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El daño medular espinal, representa la principal causa de parálisis (total o parcial), que se acompaña de secuelas irreversibles y de gran impacto negativo para el paciente, entorno familiar y laboral. Con el advenimiento y avances en tecnología, técnicas de inmunohistoquímica, citología y bioingeniería, se han podido desarrollar numerosos estudios a nivel experimental, dirigidos a la recuperación de la función vertebro-espinal, con una inmensa gama de resultados, que sirven de asiento a futuras investigaciones en seres humanos. En su mayoría, evalúan funciones motoras y sensitivas durante las 3 fases de la lesión espinal. Para ello se emplean técnicas de implantación de células madre (de origen alogénico, autólogo o xenogénico) a través de la inyección intratecal o directa en parénquima nervioso. Los resultados a nivel experimental son alentadores; sin embargo, aún queda mucho por dilucidar en torno a la formación de la cicatriz glial, de los factores inductores que se expresan y su repercusión en humanos. Las directrices actuales en el tratamiento de la lesión espinal, incluyen desde mejoras en las técnicas de inmovilización y traslado pre-hospitalario del paciente lesionado espinal, pasando por el empleo de fármacos (Esteroides, Lazaroides, Calcio antagonistas, diuréticos osmóticos, etc.), hasta el uso de estimulación cortical, epidural y nanoimplantes medulares, así como la aplicación de exoesqueletos y de la Terapia Celular. En este artículo se reúnen los resultados de la revisión de estudios con más de 21mil publicaciones (hasta octubre del 2017), donde se han empleado células madre para tratar la lesión medular espinal (traumática)(AU)

Spinal cord damage represents the main cause of paralysis (total or partial), which is accompanied by irreversible sequelae and a high negative impact on the patient, family and work environment. With the advent and advances in technology, techniques of immunohistochemistry, cytology and bioengineering, numerous experimental studies have been developed, aimed at recovering vertebro-spinal function, with an immense range of results, which serve as a seat for future investigations in human beings. In their majority, they evaluate motor and sensory functions during the 3 phases of the spinal injury. For this purpose, implantation techniques of stem cells (of allogeneic, autologous or xenogenic origin) are used through intrathecal or direct injection in nervous parenchyma. The results at the experimental level are encouraging; However, much remains to be elucidated about the formation of the glial scar, the inducing factors that are expressed and their impact on humans. The current guidelines in the treatment of spinal injury include improvements in the techniques of immobilization and pre-hospital transfer of the injured spinal patient, through the use of drugs (steroids, lazaroids, calcium antagonists, osmotic diuretics, etc.) up to the use of cortical stimulation, epidural and spinal nanoimplantation, as well as the application of exoskeletons and Cell Therapy. This article brings together the results of the review of studies with more than 21 thousand publications (until October 2017), where stem cells have been used to treat spinal cord injury (traumatic)(AU)

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Antecedentes: Las redes de apoyo social son utilizadas por las personas para obtener o mantener ciertos beneficios a lo largo de la vida. Existen evidencias sobre el impacto y la influencia positiva que estas pueden tener en la salud, bienestar, funcionalidad y calidad de vida de las personas mayores, por lo que pueden ser fundamentales en la provisión de diferentes tipos de ayuda de ahí que es importante considerar el estudio de estos contactos y apoyos sociales. Objetivo: Determinar la influencia de las redes de apoyo social en la funcionalidad física y calidad de vida en adultos mayores. Método: Se llevó a cabo un estudio analítico y comparativo con 150 adultos mayores en la Ciudad de México, se aplicaron escalas: Redes de apoyo social para adultos mayores (RAS), así como las escalas de funcionalidad física Barthel, Lawton y Brody, Nagi y el instrumento calidad de vida de la OMS WHOQoL. Los resultados se analizaron a través de frecuencias, porcentajes, y como prueba de comparación Ji Cuadrada, razón de momios como estimador de riesgo con un intervalo de confianza al 95% y coeficiente de correlación. Resultados: Se encontró que los adultos mayores que cuentan con escaso apoyo familiar y contacto social, se ven afectados significativamente para realizar actividades básicas de la vida diaria (ABVD) (p<0.03), evaluadas a través de la escala Barthel. En relación a la escala Nagi se observó que los que tienen escaso; Apoyo extrafamiliar (p=0.01), contacto social (p=0.02) y apoyo recibido (p=0.05) tienen riesgo para depender de alguien para ABVD. En cuanto a las Actividades Instrumentales de la Vida Diaria de Lawton y Brody AIVD, se pudo observar que quienes tienen escaso; contacto social (p=0.006) y satisfacción de apoyo (p=0.03) presentanriesgo de dependencia para AIVD. Existe una asociación correlacional estadísticamente significativa entre la funcionalidad de las escalas Barthel, Lawton y Brody, Nagi y las dimensiones de RAS; Apoyo familiar, apoyo extra familiar, Satisfacción de apoyo, apoyo recibido y contacto social. Al evaluar la calidad de vida, los participantes perciben como promedio o baja; la salud física (p=0.01), aspectos psicológicos (p=0.000004) y medio ambiente (p=0.03). Conclusiones: Nuestros hallazgos sugieren que el contar con escaso contacto social, constituye un factor de riesgo de dependencia para realizar actividades Básicas de la Vida Diaria, Actividades Instrumentales de la Vida Diaria y perciben su calidad de vida como baja o promedio en la salud física, aspectos psicológicos y medio ambiente.

Background: Social support networks are used by people to obtain or maintain certain benefits over a lifetime. There is evidence of the impact and positive influence than these can have on health, welfare, functionality and life quality of old people and can be fundamental in the provision of different types of help, hence, it's important consider the study of these contacts and social supports. Objective: Determine the influence of social support networks on physical functioning and life quality of older adults. Methodology: An analytical and comparative study was carried out in 150 older adults. The following scale were applied in the Mexico City: Social support networks for older adults, as well as the physical functionality scales of Barthel, Lawton and Brody, Nagi and the quality of life instrument of the WHOQoL World Health Organization. Results were analyzed using frequencies, percentages, Ji2 comparison tests, as risk estimator odds ratio with a (CI95%) and correlation coefficient. Results: it was found that older adults with low support family and social contact were significantly affected to perform basic activities of daily life (ABVD) (p=0.03), evaluated through the Barthel scale. In relation to the Nagi scale, it was observed that those with low; support extra family (p=0.01), social contact (p = 0.02) and received support (p = 0.05) are at risk of depending on someone for basic activities of daily life. Regarding the daily life instrumental activities of Lawton and Brody, it was observed that those with low social contact (p=0.006) and support satisfaction (p=0.03) presented a risk of dependence for daily life instrumental activities. There is a statistically significant correlation between the functionality of the Barthel, Lawton and Brody, Rosow, Nagi and dimensions of support networks; Family support, extra family support, support satisfaction, support received and social contact. When assessing quality of life, participants perceive as low or average; Physical health (p=0.01), psychological aspects (p=0.0001), environment (p=0.05). Conclusion: Our findings suggest that having few contacts of social support or social support networks constitutes a risk factor for dependence to perform daily life basic activities, daily life instrumental activities and perceive their quality of life as low or average in physical health, psychological aspects and environment.

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In 1988 the health care network in Bolivia had 80 health districts, of which 18 were urban and 62 were rural. The city of Santa Cruz de la Sierra, located in the country's tropical area, was divided into five health districts. One of these was selected for implementation of a local health system, based on four priority criteria: socioeconomic situation, epidemiologic profile, access to health services, and services coverage. After the model had been in place for ten months, significant results could be seen, which are summarized as follows: effective participation by the people in the district, increased demand for preventive services, interest in receiving information and health education, satisfaction on the part of the people with the actions carried out vis-à-vis the perceived needs, and effective coordination of all the institutions making up the local health system.

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