RESUMEN
El envejecimiento está asociado con la disminución de las capacidades cognitivas de las personas y, en muchos casos, va acompañado de un descenso de la calidad de vida. El objetivo de este trabajo de investigación consiste en identificar los efectos que un entrenamiento adaptado y continuado en karate puede tener en las capacidades cognitivas de personas de más de cuarenta años. Para ello se obtuvo una muestra incidental de 275 sujetos. Se llevó a cabo un trabajo empírico descriptivo y correlacional. La variable investigada es la velocidad de anticipación, medida mediante la puntuación obtenida en el test Kelvin (KCC). Las variables controladas son la edad, sexo y la práctica continuada de karate. El entrenamiento regular en karate ha tenido efectos positivos en la velocidad de anticipación de las personas mayores de cuarenta años, lo que implica una mejora en la atención y otras capacidades cognitivas de estas personas. En los sujetos no practicantes de Karate, al llevar a cabo la comparación de medias entre mayores y menores de 40 años, sí se han encontrado diferencias significativas. Por tanto, el entrenamiento adaptado de karate puede ser una opción interesante para mantener las capacidades cognitivas a lo largo de los procesos envejecimiento (AU)
Normally, aging has been associated to the decrease of peoples cognitive capacity and, in several cases, related to a decrease in the quality of life. The objective of this research work is the identification of the effects that an adapted and continuous practice of karate would have in the cognitive capacity of people having more than 40 years old. To achieve this aim, 275 subjects were analysed through an empirical and correlational approach. The dependent variable analysed was the anticipation speed measured by he points obtained by the participants in the Kelvin test (KCC). The independent variables considered were age, gender and the continuous practice of karate. The results obtained indicate that the regular and adapted karate training have positive effects in the anticipation speed of people having more than 40 years old. In this group the anticipation speed has not relevant differences between people having less and more than 40 years old. There were relevant differences between both subsets in the case of subjects that were not karate practitioners. In this sense, the continuous practice of karate could be an interesting option to maintain the cognitive capacities throughout aging processes (AU)
Asunto(s)
Humanos , Masculino , Femenino , Deportes/educación , Deportes/psicología , Nootrópicos/metabolismo , Artes Marciales/psicología , Calidad de Vida , Envejecimiento/metabolismo , España , Deportes/clasificación , Deportes/fisiología , Nootrópicos/normas , Artes Marciales/educación , Calidad de Vida/psicología , Epidemiología Descriptiva , Envejecimiento/patología , España/etnologíaRESUMEN
In 2013 the Dutch authorities issued a warning against a dietary supplement that was linked to 11 reported adverse reactions, including heart problems and in one case even a cardiac arrest. In the UK a 20-year-old woman, said to have overdosed on this supplement, died. Since according to the label the product was a herbal mixture, initial LC-MS/MS analysis focused on the detection of plant toxins. Yohimbe alkaloids, which are not allowed to be present in herbal preparations according to Dutch legislation, were found at relatively high levels (400-900 mg kg(-1)). However, their presence did not explain the adverse health effects reported. Based on these effects the supplement was screened for the presence of a ß-agonist, using three different biosensor assays, i.e. the validated competitive radioligand ß2-adrenergic receptor binding assay, a validated ß-agonists ELISA and a newly developed multiplex microsphere (bead)-based ß-agonist assay with imaging detection (MAGPIX(®)). The high responses obtained in these three biosensors suggested strongly the presence of a ß-agonist. Inspection of the label indicated the presence of N-isopropyloctopamine. A pure standard of this compound was bought and shown to have a strong activity in the three biosensor assays. Analysis by LC-full-scan high-resolution MS confirmed the presence of this 'unknown known' ß3-agonist N-isopropyloctopamine, reported to lead to heart problems at high doses. A confirmatory quantitative analysis revealed that one dose of the preparation resulted in an intake of 40-60 mg, which is within the therapeutic range of this compound. The case shows the strength of combining bioassays with chemical analytical techniques for identification of illegal pharmacologically active substances in food supplements.
Asunto(s)
Agonistas de Receptores Adrenérgicos beta 3/envenenamiento , Antipirina/análogos & derivados , Depresores del Apetito/efectos adversos , Suplementos Dietéticos/efectos adversos , Contaminación de Alimentos , Cardiopatías/etiología , Preparaciones de Plantas/efectos adversos , Agonistas de Receptores Adrenérgicos beta 3/análisis , Alcaloides/análisis , Alcaloides/toxicidad , Anabolizantes/efectos adversos , Anabolizantes/química , Anabolizantes/envenenamiento , Anabolizantes/normas , Antipirina/análisis , Antipirina/envenenamiento , Depresores del Apetito/química , Depresores del Apetito/envenenamiento , Depresores del Apetito/normas , Técnicas Biosensibles , Suplementos Dietéticos/análisis , Suplementos Dietéticos/envenenamiento , Suplementos Dietéticos/normas , Inspección de Alimentos , Etiquetado de Alimentos , Enfermedades Transmitidas por los Alimentos/etiología , Enfermedades Transmitidas por los Alimentos/mortalidad , Enfermedades Transmitidas por los Alimentos/terapia , Cardiopatías/mortalidad , Cardiopatías/terapia , Hospitalización , Humanos , Internet , Países Bajos , Nootrópicos/efectos adversos , Nootrópicos/química , Nootrópicos/envenenamiento , Nootrópicos/normas , Pausinystalia/efectos adversos , Pausinystalia/química , Sustancias para Mejorar el Rendimiento/efectos adversos , Sustancias para Mejorar el Rendimiento/química , Sustancias para Mejorar el Rendimiento/envenenamiento , Sustancias para Mejorar el Rendimiento/normas , Preparaciones de Plantas/química , Preparaciones de Plantas/envenenamiento , Preparaciones de Plantas/normasRESUMEN
A chiral procedure based on EKC was developed and validated for determination of the enantiomeric purity of PHA-543613, a drug candidate that was under development for treatment of the cognitive deficits of Alzheimer's disease and schizophrenia. Separation of enantiomers is accomplished via differential, enantiospecific complexation with a single-isomer, precisely sulfated beta-CD and heptakis-6-sulfato-beta-CD (HpS-beta-CD). Both neutral and sulfated CDs were screened before selecting HpS-beta-CD as the chiral selector. The separation is conducted in a 61 cm x 50 microm uncoated fused silica capillary with 25 mM HpS-beta-CD in pH 2.50, 25 mM lithium phosphate as the separation buffer with detection at 220 nm. Application of reverse polarity at -30 kV results in an elution time of about 12 min for PHA-543613 and 13 min for the undesired S-enantiomer. Quantification is versus an authentic reference S-enantiomer as an external standard in combination with an internal standard. The procedure was validated over the range 0.1-2.0% w/w. The detection limit is 0.01-0.02%. The amount of distomer intrinsic to the drug substance is about 0.1% or less. The developed method was used to generate stability data on multiple lots: in one case for up to 3 years.
Asunto(s)
Compuestos Bicíclicos Heterocíclicos con Puentes/aislamiento & purificación , Electroforesis Capilar/métodos , Quinuclidinas/aislamiento & purificación , Compuestos Bicíclicos Heterocíclicos con Puentes/química , Compuestos Bicíclicos Heterocíclicos con Puentes/normas , Cromatografía Líquida de Alta Presión/métodos , Cromatografía Capilar Electrocinética Micelar/métodos , Cromatografía Capilar Electrocinética Micelar/normas , Cromatografía Capilar Electrocinética Micelar/estadística & datos numéricos , Electroforesis Capilar/normas , Electroforesis Capilar/estadística & datos numéricos , Agonistas Nicotínicos/química , Agonistas Nicotínicos/aislamiento & purificación , Agonistas Nicotínicos/normas , Nootrópicos/química , Nootrópicos/aislamiento & purificación , Nootrópicos/normas , Quinuclidinas/química , Quinuclidinas/normas , Estándares de Referencia , EstereoisomerismoRESUMEN
OBJECTIVE: To review the drug treatment of Alzheimer's disease (AD) and to provide guidelines for the physician on how to integrate these treatments into the overall management of this disorder. METHOD: A qualitative review of randomized, double-blind, placebo-controlled trials of medications used to treat cognitive deficits, disease progression, agitation, psychosis, or depression in AD. A computerized search of Medline was used to identify relevant literature published during the period 1968-1998. Key words used in the search were 'randomized controlled trials,' with 'dementia' and with 'Alzheimer's disease'. RESULTS: Agents that are currently available in Canada to treat the cognitive deficits of AD include donepezil, ginkgo biloba, selegiline, and ergoloid mesylates. Donepezil and ginkgo biloba are associated with a statistically significant but clinically modest improvement in cognitive function in a substantial minority of patients with mild to moderate AD. Selegiline may have a mild beneficial effect on cognitive function in some patients with AD, but the data are inconclusive. Ergoloid mesylates have questionable efficacy in AD and can only be recommended as a last line of treatment. The results of a single trial suggest that vitamin E or selegiline (both have antioxidant properties) may slow the progression of AD. Antipsychotic medications can result in clinically significant improvement in agitation and psychosis. Carbamazepine also appears to be an effective treatment for agitation in AD, and there is preliminary evidence that the selective serotonin reuptake inhibitor citalopram reduces irritability in this disorder. There is no evidence that other nonneuroleptic medications are more efficacious than placebo in treating agitation in AD. Limited data indicate that depression in dementia responds to antidepressant medication. CONCLUSION: These data indicate that selected medications can be used to treat cognitive deficits, disease progression, agitation, psychosis, and depression in AD. However, there is considerable heterogeneity in patients' responses to these medications. Pharmacotherapy needs to be considered as a component of a package of care that also includes psychosocial and environmental interventions and support of the caregiver.
Asunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Nootrópicos/uso terapéutico , Anciano , Enfermedad de Alzheimer/prevención & control , Antidepresivos/uso terapéutico , Antipsicóticos/uso terapéutico , Trastornos del Conocimiento/tratamiento farmacológico , Humanos , Nootrópicos/normas , Guías de Práctica Clínica como Asunto , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
Pharmacoeconomics is a new discipline with its own terminology and techniques, little known to most clinicians but destined to become more important to them and to their patients. This article reviews basic approaches in pharmacoeconomics; current knowledge of costs related to dementia; assessment of quality of life in patients with cognitive impairment; models of relationships among degree of cognitive impairment, caregiver burden, and health care utilization; existing pharmacoeconomic guidelines for drug studies; pharmacoeconomic studies of tacrine, a drug used in Alzheimer disease; and further work needed to advance the critical area of pharmacoeconomic studies in dementia.
Asunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Trastornos del Conocimiento/tratamiento farmacológico , Trastornos del Conocimiento/economía , Aprobación de Drogas/economía , Economía Farmacéutica , Nootrópicos/economía , Enfermedad de Alzheimer/complicaciones , Enfermedad de Alzheimer/economía , Enfermedad Crónica , Ensayos Clínicos Fase III como Asunto , Trastornos del Conocimiento/etiología , Costos y Análisis de Costo , Economía Farmacéutica/normas , Salud de la Familia , Guías como Asunto , Humanos , Modelos Económicos , Nootrópicos/normas , Calidad de Vida , Proyectos de Investigación , Tacrina/economía , Tacrina/normasRESUMEN
The evidence to support a claim that a new drug will slow the progression of Alzheimer disease (AD) must derive from epistemologically valid research methods. Although agency regulations do not specify the magnitude of an effect that a drug must possess to be granted a claim as a treatment for AD, the evidence to support any claim must be adduced in adequate and well-controlled clinical investigations and must meet the standard of "substantial evidence." Because a claim presented in drug product labeling may not be false or misleading in any particular, a distinction must be made between treatments that provide a "symptomatic" benefit and those that alter the course of dementia. Examples of some of the difficulties likely to be encountered by sponsors seeking to develop evidence to support a claim that a new drug slows the progression of dementia are presented. A suggestion is made for a clinical trial design, designated as the "randomized start design," that may be useful in such a question. Why this design might overcome many of the difficulties, both practical and ethical, present in the "discontinuation" design, the design ordinarily proposed to assess a drug's effect on disease progression, is discussed.
Asunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Nootrópicos/normas , Ensayos Clínicos Controlados Aleatorios como Asunto/métodos , Progresión de la Enfermedad , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Esquema de Medicación , Aprobación de Drogas/legislación & jurisprudencia , Aprobación de Drogas/métodos , Evaluación de Medicamentos/métodos , Humanos , Evaluación de Resultado en la Atención de Salud/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto/normas , Proyectos de Investigación/normas , Factores de Tiempo , Estados UnidosRESUMEN
Choline supplementation of pregnant rats between d 12 and 17 of pregnancy permanently enhances the spatial memory of offspring; however, the mechanism is unknown. We examined the effect of choline supplementation on metabolism of orally ingested choline by nonmated rats and pregnant rats and their fetuses. We studied the metabolism of an acute oral dose of 14C-choline chloride in pregnant and nonmated rats with and without choline supplementation (25 mmol/L choline chloride in water) on d 12-17 of pregnancy. During the first 2 h after oral dosing, plasma radiolabeled choline was detectable, whereas plasma choline metabolites contributed little to total radioactivity at any time. The pattern of accumulation of label in placentas was similar in all groups. Fetal tissues (i.e., brain, liver and carcass remnant) contained primarily 14C-phosphatidylcholine and 14C-phosphorylcholine. Also, we examined the fetal tissue distribution of isotopically labeled (deuterated) choline derived from the diet and from the dietary choline supplement. The distribution patterns for radiolabeled choline metabolites in fetuses of supplemented dams accumulated significantly (P < 0.01) more of their total choline and its metabolites than fetuses of control dams during d 12-17 of gestation (50 vs. 20%). In fetuses from supplemented dams, betaine concentrations were greater than in fetuses from control dams in all organs assayed (by 36-57%). Phosphorylcholine concentrations in brain of fetuses from supplemented dams were also greater. These experiments identify potential metabolites of choline that might mediate the observed effects on brain development in the rats.