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BACKGROUND: Parkinson's disease (PD) is the second most common neurodegenerative disorder worldwide. The symptoms of PD are characterized not only by motor alterations but also by a spectrum of nonmotor symptoms. Some of these are psychiatric manifestations such as sleep disorders; depression; cognitive difficulties that can evolve into dementia; and symptoms of psychosis, which include hallucinations, illusions, and delusions. Parkinson's disease psychosis (PDP) occurs in 18-50% of patients with PD. Treating PDP is challenging because antipsychotic drugs tend to be inefficient or may even worsen the disease's motor symptoms. OBJECTIVE: This review aims to summarize the current understanding of the molecular mechanisms involved in PDP and recent innovative alternatives for its treatment. METHODS: This is a narrative review in which an extensive literature search was performed on the Scopus, EMBASE, PubMed, ISI Web of Science, and Google Scholar databases from inception to August 2021. The terms "Parkinson's disease psychosis", "Parkinson psychosis," "neurodegenerative psychosis", and "dopamine psychosis" were among the keywords used in the search. RESULTS: Recently, views on the etiology of hallucinations and illusions have evolved remarkably. PDP has been cemented as a multifactorial entity dependent on extrinsic and novel intrinsic mechanisms, including genetic factors, neurostructural alterations, functional disruptions, visual processing disturbances, and sleep disorders. Consequently, innovative pharmacological and biological treatments have been proposed. Pimavanserin, a selective 5-HT2A inverse agonist, stands out after its approval to treat PDP-associated hallucinations and illusions. CONCLUSION: Future results from upcoming clinical trials should further characterize the role of this drug in the management of PDP as well as other treatment options with novel mechanisms of action, such as saracatinib, SEP-363856, cannabidiol, electroconvulsive therapy, and transcranial magnetic stimulation.
Assuntos
Antipsicóticos , Ilusões , Doença de Parkinson , Transtornos Psicóticos , Transtornos do Sono-Vigília , Humanos , Doença de Parkinson/tratamento farmacológico , Dopamina , Transtornos Psicóticos/tratamento farmacológico , Alucinações/induzido quimicamente , Alucinações/tratamento farmacológico , Antipsicóticos/uso terapêutico , Ureia/farmacologia , Ureia/uso terapêutico , Transtornos do Sono-Vigília/induzido quimicamenteRESUMO
Electroconvulsive therapy (ECT) is based on conducting an electrical current through the brain to stimulate it and trigger generalized convulsion activity with therapeutic ends. Due to the efficient use of ECT during the last years, interest in the molecular bases involved in its mechanism of action has increased. Therefore, different hypotheses have emerged. In this context, the goal of this review is to describe the neurobiological, endocrine, and immune mechanisms involved in ECT and to detail its clinical efficacy in different psychiatric pathologies. This is a narrative review in which an extensive literature search was performed on the Scopus, Embase, PubMed, ISI Web of Science, and Google Scholar databases from inception to February 2022. The terms "electroconvulsive therapy", "neurobiological effects of electroconvulsive therapy", "molecular mechanisms in electroconvulsive therapy", and "psychiatric disorders" were among the keywords used in the search. The mechanisms of action of ECT include neurobiological function modifications and endocrine and immune changes that take place after ECT. Among these, the decrease in neural network hyperconnectivity, neuroinflammation reduction, neurogenesis promotion, modulation of different monoaminergic systems, and hypothalamus-hypophysis-adrenal and hypothalamus-hypophysis-thyroid axes normalization have been described. The majority of these elements are physiopathological components and therapeutic targets in different mental illnesses. Likewise, the use of ECT has recently expanded, with evidence of its use for other pathologies, such as Parkinson's disease psychosis, malignant neuroleptic syndrome, post-traumatic stress disorder, and obsessive-compulsive disorder. In conclusion, there is sufficient evidence to support the efficacy of ECT in the treatment of different psychiatric disorders, potentially through immune, endocrine, and neurobiological systems.
Assuntos
Eletroconvulsoterapia , Transtorno Obsessivo-Compulsivo , Transtornos Psicóticos , Humanos , Sistemas Neurossecretores , Transtornos Psicóticos/psicologia , Resultado do TratamentoRESUMO
The placebo effect can be defined as the improvement of symptoms in a patient after the administration of an innocuous substance in a context that induces expectations regarding its effects. During recent years, it has been discovered that the placebo response not only has neurobiological functions on analgesia, but that it is also capable of generating effects on the immune and endocrine systems. The possible integration of changes in different systems of the organism could favor the well-being of the individuals and go hand in hand with conventional treatment for multiple diseases. In this sense, classic conditioning and setting expectations stand out as psychological mechanisms implicated in the placebo effect. Recent advances in neuroimaging studies suggest a relationship between the placebo response and the opioid, cannabinoid, and monoaminergic systems. Likewise, a possible immune response conditioned by the placebo effect has been reported. There is evidence of immune suppression conditioned through the insular cortex and the amygdala, with noradrenalin as the responsible neurotransmitter. Finally, a conditioned response in the secretion of different hormones has been determined in different studies; however, the molecular mechanisms involved are not entirely known. Beyond studies about its mechanism of action, the placebo effect has proved to be useful in the clinical setting with promising results in the management of neurological, psychiatric, and immunologic disorders. However, more research is needed to better characterize its potential use. This review integrates current knowledge about the psycho-neuro-endocrine-immune basis of the placebo effect and its possible clinical applications.
Assuntos
Analgesia , Efeito Placebo , Sistema Endócrino , Humanos , Dor/tratamento farmacológico , Manejo da DorRESUMO
Contexto: la enfermedad de Fabry se comporta como una enfermedad crónica con compromiso multisistémico y alto costo en salud. Objetivo: generar recomendaciones basadas en la evidencia para el diagnóstico, el tratamiento y el seguimiento de la enfermedad de Fabry con compromiso renal mediante un consenso de expertos. Metodología: a partir de la búsqueda de evidencia en Pubmed, Embase y Google Scholar entre 2010 y agosto 2020, se formulan recomendaciones sobre la definición, el diagnóstico y el tratamiento de la enfermedad de Fabry en población adulta, las cuales se consultan a un panel de expertos a través de la metodología de consenso Delphi modificado. La calidad de los documentos se evaluó por equipo metodológico aplicando herramientas en función del tipo de documento incluido. Resultados: se formularon 53 recomendaciones sobre la definición, el diagnóstico y el tratamiento. Un panel de cinco expertos clínicos nacionales e internacionales externos al grupo desarrollador participaron en la consulta preconsenso y 50 recomendaciones fueron acordadas para su inclusión, para tres de ellas se requirió una sesión formal de consenso que se dio en una ronda, incorporando tres nuevas recomendaciones. Conclusiones: las recomendaciones basadas en evidencia y experticia clínica permitirán orientar de manera estandarizada a nivel nacional y regional, el diagnóstico y el tratamiento de pacientes con sospecha o enfermedad de Fabry con compromiso renal.
Background: Fabry disease behaves like a chronic condition, with multisystem involvement and high health care costs. Objective: To generate evidence-based recommendations for the diagnosis, treatment and follow-up of the Anderson-Fabry disease with renal commitment, through an expert consensus. Methodology: Based on the search of evidence in PubMed, Embase and Google Scholar between 2010 and August, 2020, recommendations on the definition, diagnosis and treatment of Fabry Disease in adult population were formulated after consulting with an expert panel through the modified Delphi consensus methodology. The quality of the documents was assessed by methodological team applying tools according to the type of document included. Results: 53 recommendations for the definition, diagnosis and treatment were formulated. A panel of five national and international clinical experts external to the developer group participated in the pre-consensus consultation and 50 recommendations were agreed upon for their inclusion. For 3 recommendations, a formal consensus session which took place in one round was required, and 3 new recommendations were incorporated. Conclusions: The recommendations based on evidence and clinical expertise will allow us to guide the diagnosis and treatment of patients with Fabry disease with renal involvement or suspicion thereof in a standardized manner at national and regional levels.
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RESUMEN El estudio analizó el vínculo entre la didáctica de maestros y las habilidades cognoscitivas de atención, memoria, velocidad y fluidez verbal en estudiantes de primeros grados de un colegio público en Cúcuta-Colombia. Se propuso un diseño exploratorio concurrente con análisis cualitativo y recolección de datos de fuente mixta, con muestreo intencional de 22 estudiantes y 4 maestras. Se evaluaron habilidades cognoscitivas mediante pruebas neuropsicológicas estandarizadas para Colombia y la didáctica fue explorada mediante entrevista semiestructurada siguiendo categorías de enseñanza, aprendizaje y técnicas. Las habilidades cognoscitivas se analizaron mediante estadística descriptiva y las entrevistas por análisis de triangulación categorial, concluyendo en los niños sobresaliente memoria-velocidad y disminuida atención y fluidez verbal, hallazgos sobresalientes vinculados a didácticas basadas en uso de fichas de aprendizaje, repetición, mecanización, mientras que los resultados inferiores se asociaron al uso de video y pasatiempos.
RESUMO O estudo analisou a relação entre a didática de professores e as habilidades cognoscitivas de atenção, memória, velocidade e fluidez verbal em estudantes de primeiros anos de uma escola pública em Cúcuta - Colômbia. Utilizou-se um roteiro exploratório junto com análises qualitativa e levantamento de dados de fonte mista, com amostra intencional de 22 estudantes e 4 professores. Avaliaram-se habilidades cognoscitivas mediante testes neuropsicológicos normatizados para Colômbia e a didática foi explorada mediante entrevista semiestruturada seguindo categorias de ensino, aprendizagem e técnicas. As habilidades cognoscitivas foram analisadas mediante estatística descritiva e as entrevistas por análise de triangulação categorial, concluindo-se nas crianças importantes memória-velocidade e diminuída atenção e fluidez verbal, achados marcantes vinculados a didáticas baseadas no uso de fichas de aprendizagem, repetição, mecanização, enquanto os resultados inferiores foram associados ao uso de vídeo e passatempos.
ABSTRACT The study analyzed the relationship between teacher didactics and cognitive skills of attention, memory, speed and verbal fluidity in first-year students of a public school in Cúcuta-Colombia. An exploratory script was used, together with qualitative analysis and mixed-source data collection, with an intentional sample of 22 students and 4 teachers. Cognitive abilities were evaluated through neuropsychological tests standardized for Colombia, and didactics were explored through semi-structured interviews following categories of teaching, learning and techniques. Cognitive skills were analyzed using descriptive statistics and interviews by categorical triangulation analysis, concluding in important children memory-speed and reduced attention and verbal fluidity, remarkable findings linked to didactics based on the use of learning sheets, repetition, mechanization, while lower results were associated with the use of video and hobbies.
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RESUMEN Las complicaciones respiratorias por la COVID-19 pueden llevar a la muerte, por lo que, dentro de las políticas de protección para evitar los contagios masivos, se han sugerido estrategias de cuarentena y confinamiento en muchos países, que han originado alteraciones en la salud mental y el sueño. A través de la siguiente revisión narrativa se pretende sistematizar los hallazgos más significativos en cuanto a la presencia de insomnio en pacientes hospitalizados con COVID-19, y de personas sanas que han estado sometidas a confinamiento como medida preventiva. Las condiciones propias de la enfermedad han hecho que los pacientes desarrollen insomnio, lo que puede empeorar su estado de salud y alterar su sistema inmunológico. Para las personas sanas en cuarentena los cambios en el estilo de vida, el miedo a contraer la enfermedad, la edad joven, el sexo femenino, los antecedentes de enfermedades mentales y una menor capacidad de afrontamiento al estrés parecen ser factores de riesgo para el insomnio. Al igual que la implementación de medidas epidemiológicas de cuidado y prevención contra el COVID-19, se debe tener en consideración promover la higiene del sueño como una estrategia de afrontamiento integral contra esta pandemia.
ABSTRACT Respiratory complications from COVID-19 can lead to death. For this reason, public health measures to curb the spread of the disease such as quarantine and other confinement strategies have been proposed in several countries, resulting in mental health and sleep disorders. We carried out a narrative review to systematize the most significant findings regarding insomnia in hospitalized patients with COVID-19, and in healthy persons who have been under confinement as a preventive measure. COVID-19-related conditions have caused insomnia in patients, which can alter the immune system and have a negative effect on health. For healthy people in quarantine, lifestyle changes, fear of becoming infected, young age, female gender, history of mental illness and reduced ability to cope with stress appear to be risk factors for insomnia. As well as the implementation of epidemiological and preventive measures, sleep hygiene should be promoted as a comprehensive coping strategy against the COVID-19 pandemic.
Assuntos
Transtornos do Sono-Vigília , COVID-19 , Distúrbios do Início e da Manutenção do Sono , Quarentena , Nível de Saúde , PandemiasRESUMO
Respiratory complications from COVID-19 can lead to death. For this reason, public health measures to curb the spread of the disease such as quarantine and other confinement strategies have been proposed in several countries, resulting in mental health and sleep disorders. We carried out a narrative review to systematize the most significant findings regarding insomnia in hospitalized patients with COVID-19, and in healthy persons who have been under confinement as a preventive measure. COVID-19-related conditions have caused insomnia in patients, which can alter the immune system and have a negative effect on health. For healthy people in quarantine, lifestyle changes, fear of becoming infected, young age, female gender, history of mental illness and reduced ability to cope with stress appear to be risk factors for insomnia. As well as the implementation of epidemiological and preventive measures, sleep hygiene should be promoted as a comprehensive coping strategy against the COVID-19 pandemic.
Las complicaciones respiratorias por la COVID-19 pueden llevar a la muerte, por lo que, dentro de las políticas de protección para evitar los contagios masivos, se han sugerido estrategias de cuarentena y confinamiento en muchos países, que han originado alteraciones en la salud mental y el sueño. A través de la siguiente revisión narrativa se pretende sistematizar los hallazgos más significativos en cuanto a la presencia de insomnio en pacientes hospitalizados con COVID-19, y de personas sanas que han estado sometidas a confinamiento como medida preventiva. Las condiciones propias de la enfermedad han hecho que los pacientes desarrollen insomnio, lo que puede empeorar su estado de salud y alterar su sistema inmunológico. Para las personas sanas en cuarentena los cambios en el estilo de vida, el miedo a contraer la enfermedad, la edad joven, el sexo femenino, los antecedentes de enfermedades mentales y una menor capacidad de afrontamiento al estrés parecen ser factores de riesgo para el insomnio. Al igual que la implementación de medidas epidemiológicas de cuidado y prevención contra el COVID-19, se debe tener en consideración promover la higiene del sueño como una estrategia de afrontamiento integral contra esta pandemia.
Assuntos
COVID-19/psicologia , Quarentena/psicologia , Transtornos do Sono-Vigília/epidemiologia , Adaptação Psicológica , Fatores Etários , COVID-19/complicações , COVID-19/prevenção & controle , Humanos , Transtornos Mentais/complicações , Fatores de Risco , Fatores Sexuais , Higiene do Sono , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/etiologia , Transtornos do Sono-Vigília/etiologiaRESUMO
El estudio tiene como objetivo establecer la relación entre el acompañamiento psicológico y la permanencia estudiantil, mediante el análisis de las variables individuales, académicas y sociodemográficas. El estudio siguió un diseño Ex post-facto, de tipo descriptivo correlacional con un muestreo censal de 520 estudiantes quienes han asistido a acompañamiento psicológico de manera voluntaria. La información fue obtenida mediante un cuestionario que explora características sociodemográficas, académicas y específicas de seguimiento psicológico. Se realizaron análisis comparativos y correlaciónales encontrando una relación positiva entre la permanencia y el acompañamiento psicológico breve ante crisis situacionales. Adicionalmente, se concluyó que la permanencia estudiantil se relaciona con la edad, el género, el semestre, el promedio, el motivo de consulta y el método terapéutico desarrollado en el proceso de acompañamiento psicológico. Se discutieron los resultados a la luz de antecedentes que han explicado los fenómenos de la permanencia y la deserción en contexto escolares.
O estudo tem como objetivo estabelecer a relação entre o acompanhamento psicológico e a permanência estudantil, mediante a análise das variáveis individuais, acadêmicas e sóciodemográficas. O estudo seguiu um modelo Ex post-facto, de tipo descritivo com uma amostra de censo de 520 estudantes os quais se submeteram a acompanhamento psicológico de maneira voluntária. A informação foi obtida mediante um questionário que explora características sóciodemográficas, acadêmicas e específicas de seguimento psicológico. Realizaram-se análises comparativas e correlacionais encontrando uma relação positiva entre a permanência e o acompanhamento psicológico breve ante crises situacionais. Adicionalmente, concluiu-se que a permanência estudantil se relaciona com a idade, o gênero, o semestre, a média, o motivo de consulta e o método terapêutico desenvolvido no processo de acompanhamento psicológico. Discutiram-se os resultados à luz de antecedentes que explicam os fenômenos da permanência e a deserção em contextos escolares.
The study aims to establish the relationship between psychological support and university permanence, through the analysis of individual, academic and sociodemographic variables. The study followed an ex post-facto, descriptive correlational design with a census sampling of 520 students who have voluntarily attended psychological support. The information was obtained through a questionnaire that explores sociodemographic, academic and specific characteristics of psychological follow-up. Comparative and correlational analyzes were performed finding a positive relationship between permanence and brief psychological accompaniment in the face of situational crises. Additionally, it was concluded that university permanence is related to age, gender, semester, average, the reason for consultation and the therapeutic method developed in the psychological accompaniment process. The results were discussed in the light of background that have explained the phenomena of permanence and dropout in school context.
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Psicoterapia , Evasão EscolarRESUMO
BACKGROUND: HIV-1 induces an uncontrolled inflammatory response of several immune components, such as inflammasomes. These molecular complexes, associated with Toll-like receptor (TLR) activity, induce the maturation and release of IL-1ß and IL-18 and eventually induce pyroptosis. It has been previously demonstrated that HIV induces inflammasome activation, which is significantly lower in the gastrointestinal tissue and blood from people living with HIV-1 with spontaneous control of viral replication. Therefore, immunomodulatory agents could be useful in improving HIV prognosis. OBJECTIVE: To evaluate the potential inhibitory effect of sulfasalazine (SSZ) on inflammasomes and TLRs in peripheral blood mononuclear cells (PBMCs) from people living with HIV and healthy donors. METHODS: PBMCs were obtained from 15 people living with HIV and 15 healthy donors. Cells were stimulated with agonists of TLRs and inflammasomes and subsequently treated with SSZ. The concentration of IL-1ß and the relative expression of NLRP3, NLRC4, NLRP1, AIM2, ASC, Caspase-1, IL-1ß, and IL-18 were quantified. RESULTS: Cells treated with SSZ exhibited a decreased IL-1ß production after inflammasome and TLR stimulation, as well as regulation of inflammasome-related genes, in both people with HIV and healthy individuals. The concentration of IL-1ß was positively correlated with the CD4+ T-cell count and negatively with the viral load. CONCLUSION: Our results suggest that SSZ has an immunomodulatory effect on inflammasome and TLR activation that depends on the clinical HIV status.
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Infecções por HIV/tratamento farmacológico , Infecções por HIV/imunologia , HIV-1/fisiologia , Fatores Imunológicos/uso terapêutico , Inflamação/tratamento farmacológico , Inflamação/imunologia , Sulfassalazina/uso terapêutico , Proteínas Adaptadoras de Transdução de Sinal/metabolismo , Adolescente , Adulto , Proteínas Reguladoras de Apoptose/metabolismo , Linfócitos T CD4-Positivos/imunologia , Sobrevivência Celular/efeitos dos fármacos , Feminino , Regulação da Expressão Gênica/efeitos dos fármacos , Infecções por HIV/virologia , HIV-1/efeitos dos fármacos , Humanos , Fatores Imunológicos/farmacologia , Inflamassomos/antagonistas & inibidores , Inflamassomos/metabolismo , Inflamação/patologia , Interleucina-1beta/metabolismo , Leucócitos Mononucleares/efeitos dos fármacos , Leucócitos Mononucleares/metabolismo , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Proteína 3 que Contém Domínio de Pirina da Família NLR/metabolismo , Proteínas NLR , Sulfassalazina/farmacologia , Receptores Toll-Like/metabolismo , Carga Viral , Adulto JovemRESUMO
OBJECTIVE: To analyse the Nutritional Knowledge Test (NKT) using Item Response Theory (ITR) analysis and to assess the construct validity of the Nutritional Knowledge Scale (NKTS) and its associations with adolescent food group consumption and nutritional biomarkers. DESIGN: Cross-sectional study. SETTING: Multicentre investigation conducted in ten European cities.ParticipantsAdolescents aged 12·5-17·5 years (n 3215) who completed over 75 % of the NKT. RESULTS: Factor analysis indicated that the NKT can be analysed with a one-dimensional model. Eleven out of twenty-three items from the NKT presented adequate parameters and were selected to be included in the NKTS. Nutrition knowledge was positively associated with consumption of fruits, cereals, dairy products, pulses, meat and eggs, and fish, as well as with blood concentrations of vitamin C, ß-carotene, n-3 fatty acids, holo-transcobalamin, cobalamin and folate; nutrition knowledge was negatively associated with intake of olives and avocado, alcohol and savoury snacks. CONCLUSIONS: The NKTS assessed nutritional knowledge adequately and it is proposed as a new tool to investigate this subject in future studies.
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Dieta/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Avaliação Nutricional , Adolescente , Criança , Estudos Transversais , Europa (Continente)/epidemiologia , Feminino , Humanos , Masculino , Estado Nutricional , Psicometria/métodos , Psicometria/normasRESUMO
Background: A growing body of evidence suggests that cigarette smoking can cause the onset of metabolic syndrome prior to cardiovascular diseases. Therefore, the objective of this study was to evaluate the relationship between smoking habit and metabolic syndrome components in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub-study, 2212 adults from both genders were selected. On the basis of their medical background, they were classified as smokers, non-smokers and former smokers. Metabolic syndrome was defined according to Harmonizing 2009 criteria, using population-specific abdominal circumference cut-off points. The association between risk factors was evaluated using a logistic regression model. Results: In the studied population, 14.8% were smokers, 15.4% were former smokers. In the multivariate analysis, the presence of metabolic syndrome (smokers: OR, 1.54; 95% CI, 1.11-2.14; p=0.010) and its components were related to cigarette smoking, with the exception of hyperglycemia. High blood pressure was inversely associated with current smoking status (smokers: OR, 0.70 (0.51-0.95); p=0.025). Conclusion: Cigarette smoking represents a related factor with metabolic syndrome, being associated with low high-density lipoprotein-cholesterol, increased abdominal circumference and elevated triacylglyceride levels. Former smokers did not present a greater risk for developing this metabolic disease when compared to non-smokers. The effect of avoiding this habit should be evaluated in future studies in our population.
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Fumar Cigarros/epidemiologia , Síndrome Metabólica/epidemiologia , Adulto , HDL-Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Hiperglicemia/sangue , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Obesidade Abdominal/sangue , Fatores de Risco , Triglicerídeos/sangue , Venezuela/epidemiologia , Adulto JovemRESUMO
La investigación describe el perfil neuropsicológico de un paciente con esquizofrenia en Cúcuta, Colombia. Se utilizó un diseño de investigación tipo ensayo clínico con fin diagnóstico y alcance descriptivo basado en un paciente de 52 años diagnosticado con esquizofrenia paranoide desde los 17 años, quien actualmente es tratado con antipsicótico atípico (risperidona 4,5 mg/día) y antidepresivo tricíclico (clorimipramina 300 mg/día). Se evaluó mediante un protocolo neuropsicológico conformado por Evaluación Cognitiva Montreal (MOCA, del acrónimo en inglés Montreal Cognitive Assessment), Test del Trazo (Trail Making, en inglés) A y B, subpruebas del Test Barcelona, curva de aprendizaje del Test Verbal de California, Figura Compleja de ReyOsterrieth, y subpruebas de WAIS III, cuyas respuestas generaron indicadores globales asociados con deterioro cognitivo leve, compromiso de la capacidad de atención alternante, memoria de trabajo, conversión acústico-fonológica y memoria declarativa de largo plazo, al igual que sus funciones ejecutivas.
This research aims to describe the neuropsychological profile in a patient with schizophrenia in the city of Cucuta, Colombia. A clinical trial type research design with a diagnostic purpose and descriptive scope was used in a patient aged 52 diagnosed with paranoid schizophrenia since age 17, currently being treated with atypical antipsychotic (Risperidone 4.5 mg/day) and tricyclic antidepressants (Clomipramine 300 mg/day). A neuropsychological protocol consisting of Montreal Cognitive Assessment (MOCA), Trail Making Test A and B, subtest of Barcelona Test, learning curve of the California Verbal Learning ââTest, ReyOsterrieth Complex Figure Test, and WAIS III subtests, recorded global indicators associated with mild cognitive impairment, commitment in the capacity of alternating attention, working memory, acoustic-phonemic conversion, and long-term declarative memory, as well as his executive functions.
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Humanos , Masculino , Pessoa de Meia-Idade , Psicologia do Esquizofrênico , Função Executiva/fisiologia , Disfunção Cognitiva , Testes NeuropsicológicosRESUMO
Resumen En las relaciones sexuales de jóvenes, las variables asociadas al uso del condón son diversas y comúnmente se presentan con otras variables que, a su vez, se asocian con la práctica sexual desprotegida. Los objetivos de este estudio consistieron en determinar en qué medida la percepción de autoeficacia, la baja percepción de riesgo y el rechazo del uso del condón se relacionan con el uso del condón en las relaciones sexuales de jóvenes colombianos. Participaron en él 308 estu diantes universitarios de la ciudad de Cúcuta, Colombia. Los resultados indican correlaciones significativas en hombres entre el uso del condón y la percepción de autoeficacia, y correlaciones negativas en mujeres entre el uso del condón, la baja percepción de riesgo y el rechazo del uso del condón. Solo en el grupo de hombres, la percepción de autoeficacia predice el uso del condón.
Abstract In the sexual relations of the youth, the variables associated with condom use are diverse and are often presented with other variables, that are also associated with unprotected sexual practice. This study aimed to determine to what extent the perception of self-efficacy, low risk perception and condom use shunning are associated with condom use in sexual relations of young Colom bians. 308 university students in the city of Cúcuta, Colombia, participated in the study. The results indicate significant correlations in men between condom use and self-efficacy perception and negative correlations in women between condom use, low risk perception and condom use shunning. Only in the male groups, the perception of self-efficacy predicts condom use.
RESUMO
Desde la perspectiva histórico-cultural, el trastorno por déficit de atención (TDA) se asocia con la inmadurez del factor de programación y control, que involucra el funcionamiento de regiones frontales del cerebro y hace parte del sistema ejecutivo. El artículo aborda un estudio de caso clínico en el que se exploró el impacto sistémico de un programa de intervención breve basado en el análisis del factor neuropsicológico, para comprobar su efectividad y eficiencia en el manejo sintomatológico del (TDA) y para proponer nuevos estudios controlados y aleatorizados que eventualmente validen esta metodología. Para lograrlo, se describieron los alcances del programa de corrección neuropsicológica orientada al fortalecimiento del factor de regulación y control mediante el desarrollo de la función reguladora del lenguaje, para incrementar las capacidades de planeación, control de espera, de autoverificación y la atención voluntaria. La intervención se basó en un diseño de línea de base múltiple tipo A-B-A, cuyos resultados se analizaron a partir de los puntajes de pruebas normalizadas y del análisis cualitativo de sus ejecuciones, realizadas al inicio del estudio y seis meses después. El caso analizado mostró un fortalecimiento de la función reguladora del lenguaje que impactó el desarrollo de los procesos psicológicos ejecutivos y se tradujo en un incremento del control atencional voluntario, la regulación de espera y la capacidad de planeación. Se concluye que el resultado de este caso ubica a este método como alternativa de manejo del (TDA) susceptible de ser estudiada en mayores grupos poblacionales controlados para validar el resultado, y eventualmente ofrecer un manejo extrapolable a la población diagnosticada.
From a cultural-historical perspective, attention deficit disorder (ADD) is associated with immaturity factor programming and control, which involves the functioning of the brain's frontal region and makes part of the executive system. This paper presents a clinical case study in which the systemic impact of a brief intervention program was explored; such intervention was based on the neuropsychological factor analysis, in order to prove its effectiveness and efficacy at ADD's management of symptoms as well as to propose new controlled and random studies to eventually validate this methodology. To achieve this, we described the scope of the program oriented neuropsychological correction factor strengthening the regulation and control, by developing the regulatory function of language, in order to improve planning, control of waiting, self-check and voluntary attention. Intervention was supported on an A-B-A multiple base line design, whose results were analyzed from the scores of standardized tests and the qualitative analysis of its performances at the beginning and six months after. The case analyzed showed a strengthening in the regulatory function of language, which affected the development of the executive psychological processes and showed an increase in the voluntary attentional control, regulation of waiting and planning ability. In conclusion, the result of this case places this method as an alternative to manage ADD, susceptible to be studied in larger controlled groups in order to validate the result and eventually offering an extrapolated management to a population diagnosed.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Idioma , NeuropsicologiaRESUMO
La infestación de tumores del tracto genital inferior por parásitos o larvas vivas es un acontecimiento raro, pocas veces reportado en la literatura. Presentamos el caso de una paciente de 82 años que acude a la emergencia de ginecología por presentar tumor ulcerado localizado en el tercio inferior de la pared vaginal izquierda, colonizado por múltiples larvas vivas. Nos parece importante el caso debido a la naturaleza rara de la misma, ya que existen pocos reportes en la literatura a nivel mundial. Consideramos necesario educar a la comunidad femenina para que acuda a sus controles anuales de rutina, y más aún ante la presencia de masas a nivel vulvar o vaginal, ya que por su crecimiento lento e indoloro se le resta importancia a este evento.
The infestation of tumors of the inferior genital tract for parasites or alive larvas is an event extraordinarily strange, few times reported in the literature. We present the case of a 82 year-old patient that goes to the gynecology emergency for great ulcerated tumor located in the inferior third of wall vaginal left, colonized by multiple alive larvas. We find important the case due to the strange nature of the same one, since few reports exist in the literature, what corroborates the previously exposed thing. We consider necessary to educate to the feminine community so that she goes to their annual controls of routine, and stiller before the presence of masses at level vulvar or vaginal, since maybe for their slow and painless growth she is subtracted importance.
Assuntos
Adulto , Feminino , Carcinoma Verrucoso , Condiloma Acuminado , Miíase , Vagina , Infecções por PapillomavirusRESUMO
Tipo de estudio: retrospectivo, longitudinal, de enero 1995 a enero del 2000 en el hospital de la Policía Nacional Guayaquil Nº 2. Objetivo: determinar el tipo de lesión más frecuente de la patología ulcero péptica que se asocia a la infección por helicobacter pylori; conocer su incidencia; establecer los grupos de edad, y procedencia más afectada, así como conocer el esquema terapéutico más utilizado contra helicobacter pylori. Resultados: de los 111 pacientes con enfermedad úlcero péptica, 63 casos presentaron tinción de hematoxilina eosina positiva para helicobacter pylori, constituyendo el 56.7 de todos los casos. La edad más frecuente en la que se presentó la infección por helicobacter pylori fue entre 30 39 años, con 29 casos (46). conclusión: la presencia de infección por helicobacter pylori en este estudio no constituyó un factor de riesgo asociado a la aparición de enfermedad úlcero-péptica. El tipo de lesión que con mayor frecuencia se asoció a helicobacter pylori fue la úlcera péptica aislada, seguido por el ulcus péptico asociado a gastritis.
Type of study: retrospective, longitudinal, from January 1995 to january 2000 in the hospital N° 2 of the National Police of Guayaquil. Objective: determine the most frequent type of lesion of peptic ulcer pathology which is associated with the infection by helicobacter pylori; learn about its incidence, establish the most affected age range and origin; as well as, get to know the most used therapeutic scheme against helicobacter pylori. Results: out of the 111 patients with peptic ulcer disease, 63 cases presented positive hematoxylin and eosin (H&E) stain for helicobacter pylori, representing 56.7 of all the cases. The most frequent age range at which the helicobacter pylori infection was present was between 30-39 with 29 cases (46). Conclusion: the presence of the helicobacter pylori infection in this study did not constitute a risk factor associated with the appearance of a peptic ulcer disease. The type of lesion that was most frequently associated with helicopter pylori was the isolated peptic ulcer, followed by the peptic ulcus associated with gastritis.
Assuntos
Masculino , Adulto , Feminino , Gastrite , Infecções por Helicobacter , Helicobacter pylori , Úlcera Péptica , Gastrite Atrófica , Azia , VômitoRESUMO
Tipo de estudio: retrospectivo, descriptivo de enero a junio de 2006 en el Instituto Oncológico Nacional de SOLCA en mujeres con diagnóstico de cáncer mamario. Objetivo: mejorar la evaluación pronóstica en la sobrevida de las pacientes con cáncer de mama, colaborando en su terapéutica y determinar la tasa de proliferación celular a través de técnicas de inmunohistoquímica utilizando el anticuerpo monoclonal KI-67. Resultados: de los 112 pacientes diagnosticados con cáncer de mama, 102 tenían carcinoma ductal infiltrante de los cuales el 68,6 presentaron Sobreexpresión (+ del 50 de células tumorales) del anticuerpo KI-67. Del total de pacientes 92 correspondieron a un grado histológico II de los cuales, 55 presentaron sobreexpresión del anticuerpo. Metástasis ganglionares linfáticas tenían 60 pacientes; y de éstas, 34 sobreexpresaron el anticuerpo. El tamaño tumoral que predominó fue el de mayor de 2 cm. (70 casos) de éstos, 45 presentaron sobreexpresión del KI-67. Conclusión: se concluye que el anticuerpo KI-67 no es suficiente para ser considerado como marcador tumoral con posible valor pronóstico y sobre todo predictivo para el cáncer de mama. La media de los años de presentación luego de la interpretación de los datos es similar a la información obtenida de la revisión bibliográfica, y que en Ecuador el cáncer de mama puede tener presentación precoz (menor de 40 años).
Study type: retrospective, descriptive, from january to june/2006in the National Oncological Institute of SOLCA in women with a breast cancer diagnosis. Objective: to improve the prognosis assessment in survival time of patients with breast cancer, to cooperate with their treatment and set the cell proliferation rate through immunohistochemistry techniques using the KI-67 Monoclonal Antibody. Results: 102 out of the 112 patients with breast cancer diagnosis, had infiltrative ductal carcinoma and 68.6 of them presented KI-67 antibody (+ than 50 of tumoral cells) overexpression. Ninety two patients had a histological grade II, and 55 of them presented the antibody overexpression. Sixty patients had ganglion metastasis and from them, 34 overexpressed the antibody. The predominant tumor size was longer than 0.8 (70 cases). From them 45 presented KI-67 antibody overexpression. Conclusion: KI-67 antibody is not enough to be considered as a tumor marker with a possible prognosis value and specially predictive for breast cancer. The average of years of presentation after data interpretation is similar to the information obtained from bibliographic revision, and that in Ecuador breast cancer may have an early presentation (younger than 40 years).
Assuntos
Adulto , Feminino , Pessoa de Meia-Idade , Neoplasias da Mama , Carcinoma in Situ , Carcinoma Ductal de Mama , Ciclo Celular , Imuno-Histoquímica , Mastectomia , Metástase NeoplásicaRESUMO
Dehydration is one of the main problems associated to endurance sports. In order to avoid the negative effects of dehydration athletes tend to drink well above their current needs. The negative effect of drinking too much fluid is hyponatremia. Hyponatremia is defined as a plasma sodium concentration lower than 135 mmol/L. Hyponatremia is the first cause of severe illness in ultraendurance sports and has been associated with sudden death. In this article, we analyze the causes, consequences, associated factors, therapeutic treatment and prevention of ultraendurance sports-associated hyponatremia. It is concluded that an adequate fluid ingestion is the best method to avoid hyponatremia. There is not conclusive data about the amount and necessity of sodium supplementation to avoid hyponatremia. However, it might be that it is not necessary to ingest additional sodium to prevent the development of hyponatremia in athletes who only partially replace their fluid losses during prolonged exercise.
Assuntos
Exercício Físico/fisiologia , Hiponatremia/etiologia , Resistência Física/fisiologia , Ingestão de Líquidos , Feminino , Guias como Assunto , Humanos , Hiponatremia/diagnóstico , Hiponatremia/tratamento farmacológico , Masculino , Sódio/administração & dosagem , Sódio/deficiência , Esportes/fisiologiaRESUMO
La deshidratación es uno de los principales enemigos de los deportes de resistencia. Sin embargo, la ingesta excesiva de líquido con el objetivo de evitar dicha deshidratación, ha provocado en los últimos años numerosos casos de hiponatremia, especialmente en esfuerzos de extrema duración. La hiponatremia se define como la presentación de concentraciones de sodio en plasma por debajo de 135 mmol/L. Representa la primera causa de enfermedad severa en deportes de ultraresistencia, a lo que ha sido asociado numerosos casos de muerte súbita. Las extremadas exigencias físicas de este tipo de deportes de creciente popularidad, junto con el peligro potencial que supone para la salud del deportista, nos ha conducido al estudio profundo de las causas, consecuencias, factores asociados, abordaje terapéutico y prevención de la hiponatremia , tanto desde un punto de vista científico como práctico. La ingesta de la cantidad adecuada de líquido se presenta como el método más importante para prevenir su aparición. No está clara la cantidad idónea y/o necesidad de una suplementación de sodio en la bebida para evitar el desarrollo de hiponatremia y mejorar el rendimiento deportivo en pruebas de ultraresistencia. No obstante, parece ser que esta suplementación sólo sería útil en aquellos individuos que ingirieron una excesiva cantidad de líquido
Assuntos
Humanos , Desidratação , Hidratação , Hiponatremia , Resistência Física , Sódio , Ciências da Nutrição , Espanha , EsportesRESUMO
Se realiza un estudio abierto en 50 niños menores de 15 años, que fueron atendidos en nuestro centro, los que presentaban una de las afecciones producidas por herpesvirus humano, y a los cuales se les administró el tetramisol-L (levamisol), en dosis de 2,5 mg por kg de peso corporal por día, en 2 subdosis durante 3 días consecutivos, y en los cuales los resultados obtenidos sugieren que este fármaco resultó útil en el tratmiento de las mismas, ya que inició antes la mejoría clínica, aceleró la curación y evitó o minimizó la aparición de complicaciones en los mismos. Por esto se concluye, que debe de realizarse un estudio a doble ciegas con una muestra mayor (ya en ejecución), que nos permita recomendar su empleo sistemático en el tratamiento de dichas afecciones, para las cuales no existe ningún tratamiento específico que haga variar la evolución antural de las mismas, ni evitar sus complicaciones