavirenz antes de la PSG.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Los pacientes recordaron algún tipo de ensoñación en el 84% de las veces antes del tratamiento con efavirenz, mientras que después del tratamiento sólo fue el 43% (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,024). No hubo diferencias en el número medio de palabras por sueño antes y después del tratamiento con efavirenz (61,96 versus 47,5; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,115). La proporción de sueños con contenido emocional no neutro (agradable o desagradable) fue 37,5% antes de efavirenz y 66,7% después (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.046).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Tras el tratamiento con efavirenz disminuye la ensoñación con contenido neutro, pero no aumenta ni la duración ni el contenido emocional negativo de la ensoñación. Además, no hubo sueños más largos y la tasa de recuerdo de la ensoñación fue menor.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Level 1-4<span class="elsevierStyleHsp" style=""></span>μg/mL is the therapeutic range of efavirenz plasma levels.</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">D4T: stavudine; EFV: efavirenz; TDF: tenofovir; ZDV: zidovudine; 3TC: lamivudine.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Patient number \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Days on efavirenz treatment at 2° PSG \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Plasma levels efavirenz (1-4<span class="elsevierStyleHsp" style=""></span>μg/ml) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">HAART \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.06 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">d4T<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>3TC<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EFV \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.93 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ZDV<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>3TC<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EFV \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.44 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ZDV<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>3TC<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EFV \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ZDV<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>3TC<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EFV \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ZDV<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>3TC<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EFV \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">- \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Not performed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ZDV<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>3TC<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EFV \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TDF<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>3TC<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EFV \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">- \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Not performed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">TDF<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>3TC<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EFV \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ZDV<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>3TC<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EFV \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ZDV<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>3TC<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>EFV \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab191810.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Plasmatic levels of efavirenz and time on efavirenz treatment at the 2° polysomnogram (PSG).</p>" ] ] 1 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Emotional contents are expressed by number and grouped as pleasant/neutral/unpleasant (which includes violent, highly anxious and moderately anxious) as a percentage.</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">* Recall rate was defined as the number of dreams recalled (numerator) referred to the number of REM periods (denominator).</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">§</span>Z signs; <span class="elsevierStyleSup">†</span>Wilcoxon; <span class="elsevierStyleSup">‡</span>Chi square; <span class="elsevierStyleSup">#</span>Student T Test.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Before (1st PSG, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>10)</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">After (2nd PSG, <span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8)</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Emotional content \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">0.442<span class="elsevierStyleSup">§</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Pleasant</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Neutral</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.046<span class="elsevierStyleSup">†</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Unpleasant</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">25.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Violent \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Highly anxious \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Moderately anxious \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Recall rate</span> * \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 / 19 (84%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 /14 (43%) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.024<span class="elsevierStyleSup">‡</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Number of thematic units</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.442<span class="elsevierStyleSup">#</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Number of words (length of dreams)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">61.9 (47.0) median 54 (IQ 21.5-87.0) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">47.5 (49.1) median 30 (IQ 11.75-68.5) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.115<span class="elsevierStyleSup">#</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab191811.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Description of dreams.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Safety and tolerance of efavirenz in different antiretroviral regimens: results from a national multicenter prospective study in 1,033 HIV-infected patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "J.A. Perez-Molina" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1310/hct.2002.3.4.003" "Revista" => array:6 [ "tituloSerie" => "HIV Clin Trials." "fecha" => "2002" "volumen" => "3" "paginaInicial" => "279" "paginaFinal" => "286" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12187501" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of efavirenz on neuropsychological performance and symptoms in HIV-infected individuals" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.B. Clifford" 1 => "S. Evans" 2 => "Y. Yang" 3 => "E.P. Acosta" 4 => "K. Goodkin" 5 => "K. Tashima" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Intern Med." "fecha" => "2005" "volumen" => "143" "paginaInicial" => "714" "paginaFinal" => "721" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16287792" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Analyzing sleep abnormalities in HIV-infected patients treated with Efavirenz" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Gallego" 1 => "P. Barreiro" 2 => "R. del Río" 3 => "D. González de Requena" 4 => "A. Rodríguez-Albariño" 5 => "J. González-Lahoz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/380791" "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis." "fecha" => "2004" "volumen" => "38" "paginaInicial" => "430" "paginaFinal" => "432" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14727217" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Changes in sleep quality and brain wave patterns following initiation of an efavirenz-containing triple antiretroviral regimen" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G. Moyle" 1 => "C. Fletcher" 2 => "H. Brown" 3 => "S. Mandalia" 4 => "B. Gazzard" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-1293.2006.00363.x" "Revista" => array:6 [ "tituloSerie" => "HIV Med." "fecha" => "2006" "volumen" => "7" "paginaInicial" => "243" "paginaFinal" => "247" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16630036" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efavirenz and chronic neuropsychiatric symptoms: a cross-sectional case control study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T.A. Rihs" 1 => "K. Begley" 2 => "D.E. Smith" 3 => "J. Sarangapany" 4 => "A. Callaghan" 5 => "M. Kelly" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-1293.2006.00419.x" "Revista" => array:6 [ "tituloSerie" => "HIV Med." "fecha" => "2006" "volumen" => "7" "paginaInicial" => "544" "paginaFinal" => "548" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17105514" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Measuring nightmare and bad dream frequency: impact of retrospective and prospective instruments" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G. Robert" 1 => "A. Zadra" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2869.2008.00649.x" "Revista" => array:6 [ "tituloSerie" => "J Sleep Res." "fecha" => "2008" "volumen" => "17" "paginaInicial" => "132" "paginaFinal" => "139" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18482103" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Analysis of polysomnographic events surrounding 252 slow-wave sleep arousals in thirty-eight adults with injurious sleepwalking and sleep terrors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.H. Schenck" 1 => "J.A. Pareja" 2 => "A.L. Patterson" 3 => "M.W. Mahowald" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Neurophysiol." "fecha" => "1998" "volumen" => "15" "paginaInicial" => "159" "paginaFinal" => "166" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9563584" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Changes in dreaming induced by CPAP in severe obstructive sleep apnea syndrome patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Carrasco" 1 => "J. Santamaría" 2 => "A. Iranzo" 3 => "L. Pintor" 4 => "J. dDe Pablo" 5 => "A. Solanas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2869.2006.00553.x" "Revista" => array:6 [ "tituloSerie" => "J Sleep Res." "fecha" => "2006" "volumen" => "15" "paginaInicial" => "430" "paginaFinal" => "436" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17118100" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prediction of neuropsychiatric adverse events associated with long-term efavirenz therapy, using plasma drug level monitoring" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Gutiérrez" 1 => "A. Navarro" 2 => "S. Padilla" 3 => "R. Antón" 4 => "M. Masiá" 5 => "J. Borrás" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/497835" "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis." "fecha" => "2005" "volumen" => "41" "paginaInicial" => "1648" "paginaFinal" => "1653" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16267739" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Preliminary data of a prospective study on neuropsychiatric side effects after initiation of efavirenz" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Blanch" 1 => "E. Martínez" 2 => "A. Rousaud" 3 => "J.L. Blanco" 4 => "M.A. García-Viejo" 5 => "J.M. Peri" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Acquir Immune Defic Syndr." "fecha" => "2001" "volumen" => "27" "paginaInicial" => "336" "paginaFinal" => "343" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11468421" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "identificador" => "xack36019" "titulo" => "Acknowledgements" "texto" => "<p id="par0100" class="elsevierStylePara elsevierViewall">We thank Dr J Santamaria for critically reviewing the manuscript.</p> <p id="par0105" class="elsevierStylePara elsevierViewall">Our acknowledgements to nurse and medical staff in Internal Medicine and Laboratory Units.</p>" ] ] ] "idiomaDefecto" => "en" "url" => "/00257753/0000013600000003/v1_201304301937/S0025775310007487/v1_201304301937/en/main.assets" "Apartado" => array:4 [ "identificador" => "7184" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Oribginal breve" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00257753/0000013600000003/v1_201304301937/S0025775310007487/v1_201304301937/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775310007487?idApp=UINPBA00004N" ]
