La fragilidad.

Fragility is an increase in the vulnerability to stressors of low intensity, produced by an alteration in multiple and interrelated systems, which leads to a decrease in the homeostatic reserve and the capacity of adaptation of the organism, which predisposes to adverse events affecting the funcionality. In Geriatrics we group the elderly in Healthy, Sick, Fragile and Geriatric Patient. A very powerful tool is used, which is the Comprehensive Geriatric Assessment with the basic valuations: functional, Cognitive, social, and the complementary ones: Nutritional, affective, of the risk of falls, of the fragility, etc. It is very important to know the reversibility of the problem with a structured and multidisciplinary approach in terms of physical, nutritional, psychological intervention and pharmacological adjustment.La fragilidad es un incremento de la vulnerabilidad a estresores de baja intensidad, producido por una alteración en múltiples e interrelacionados sistemas, que conduce a una disminución en la reserva homeostática y de la capacidad de adaptación del organismo, lo que predispone a eventos adversos afectando a la funcionalidad. En Geriatría agrupamos los ancianos en Sanos, Enfermos, Frágiles y Paciente Geriátrico. Se utiliza una herramienta muy potente, que es la Valoración Geriátrica Integral con las valoraciones básicas: funcional, Cognitiva, social, y las complementarias: Nutricional, afectiva, del riesgo de caídas, de la fragilidad, etc. Es muy importante conocer la reversibilidad del problema con un abordaje estructurado y multidisplinar en cuanto a la intervención física, nutricional, psicológica y ajuste farmacológico

Disfagia y trastornos de la conducta alimenticia en la persona con demencia: protocolo de actuación

Objective: To develop a protocol in thecare of patients with advanced dementiaand feed problems,according to thescientific evidence. Method: A systematic review was carried out, consulting CUIDEN, EMBASE, MEDLINE, SCIELO, HEALTH GUIDE and NHS databases as well as protocols of Scientific Societies and Health Centers. The DeCs and MeSH terms related to the objective of the study were used. Studies published in English or Spanish were selected, since 2000, which assessed dysphagia and eating disorders in the person with dementia, with at least the summary available. Results: Nine studies were selected, whose results allowed to develop an action protocol in patients with advanced dementia and feed problems. In the protocol obtained, any intervention in this type of patients should be based on the previous comprehensive geriatric and nutritional assessment. Conclusion: The implementation of the dysphagia and eating disorders protocol in patients with advanced dementia improves their clinical and nutritional status.Objetivo: Desarrollar un protocolo de actuación en la atención a pacientes con demencia avanzada que presentan problemas de alimentación, según la evidencia científica existente. Método: Se realizó una revisión sistemática, consultando las bases de datos CUIDEN, EMBASE, MEDLINE, SCIELO, GUIA SALUD y NHS así como de protocolos de Sociedades Científicas y Centros Sanitarios. Se usaron los DeCs y MeSH adecuados al objetivo del estudio. Se seleccionaron los trabajos, publicados en inglés o castellano, desde el año 2000, que en sus resultados valorasela disfagia y los trastornos alimenticios en la persona con demencia, con al menos el resumen disponible. Resultados: Se seleccionaron 9 trabajos cuyos resultados permitieron desarrollar un protocolo de actuación en pacientes con demencia avanzada y problemas de alimentación. En el protocolo obtenido, toda intervención en estos pacientes debería fundamentarse en la previa realización de una valoración geriátrica integral y de una valoración nutricional. Conclusión: La implantación de un protocolo de actuación en la disfagia y trastornos de la conducta alimenticia en la persona con demencia avanzada mejora su situación clínica y nutricional

Insecticidal Properties of Ocimum basilicum and Cymbopogon winterianus against Acanthoscelides obtectus, Insect Pest of the Common Bean (Phaseolus vulgaris, L.)

[EN] The bean weevil, Acanthoscelides obtectus Say (Coleoptera: Chrysomelidae: Bruchinae), causes severe post-harvest losses in the common bean, Phaseolus vulgaris L. The control of this insect is still poor and involves the use of conventional insecticides. There is an increasing demand in the search for new active substances and products for pest control towards reduction of adverse e ects on human health and the environment. The protection of grains with alternative products, such as essential oils, is a possible alternative to meet the needs described above. Therefore, this investigation evaluated the applications of basil, Ocimum basilicum, and citronella, Cymbopogon winterianus, essential oils for A. obtectus control. These essential oils significantly reduced the bean weight losses and the number of beans damaged by A. obtectus at higher doses than 60 or 120 L/sample. The number of holes per bean did not di er between the doses of basil essential oil, not even at the dose of 60 L, while it was higher at 120 L, probably due to a lower capacity of movement of the insects treated with this dose and/or the oil’s direct or indirect e ects on the insects. Basil and citronella oils exhibited similar patterns of insecticidal activity over the insect, both directly in adult insects or indirectly over bean seeds. These essential oils a ected the development of A. obtectus since the greatest doses applied on beans decreased the emergence of the bean weevil. The results prove the insecticidal capacity of the tested essential oils and hence their potential as active substances against A. obtectus in environmentally low risk pest control strategies. Supplementary trials should be conducted under real storage conditions.SIThis work was funded by the Ministry of Science, Innovation and Universities (Government of Spain), according to the Resolution of 27 July 2018, (BOE No. 184, of July 31) through the grant awarded to Álvaro Rodríguez González (PTA2017–14403-I). The authors are grateful to the Federal University of Reconcavo de Bahia and especially to Franceli Da Silva for providing us with their knowledge about essential oils

Pandemic-related pregnancy stress among pregnant women during the COVID-19 pandemic in Spain

Objective: The aim was to develop and establish the psychometric properties of the Pandemic-Related Pregnancy Stress Scale (PREPS) in European Spanish speaking pregnant women in Spain. Design: A cross section design using a non-random sample of 206 women completed the questionnaire during the first COVID-19 pandemic lockdown from April to June 2020 in Spain. Psychological, sociodemographic and obstetric factors and the new PREPS were collected. Results: Bartlett's test of sphericity (chi(2)(105) = 580.36, p .77), and for F1 - Preparedness (alpha >.65), for F2 - Infection (alpha > 0.60) and for F3 - Positive appraisal (alpha >.55). The three factors exhibited good inter-item correlations, (F1 - Preparedness:.21; F2 - Infection:.23, and F3 - Positive Appraisal:.29). Convergent validity was examined through the Pearson's correlation coefficients of the PREPS with the Perceived Stress Scale (PSS) and the Prenatal Distress Questionnaire (PDQ). Correlation between PREPS total and PSS was high, and moderate with PDQ (p <.05). Conclusion: The psychometric properties of the Spanish version of the PREPS make it a valuable psychological measure to assess pandemic-related stress among pregnant women

Tratamiento de la fragilidad y apatía a través de actividades psicomotrices en la enfermedad de Alzheimer

Objective: To implement an Occupational Therapy treatment in elderly people with dementia and frailty Method: A longitudinal study of a sample of 23 users, 14 women and 9 men aged between 71 and 92 is performed, the average age 84.66 years, users of a residence, presenting frailty and dementia. Carried out an initial assessment and final tests with Short Physical Performance Battery (SPPB) and Dementia Apathy Interview and Rating (DAIR), participants attend occupational therapy sessions. Statistical analysis: it was performed nonparametric Wilcoxon, Spearman correlation and Mann Whitney U test. Results: We observed that the levels of fragility do not improve, there is no relationship of age with frailty, the level of apathy does not decrease with the intervention, there is no difference in the score of apathy or fragility by sex. Conclusions: the results indicate a maintenance of vital functions on both scales, which can be considered beneficial when dealing with degenerative processes.Objetivo: Implementar un tratamiento de Terapia Ocupacional en personas mayores con demencia y fragilidad.                                                                                                Método: Se realiza un estudio longitudinal sobre una muestra de 23 usuarios, 14 mujeres y 9 hombres con edades comprendidas entre 71 y 92, siendo la edad media 84.66 años, usuarios de una residencia, que presentan fragilidad y demencia. Se lleva a cabo una evaluación inicial y otra final con las pruebas Batería Corta del Desempeño Físico (SPPB) y Dementia Apathy Interview and Rating (DAIR), los participantes asisten a sesiones de Terapia Ocupacional.        Análisis estadístico: se llevan a cabo pruebas no paramétricas de Wilcoxon, Correlación de Spearman y U de Mann Whitney.                                                                                    Resultados: se observa que los niveles de fragilidad no mejoran, que no hay relación de la edad con la fragilidad, el nivel de apatía no disminuye con la intervención, no existen diferencias en la puntuación de apatía ni fragilidad según el sexo.                                    Conclusiones. los resultados indican un mantenimiento de las funciones vitales en ambas escalas, lo que se puede considerar beneficioso al tratarse de procesos degenerativos

Protocol to implement non-pharmacological therapies (NFT) in homes for the elderly

Resumen: Esta investigación surge ante la necesidad de abordar el desarrollo de un protocolo para la implementación de las TNF en centros residenciales, dentro de un sistema integrado donde cada día toma mayor significación el concepto de ?adherencia del paciente?. El impacto económico por la falta de adherencia en las personas mayores es muy alto e incide de forma directa en el aumento de reingresos, hospitalizaciones, resultados médicos adversos, etc.. Este trabajo se plantea en el marco de acción European Innovation Partnership on Active and Healthy Ageing (EIP 2016-2018) y se tipifica como una herramienta de mejora mediante el abordaje de los principios de complementariedad entre terapias farmacológicas y no farmacológica, el empoderamiento de los pacientes con demencia y sus cuidadores, modelos de calidad en los servicios prestados a los residentes, la comunicación activa con el paciente, y el uso de las NTIC.Abstract: This research has been motivated by the need to address the development of a Protocol for The Implementation of NFT in homes for the elderly which will contribute to strength the concept of ?patient adherence.?. The economic impact of non- adherence in elderly people is very high and impinges directly on increasing readmissions, hospitalizations, adverse medical outcomes, etc ... This Protocol is a proposal of action under European Innovation Partnership on Active and Healthy Ageing (EIP 2016-2018) and is classified as an improvement tool when addressing the principle of complementarily between pharmacological and non-pharmacological therapies, empowering patients with dementia and their careers, the models of quality services provided to residents, and active communication with the patient, professional, the health personalized itineraries, all assisted by the innovative use of ICT

Factores de riesgo en el ictus - influencia de la edad

Objective: To analyze the influence of different risk factors on the age at which a stroke occurs. Method: An observational cross-sectional study was conducted including all patients admitted consecutively with ischemic stroke at the University Hospital of Burgos (Spain). Sociodemographic and clinical, parameters were collected, exploring possible association with patient’s age by univariate and multivariate analysis. Results: 436 patients were included, with a mean age of 75.39 years (SD ±12.674). The most frequent risk factors were high blood pressure and cardiovascular disease. In the case of having a personal history of arterial hypertension (Odds Ratio [OR] 2.49; 95% Confidence Interval [CI] 1.49-4.16), having a sedentary lifestyle (OR 3.24; 95%CI 1.97-5.31) was related with a greater probability that the patient is aged 75 years or older. However, being overweight/obese (OR 0.51; 95%CI 0.30-0.88), being an active smoker (OR 0.47; 95%CI 0.02-0.11) or alcohol consumption (OR 0.42; 95%CI 0.26-0.69) increased the probability of stroke occurrence before 75 years. Conclusion: The age of occurrence of a case is related to the occurrence of certain risk factors, which are determined in the planning of future education campaigns.Objetivo: Analizar la influencia que los distintos factores de riesgo ejercen sobre la edad a la que se produce un ictus. Método: Estudio observacional transversal en el que se incluyeron a todos los pacientes con ictus ingresados de forma consecutiva en el Hospital Universitario de Burgos (España). Se recogieron parámetros sociodemográficos y clínicos, estudiándose su posible relación con la edad mediante análisis univariante y multivariante. Resultados: Se incluyeron 436 pacientes, siendo la edad media de 75,39 años (DE ±12,674). Los factores de riesgo más frecuentes fueron la hipertensión arterial y la enfermedad cardiovascular. Se observó que el tener antecedentes personales de hipertensión arterial (OR 2,49; IC95% 1,49-4,16) ó el no tener un estilo de vida sedentario (OR 3,24; 1,97-5,31) se relacionó con una mayor probabilidad de que el paciente tuviera una edad igual o superior a 75 años. Sin embargo, el tener sobrepeso/obesidad (OR 0,51; IC95% 0,30-0,88), el ser fumador activo (OR 0,47; 0,02-0,11) ó el consumir alcohol (OR 0,42; 0,26-0,69) aumentó la probabilidad de que el ictus ocurriera antes de 75 años. Conclusión: La edad de aparición de un ictus se relaciona con la ocurrencia de determinados factores de riesgo, los cuales deberían ser considerados en la planificación de futuras campañas educacionales

Activity patterns of tayra (Eira barbara) across their distribution

Species' activity patterns are driven by the need to meet basic requirements of food, social interactions, movement, and rest, but often are influenced by a variety of biotic and abiotic factors. We used camera-trap data to describe and compare the activity patterns of the relatively poorly studied tayra (Eira barbara) across 10 populations distributed from the south of Mexico to the north of Argentina, and attempted to identify biotic or abiotic factors that may be associated with variation in level of diurnality. In a subset of sites we also aimed to document potential seasonal variation in activity. We used a kernel density estimator based on the time of independent photographic events to calculate the proportion of diurnal, crepuscular, and nocturnal activity of each population. Tayras were mostly active during diurnal periods (79.31%, 759 records), with a lower proportion of crepuscular activity (18.07%, 173 records) yet we documented some variation in patterns across the 10 study areas (activity overlap coefficient varied from Δ4 = 0.64 to Δ1 = 0.95). In northern localities, activity peaked twice during the day (bimodal) with most activity ocurring in the morning, whereas closer to the geographical equator, activity was constant (unimodal) throughout the day, peaking at midday: activity either was unimodal or bimodal in southern localities. Despite investigating multiple potential abiotic and biotic predictors, only latitude was associated with variation in the proportion of diurnal activity by tayras across its range, with increased diurnal activity closer to the equator. Seasonal comparisons in activity showed a tendency to reduce diurnality in dry versus rainy seasons, but the pattern was not consistently significant. This is the most comprehensive description of tayra activity patterns to date, and lends novel insight into the potential flexibility of the species to adapt to local conditions.Fil: Villafañe Trujillo, Álvaro José. Universidad Autonoma de Queretaro.; MéxicoFil: Kolowski, Joseph M.. Instituto de Pesquisas Ecológicas; BrasilFil: Cove, Michael V.. University of Belize; BeliceFil: Medici, Emilia Patricia. Instituto de Pesquisas Ecológicas; BrasilFil: Harmsen, Bart J.. University of Belize; BeliceFil: Foster, Rebbeca J.. University of Belize; BeliceFil: Hidalgo Mihart, Mircea G.. Universidad Juárez Autónoma de Tabasco,; MéxicoFil: Espinosa, Santiago. Universidad Autónoma de San Luis Potosí; MéxicoFil: Ríos Alvear, Gorky. Universidad de Porto; PortugalFil: Reyes Puig, Carolina. Universidad de Porto; PortugalFil: Reyes Puig, Juan Pablo. Universidad de Porto; PortugalFil: Da Silva, Marina Xavier. Universidad Central del Ecuador; EcuadorFil: Paviolo, Agustin Javier. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Universidad Nacional de Misiones. Instituto de Biología Subtropical; ArgentinaFil: Cruz, Paula Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Nordeste. Instituto de Biología Subtropical. Universidad Nacional de Misiones. Instituto de Biología Subtropical; ArgentinaFil: López González, Carlos Alberto. Universidad Autonoma de Queretaro.; Méxic

Enfermedades crónicas

Adherencia al tratamiento farmacol&oacute;gico y relaci&oacute;n con el control metab&oacute;lico en pacientes con DM2Aluminio en pacientes con terapia de reemplazo renal cr&oacute;nico con hemodi&aacute;lisis en Bogot&aacute;, ColombiaAmputaci&oacute;n de extremidades inferiores: &iquest;est&aacute;n aumentando las tasas?Consumo de edulcorantes artificiales en j&oacute;venes universitariosC&oacute;mo crecen ni&ntilde;os normales de 2 a&ntilde;os que son sobrepeso a los 7 a&ntilde;osDiagn&oacute;stico con enfoque territorial de salud cardiovascular en la Regi&oacute;n MetropolitanaEfecto a corto plazo de una intervenci&oacute;n con ejercicio f&iacute;sico, en ni&ntilde;os con sobrepesoEfectos de la cirug&iacute;a bari&aacute;trica en pacientes con s&iacute;ndrome metab&oacute;lico e IMC &lt; 35 KG/M2Encuesta mundial de tabaquismo en estudiantes de profesiones de saludEnfermedades cr&oacute;nicas no transmisibles: Consecuencias sociales-sanitarias de comunidades rurales en ChileEpidemiolog&iacute;a de las muertes hospitalarias por patolog&iacute;as relacionadas a muerte encef&aacute;lica, Chile 2003-2007Estado nutricional y conductas alimentarias en adolescentes de 4&ordm; medio de la Regi&oacute;n de CoquimboEstudio de calidad de vida en una muestra del plan piloto para hepatitis CEvaluaci&oacute;n del proceso asistencial y de resultados de salud del GES de diabetes mellitus 2Factores de riesgo cardiovascular en poblaci&oacute;n universitaria de la Facsal, universidad de Tarapac&aacute;Implicancias psicosociales en la g&eacute;nesis, evoluci&oacute;n y tratamiento de pacientes con hipertensi&oacute;n arterial esencialInfarto agudo al miocardio (IAM): Realidad en el Hospital de Puerto Natales, 2009-2010Introducci&oacute;n de nuevas TIC y mejor&iacute;a de la asistencia a un programa de saludNi&ntilde;os obesos atendidos en el Cesfam de Puerto Natales y su entorno familiarPerfil de la mortalidad por c&aacute;ncer de cuello uterino en R&iacute;o de JaneiroPerfil del paciente primo-consultante del Programa de Salud Cardiovascular, Consultorio Cordillera Andina, Los AndesPrevalencia de automedicaci&oacute;n en mujeres beneficiarias del Hospital Comunitario de Til-TiPrevalencia de caries en poblaci&oacute;n preescolar y su relaci&oacute;n con malnutrici&oacute;n por excesoPrevalencia de retinopat&iacute;a diab&eacute;tica en comunas dependientes del Servicio de Salud Metropolitano Occidente (SSMOC)Problemas de adherencia farmacol&oacute;gica antihipertensiva en poblaci&oacute;n mapuche: Un estudio cualitativoRol biol&oacute;gico de los antioxidantes innatos en pacientes portadores de VIH/SidaSobrepeso en empleados de un restaurante de una universidad p&uacute;blica del estado de S&atilde;o Paul

Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020

We show the distribution of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) genetic clades over time and between countries and outline potential genomic surveillance objectives. We applied three genomic nomenclature systems to all sequence data from the World Health Organization European Region available until 10 July 2020. We highlight the importance of real-time sequencing and data dissemination in a pandemic situation, compare the nomenclatures and lay a foundation for future European genomic surveillance of SARS-CoV-2