RESUMO
Working memory abilities significantly decrease with advancing age; hence, the search for factors that may increase or mitigate this decline is critical. Several factors have been identified that influence working memory; however, their effects have been mainly assessed separately and rarely together with other factors in the same sample. We examined 120 variables to search for factors that jointly act as mediators of working memory decay across the adult life span. A sample of 1652 healthy adults was assessed in spatial and verbal working memory domains. Structural equation modeling analyses were conducted to search for potential mediators that intervened between age and working memory. Only 14 and 10 variables reliably mediated spatial and verbal working memory, respectively. Factors from several domains remained in the models, such as individual characteristics, physiological traits, consumption habits, and regular activities. These factors are sufficiently powerful to influence working memory decline when they jointly interact, as in everyday living.
Assuntos
Memória de Curto Prazo/fisiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Escolaridade , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Análise de Classes Latentes , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Comportamento Social , Adulto JovemRESUMO
The ability to remember the details of our own experiences declines gradually as we get old. The reason for this decay has been attributed to several factors besides age, such as education, nutrient intake and health status. However, the influence of these factors has mainly been examined individually and rarely together. Here we identify those factors that jointly act as mediators of episodic memory decay across the adult life span. We examined source memory in a lifespan sample of 1557 healthy adults. A total of 70 physical, biological and lifestyle variables were measured and introduced into a structural equation model as potential mediators that intervene between age and source memory. Only 14 mediator variables reliably mediated source memory decay; notably, eight of these variables have an effect on the cardiovascular system. The model unequivocally highlights that the mediators that may impair cardiovascular functioning also impact brain resources involved in episodic memory. We identified the factors that are relevant to episodic memory decline when they interact together as occurs in real life.
Assuntos
Envelhecimento Cognitivo , Estilo de Vida , Transtornos da Memória/fisiopatologia , Memória Episódica , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Rememoração Mental , México , Pessoa de Meia-Idade , Testes NeuropsicológicosRESUMO
Drug-induced adverse reactions (ADR) include any undesirable pharmacological effect that occurs following drug administration at therapeutic doses. The appearance of ADR significantly limits the use of drugs in as much as their clinical symptoms may range from very mild discomfort such as cutaneous rash, up to very severe, or even fatal tissue necrolysis such as the Stevens Johnson syndrome.One of the most frequently involved organ during ADR is the skin. Drug-induced cutaneous reactions (CDR) incidence is variable but they may appear in 2-3% of ambulatory patients, and it may increase to 10-15% when patients are hospitalized, or even be as high as 60% when co morbidity includes the presence of virus, bacteria, or parasites.Due to the fact that skin is one of the organs most frequently involved in ADR, in this work we analyze and propose a mechanism by which epidermal dendritic cells operating as the sentinels of the skin neuro-immune-endocrine system may contribute to CDR via either immunogenic or tolerogenic immune responses towards drugs, whenever they are administered topic or systemically.
Assuntos
Toxidermias/imunologia , Células de Langerhans/imunologia , Pele/imunologia , Animais , Antígenos CD/análise , Movimento Celular , Humanos , Tolerância Imunológica , Imunidade Inata , Ativação Linfocitária , Receptores Imunológicos/metabolismo , Linfócitos T/imunologiaRESUMO
Global climate change is one of the instigating and contributing factors for epidemic outbreaks of infectious diseases in human populations. In the years 2003 to 2005 the city of Tampico, in the northern state of Tamaulipas, Mexico, experienced recurrent outbreaks of dengue virus infections (DV) and the resulting dengue fever (DF). One of the hallmark symptoms of DF, which appears to worsen as the environmental temperature increases, is thrombocytopenia. In as much as it is a hallmark for hemorrhagic manifestations, thrombocytopenia is a useful sign to monitor the course of infected patients. Extracellular calcium (Ca2+ o) plays a key role in blood clotting; its chelation in vitro with ethylenediaminetetracetic acid (EDTA) or citrate prevents clotting, while exogenous recalcification of plasma leads to shortening of clotting time. In vivo, Ca2+ o is essential for platelet function and for the regulation of the immune response. In this work we report a significant increase (p<0.05) in the number of blood platelets of patients with clinical signs and symptoms of DF following oral administration of calcium carbonate (CAL, 1.2 to 1.8 g/day; n=10) when compared with a control group (CTL, n=10): 89 (46-132) versus 206 (155-257). Data expressed as mean value (95% confidence interval, C.I.) for x1000 cells/mm3. CAL also improved overall clinical condition and reduced by 36 % the duration of signs and symptoms of DF: 6.7-11.3 days, versus 11.5-16.6 days (95 % C.I., p<0.05) when compared with CTL patients. The possible mechanism of calcium attenuated thrombocytopenia and clinical improvement is discussed.
Assuntos
Carbonato de Cálcio/uso terapêutico , Dengue/tratamento farmacológico , Trombocitopenia/tratamento farmacológico , Administração Oral , Adolescente , Adulto , Criança , Dengue/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Trombocitopenia/complicaçõesRESUMO
Quotidian clinical practice implies at least four essential activities: i) integration of diagnosis; ii) design of the therapeutic regimen; iii) following up therapeutic outcomes; and, iv) keeping updated on medical knowledge. The therapeutic regimen may include the use of drugs among other forms of treatment. A competent clinician is expected to be knowledgeable, skillful, dutiful and altruistic when deciding to use drugs. In this work, drug administration is proposed to be redefined as an ssential clinical competence that integrates basic medical pharmacology knowledge (BMPK) along with pharmacotherapy's abilities and skills. Medical students should learn and become efficient in deciding what drugs are useful for specific patients; how drug(s) should be administered, i.e., dosing and duration of treatment; when drugs should be withdrawn or not used; and, how physicians are to keep updated for a sound balance when deciding between old or new drugs. Medical Pharmacology texts review these topics in the sections of clinical pharmacology, clinical pharmacokinetics, pharmacotherapy and pharmacoeconomics. However, an integrated view on how BMPK relates to their clinical application is not clearly stated. By the same token, legal and ethical aspects of drug administration are narrowed to prescription writing skills, either for the patient or for the clinical file; thus, attenuating the appraisal of the impact on therapeutic adherence of physicians' communication skills, as well as availability and/or accessibility of recommended drugs. These issues are obviously related to therapeutic outcome but their integrated articulation occurs only if drug administration is considered as an essential clinical competence.